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Abo SMC, Layton AT. Modeling sex-specific whole-body metabolic responses to feeding and fasting. Comput Biol Med 2024; 181:109024. [PMID: 39178806 DOI: 10.1016/j.compbiomed.2024.109024] [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: 05/21/2024] [Revised: 07/27/2024] [Accepted: 08/11/2024] [Indexed: 08/26/2024]
Abstract
Men generally favor carbohydrate metabolism, while women lean towards lipid metabolism, resulting in significant sex-based differences in energy oxidation across various metabolic states such as fasting and feeding. These differences are influenced by body composition and inherent metabolic fluxes, including increased lipolysis rates in women. However, understanding how sex influences organ-specific metabolism and systemic manifestations remains incomplete. To address these gaps, we developed a sex-specific, whole-body metabolic model for feeding and fasting scenarios in healthy young adults. Our model integrates organ metabolism with whole-body responses to mixed meals, particularly high-carbohydrate and high-fat meals. Our predictions suggest that differences in liver and adipose tissue nutrient storage and oxidation patterns drive systemic metabolic disparities. We propose that sex differences in fasting hepatic glucose output may result from the different handling of free fatty acids, glycerol, and glycogen. We identified a metabolic pathway, possibly more prevalent in female livers, redirecting lipids towards carbohydrate metabolism to support hepatic glucose production. This mechanism is facilitated by the TG-FFA cycle between adipose tissue and the liver. Incorporating sex-specific data into multi-scale frameworks offers insights into how sex modulates human metabolism.
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Affiliation(s)
- Stéphanie M C Abo
- Department of Applied Mathematics, University of Waterloo, 200 University Ave W, Waterloo, N2L 3G1, Ontario, Canada.
| | - Anita T Layton
- Department of Applied Mathematics, University of Waterloo, 200 University Ave W, Waterloo, N2L 3G1, Ontario, Canada; Cheriton School of Computer Science, Department of Biology, and School of Pharmacy, 200 University Ave W, Waterloo, N2L 3G1, Ontario, Canada.
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2
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Anand K, Walia GK, Mandal S, Menon JS, Gupta R, Tandon N, Narayan KMV, Ali MK, Mohan V, Schwartz JD, Prabhakaran D. Longitudinal associations between ambient PM 2.5 exposure and lipid levels in two Indian cities. Environ Epidemiol 2024; 8:e295. [PMID: 38617424 PMCID: PMC11008625 DOI: 10.1097/ee9.0000000000000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/10/2024] [Indexed: 04/16/2024] Open
Abstract
Background Exposure to ambient PM2.5 is known to affect lipid metabolism through systemic inflammation and oxidative stress. Evidence from developing countries, such as India with high levels of ambient PM2.5 and distinct lipid profiles, is sparse. Methods Longitudinal nonlinear mixed-effects analysis was conducted on >10,000 participants of Centre for cArdiometabolic Risk Reduction in South Asia (CARRS) cohort in Chennai and Delhi, India. We examined associations between 1-month and 1-year average ambient PM2.5 exposure derived from the spatiotemporal model and lipid levels (total cholesterol [TC], triglycerides [TRIG], high-density lipoprotein cholesterol [HDL-C], and low-density lipoprotein cholesterol [LDL-C]) measured longitudinally, adjusting for residential and neighborhood-level confounders. Results The mean annual exposure in Chennai and Delhi was 40 and 102 μg/m3 respectively. Elevated ambient PM2.5 levels were associated with an increase in LDL-C and TC at levels up to 100 µg/m3 in both cities and beyond 125 µg/m3 in Delhi. TRIG levels in Chennai increased until 40 µg/m3 for both short- and long-term exposures, then stabilized or declined, while in Delhi, there was a consistent rise with increasing annual exposures. HDL-C showed an increase in both cities against monthly average exposure. HDL-C decreased slightly in Chennai with an increase in long-term exposure, whereas it decreased beyond 130 µg/m3 in Delhi. Conclusion These findings demonstrate diverse associations between a wide range of ambient PM2.5 and lipid levels in an understudied South Asian population. Further research is needed to establish causality and develop targeted interventions to mitigate the impact of air pollution on lipid metabolism and cardiovascular health.
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Affiliation(s)
- Kritika Anand
- Centre for Chronic Disease Control, New Delhi, India
| | | | | | - Jyothi S. Menon
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurugram, India
| | - Ruby Gupta
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurugram, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | - K. M. Venkat Narayan
- Emory Global Diabetes Research Center of the Woodruff Health Sciences Center, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mohammed K. Ali
- Emory Global Diabetes Research Center of the Woodruff Health Sciences Center, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Joel D. Schwartz
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurugram, India
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Bouhour S, Plantefève R, Gillet V, Abolghasemi A, Bouchouirab FZ, Baccarelli AA, Takser L, Çaku A. Establishing non-fasting reference values for plasma lipids levels based on age, sex, and puberty stage in a French-Canadian pediatric population. Lipids Health Dis 2024; 23:54. [PMID: 38388929 PMCID: PMC10882849 DOI: 10.1186/s12944-024-02040-0] [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: 11/18/2023] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Dyslipidemias, including familial hypercholesterolemia (FH), are a significant risk factor for cardiovascular diseases. FH is a genetic disorder resulting in elevated levels of low-density lipoprotein cholesterol (LDL-C) and an increased probability of early cardiovascular disorders. Heterozygous familial hypercholesterolemia (HeFH) is the most common form, affecting approximately 1 in 250 individuals worldwide, with a higher prevalence among the French-Canadian population. Childhood is a critical period for screening risk factors, but the recommendation for non-fasting screening remains controversial due to a lack of specific reference values for this state. This study aims to establish reference values for lipid levels in non-fasting children from Sherbrooke, Quebec, Canada, that will be specific for sex, age, and pubertal stages. METHODS Blood samples and corresponding anthropometric data were collected from 356 healthy children aged from 6 to 13. They were categorized either into two age groups: Cohort 6-8 and Cohort 9-13, or into pubertal stages. Reference values, specifically the 2.5th, 5th, 10th, 50th, 90th, 95th, and 97.5th percentiles were determined using the CLSI C28-A3 guidelines. RESULTS Lipid profiles did not significantly differ between sexes, except for higher levels of high-density lipoprotein (HDL-C) in boys within Cohort 6-8. HDL-C levels significantly increased, while LDL-C and non-HDL-C levels significantly decreased in both sexes with age. Non-fasting age- and pubertal stages-specific reference values were established. CONCLUSION This study established reference intervals for lipid markers in non-fasting state within the pediatric French-Canadian population. These findings could be used in dyslipidemia screening in daily practice.
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Affiliation(s)
- Sophie Bouhour
- Department of Pediatrics, University of Sherbrooke, 3001 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Rosalie Plantefève
- Department of Biochemistry and Functional Genomic, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Virginie Gillet
- Department of Pediatrics, University of Sherbrooke, 3001 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Armita Abolghasemi
- Department of Biochemistry and Functional Genomic, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Fatima Zahra Bouchouirab
- Department of Biochemistry and Functional Genomic, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Larissa Takser
- Department of Pediatrics, University of Sherbrooke, 3001 12E Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
- Department of Psychiatry, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Artuela Çaku
- Department of Biochemistry and Functional Genomic, University of Sherbrooke, Sherbrooke, QC, Canada.
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Walia GK, Panniyammakal J, Agarwal T, Jalal R, Gupta R, Ramakrishnan L, Tandon N, Roy A, Krishnan A, Prabhakaran D. Evaluation of genetic variants related to lipid levels among the North Indian population. Front Genet 2024; 14:1234693. [PMID: 38348409 PMCID: PMC10859749 DOI: 10.3389/fgene.2023.1234693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/31/2023] [Indexed: 02/15/2024] Open
Abstract
Background: A heavy burden of cardiometabolic conditions on low- and middle-income countries like India that are rapidly undergoing urbanization remains unaddressed. Indians are known to have high levels of triglycerides and low levels of HDL-C along with moderately higher levels of LDL-C. The genome-wide findings from Western populations need to be validated in an Indian context for a better understanding of the underlying etiology of dyslipidemia in India. Objective: We aim to validate 12 genetic variants associated with lipid levels among rural and urban Indian populations and derive unweighted and weighted genetic risk scores (uGRS and wGRS) for lipid levels among the Indian population. Methods: Assuming an additive model of inheritance, linear regression models adjusted for all the possible covariates were run to examine the association between 12 genetic variants and total cholesterol, triglycerides, HDL-C, LDL-C, and VLDL-C among 2,117 rural and urban Indian participants. The combined effect of validated loci was estimated by allelic risk scores, unweighted and weighted by their effect sizes. Results: The wGRS for triglycerides and VLDL-C was derived based on five associated variants (rs174546 at FADS1, rs17482753 at LPL, rs2293889 at TRPS1, rs4148005 at ABCA8, and rs4420638 at APOC1), which was associated with 36.31 mg/dL of elevated triglyceride and VLDL-C levels (β = 0.95, SE = 0.16, p < 0.001). Similarly, every unit of combined risk score (rs2293889 at TRPS1 and rs4147536 at ADH1B) was associated with 40.62 mg/dL of higher total cholesterol (β = 1.01, SE = 0.23, p < 0.001) and 33.97 mg/dL of higher LDL-C (β = 1.03, SE = 0.19, p < 0.001) based on its wGRS (rs2293889 at TRPS1, rs4147536 at ADH1B, rs4420638 at APOC1, and rs660240 at CELSR2). The wGRS derived from five associated variants (rs174546 at FADS1, rs17482753 at LPL, rs4148005 at ABCA8, rs4420638 at APOC1, and rs7832643 at PLEC) was associated with 10.64 mg/dL of lower HDL-C (β = -0.87, SE = 0.14, p < 0.001). Conclusion: We confirm the role of eight genome-wide association study (GWAS) loci related to different lipid levels in the Indian population and demonstrate the combined effect of variants for lipid traits among Indians by deriving the polygenic risk scores. Similar studies among different populations are required to validate the GWAS loci and effect modification of these loci by lifestyle and environmental factors related to urbanization.
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Affiliation(s)
- Gagandeep Kaur Walia
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
| | - Jeemon Panniyammakal
- Centre for Chronic Disease Control, New Delhi, India
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Tripti Agarwal
- Indian Institute of Public Health-Delhi, New Delhi, India
| | - Ruchita Jalal
- Indian Institute of Public Health-Delhi, New Delhi, India
| | - Ruby Gupta
- Centre for Chronic Disease Control, New Delhi, India
| | | | - Nikhil Tandon
- Indian Institute of Public Health-Delhi, New Delhi, India
| | - Ambuj Roy
- Indian Institute of Public Health-Delhi, New Delhi, India
| | - Anand Krishnan
- Indian Institute of Public Health-Delhi, New Delhi, India
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
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Molinari M, Cremaschi A, De Iorio M, Chaturvedi N, Hughes A, Tillin T. Bayesian dynamic network modelling: an application to metabolic associations in cardiovascular diseases. J Appl Stat 2022; 51:114-138. [PMID: 38179161 PMCID: PMC10763914 DOI: 10.1080/02664763.2022.2116746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/14/2022] [Indexed: 10/14/2022]
Abstract
We propose a novel approach to the estimation of multiple Graphical Models to analyse temporal patterns of association among a set of metabolites over different groups of patients. Our motivating application is the Southall And Brent REvisited (SABRE) study, a tri-ethnic cohort study conducted in the UK. We are interested in identifying potential ethnic differences in metabolite levels and associations as well as their evolution over time, with the aim of gaining a better understanding of different risk of cardio-metabolic disorders across ethnicities. Within a Bayesian framework, we employ a nodewise regression approach to infer the structure of the graphs, borrowing information across time as well as across ethnicities. The response variables of interest are metabolite levels measured at two time points and for two ethnic groups, Europeans and South-Asians. We use nodewise regression to estimate the high-dimensional precision matrices of the metabolites, imposing sparsity on the regression coefficients through the dynamic horseshoe prior, thus favouring sparser graphs. We provide the code to fit the proposed model using the software Stan, which performs posterior inference using Hamiltonian Monte Carlo sampling, as well as a detailed description of a block Gibbs sampling scheme.
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Affiliation(s)
- Marco Molinari
- Department of Statistical Science, University College, London, London, UK
| | | | - Maria De Iorio
- Department of Statistical Science, University College, London, London, UK
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nishi Chaturvedi
- Department of Population Science and Experimental Medicine, University College London, London, UK
| | - Alun Hughes
- Department of Population Science and Experimental Medicine, University College London, London, UK
| | - Therese Tillin
- Department of Population Science and Experimental Medicine, University College London, London, UK
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Tan HLE, Hure A, Peel R, Hancock S, Attia J. Prevalence and clinical risk prediction of hypertriglyceridaemia in a community cohort. Intern Med J 2021; 53:363-372. [PMID: 34779574 DOI: 10.1111/imj.15626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertriglyceridaemia (HTG) (defined as ≥1.7mmol/L) has a prevalence of 18-33% with significant inter-regional variation. Despite meta-analyses demonstrating its association with increased risk of cardiovascular disease, only 40% of HTG is identified in the community resulting in underutilisation of lipid lowering therapy and specialist clinics. Increase awareness of its clinical risk factors is needed to improve identification and management of HTG to prevent cardiovascular risk. AIMS To evaluate the prevalence, distribution and clinical predictors of hypertriglyceridaemia ≥1.7 mmol/L in a representative community group. METHODS Data were obtained from the Hunter Community Study (HCS), a longitudinal cohort of community-dwelling men and women aged between 55-85 years residing in Newcastle, NSW. Fasting triglycerides were identified based on availability of fasting blood glucose level and categorised according to normal (<1.7mmol/L), mild (1.7- <2.3mmol/L), and moderate-severe HTG (≥2.3mmol/L). Clinical predictors of HTG were assessed using linear and logistic regression models. RESULTS Of 2536 triglyceride levels, 2216 (87%) were in a fasting state and included in the study. Three hundred and two (13.6%) participants had mild HTG and 221 (10.0%) participants had moderate-severe HTG. Significant clinical predictors of HTG included male gender, increasing Body Mass Index (BMI), current smoking, decreasing daily step counts, increasing fasting glucose and higher thyroid stimulating hormone. Alcohol intake and blood pressure were not significant in either adjusted regression model. CONCLUSION Hypertriglyceridaemia ≥1.7mmol/L is common, affecting 24% of HCS. Clinical predictors identify modifiable risk factors for cardiovascular risk management. Clinician education to promote awareness is required to improve patient outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hong Lin Evelyn Tan
- Department of Endocrinology and Diabetes, John Hunter Hospital, Newcastle.,School of Medicine and Public Health, University of Newcastle
| | - Alexis Hure
- School of Medicine and Public Health, University of Newcastle.,Hunter Medical Research Institute
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle.,Hunter Medical Research Institute
| | - Stephen Hancock
- School of Medicine and Public Health, University of Newcastle.,Hunter Medical Research Institute
| | - John Attia
- School of Medicine and Public Health, University of Newcastle.,Hunter Medical Research Institute
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Wulan SN, Raza Q, Prasmita HS, Martati E, Maligan JM, Mageshwari U, Fatima I, Plasqui G. Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective. Nutrients 2021; 13:nu13113776. [PMID: 34836031 PMCID: PMC8617748 DOI: 10.3390/nu13113776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of overweight and obesity is on the rise around the world, not only in the West, but also in Asian countries. South Asian countries in particular are experiencing a rapid increase in overweight and obesity, that coexists with the rapid increase in non-communicable diseases linked to obesity such as diabetes and cardiovascular disease than any other country in Asia. The phenomena observed in South Asian countries are due to the size of the population, the ageing of the population, the high degree of urbanization and the lifestyle changes in favor of increased energy consumption and reduced physical activity. The imbalance between energy consumption and energy expenditure results in the development of a positive energy balance that, over time, accumulates in higher body fat. South Asians were reported to have a more unfavorable body composition with a higher percentage of body fat than Caucasians with an equivalent BMI. Body composition is a major determinant of resting energy expenditure. It has been reported that South Asians have a lower resting energy expenditure than Caucasians with the same BMI. Resting energy expenditure accounts for the majority of total daily energy expenditure and, therefore, plays a crucial role in achieving the balance between energy intake and expenditure.
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Affiliation(s)
- Siti N. Wulan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Qaisar Raza
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Hera S. Prasmita
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Erryana Martati
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Jaya M. Maligan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Uma Mageshwari
- Department of Food Service Management and Dietetics, Faculty of Home Science, Avinashilingham University, Coimbatore 641043, India;
| | - Itrat Fatima
- Department of Food Science and Technology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan;
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands;
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Washirasaksiri C, Srivanichakorn W, Godsland IF, Kositamongkol C, Chariyalertsak S, Kessomboon P, Assanangkornchai S, Taneepanichskul S, Neelapaichit N, Phisalprapa P, Johnston DG, Oliver NS, Aekplakorn W. Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations. Sci Rep 2021; 11:12194. [PMID: 34108497 PMCID: PMC8190299 DOI: 10.1038/s41598-021-91075-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/20/2021] [Indexed: 12/17/2022] Open
Abstract
Internationally, studies have shown associations between lipids and glycemia; however, whether the link varies by gender and population has been rarely examined. We investigated relationships between glycemia and HDL- and Non-HDL-cholesterol and their modification by gender. We undertook a cross-sectional analysis from the National Health Examination Survey for Thailand (NHES-Thailand) and the Health Survey for England (HS-England) in adults aged 18-75 year. Glycaemia was assessed by FPG in Thailand and by HbA1c in the UK. In population- and gender-stratified analyses, the relationships between glycemia and lipids were explored. A total of 15,145 Thai and 3484 UK adults with blood measurement were included. The prevalences of prediabetes were: in NHES-Thailand, 16% (SE = 0.004), based on FPG (5.6 to < 7.0 mmol/L) and in HS-England, 19% (0.007) based on HbA1c (39 to < 48 mmol/mol). Increasingly abnormal glucose homeostasis was associated with increasing age, adiposity, SBP, proportion of antihypertensive and lipid-lowering agent use and with decreasing HDL-cholesterol. Independent of age, adiposity, smoking, alcohol, physical activity, and lipid and BP lowering drug use, increasing glycemia was associated with decreasing HDL-cholesterol specifically in women with prediabetes (NHES-Thailand, beta-coefficient - 0.07 (95% CI - 0.15, - 0.001) p = 0.04 and HS-England, - 0.03 (- 0.04, - 0.006) p = 0.01). In both populations, among those with prediabetes, increasing glycaemia is associated with an adverse, significant decline in HDL cholesterol, specifically in women. These adverse effects are apparent in widely-differing international populations.
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Affiliation(s)
- Chaiwat Washirasaksiri
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Weerachai Srivanichakorn
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand.
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College, London, SW7 2AZ, UK.
| | - Ian F Godsland
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College, London, SW7 2AZ, UK
| | - Chayanis Kositamongkol
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | | | | | | | | | - Nareemarn Neelapaichit
- Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pochamana Phisalprapa
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Desmond G Johnston
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College, London, SW7 2AZ, UK
| | - Nick S Oliver
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College, London, SW7 2AZ, UK
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Rama VI Rd., Ratchathewi, Bangkok, Thailand
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Wang S, Li G, Zuo H, Yang H, Ma L, Feng J, Niu Y, Ma L, Liu S, Qi T, Liu X. Association of insulin, C-peptide and blood lipid patterns in patients with impaired glucose regulation. BMC Endocr Disord 2019; 19:75. [PMID: 31307454 PMCID: PMC6631747 DOI: 10.1186/s12902-019-0400-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate any associations between blood glucose (BG) and lipid levels in patients with different glucose tolerance statuses, including type 2 diabetes (T2DM) and impaired glucose regulation (IGR) cases as well as normal glucose tolerance (NGT) individuals. METHODS A total of 354 participants were recruited to this study including 174 in the T2DM group, 112 in the IGR group and 68 in the NGT group. We compared BG, insulin and C-peptide (CP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) serum levels during a 3 h oral glucose tolerance test (OGTT) in the 3 groups. RESULTS Basic overall HbA1c serum concentration percentages were 5.52, 6.33 and 9.76% for the NTG, IGR and T2DM cases. During the OGTT, insulin secretion in the IGR group was almost double that of the T2DM group. CP levels were highest in the IGR patients and OGTT related BG concentrations were highest in the T2DM group followed by IGR, but in the IGR group hyperglycemia was less pronounced than in T2DM patients (P < 0.001). Compared to the NGT group, TC, TG and LDL-C serum concentrations were significantly higher (P ≤ 0.001) and HDL-C concentrations were significantly lower (P ≤ 0.001) in IGR and T2DM cases compared to the NTG group. CONCLUSIONS IGR led to similar unfavorable blood lipid patterns compared with T2DM patients and an imbalance of insulin and CP serum concentrations during an OGTT.
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Affiliation(s)
- Shujin Wang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Guohong Li
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hong Zuo
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hua Yang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Lei Ma
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Jia Feng
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Yu Niu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Liming Ma
- Department of Clinical laboratory, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Songfang Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Ting Qi
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Xufeng Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
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Srivanichakorn W, Godsland IF, Washirasaksiri C, Phisalprapa P, Charatcharoenwitthaya P, Pramyothin P, Sitasuwan T, Preechasuk L, Elkeles R, Alberti KGMM, Johnston DG, Oliver NS. Cardiometabolic risk factors in Thai individuals with prediabetes treated in a high-risk, prevention clinic: Unexpected relationship between high-density lipoprotein cholesterol and glycemia in men. J Diabetes Investig 2019; 10:771-779. [PMID: 30387292 PMCID: PMC6497610 DOI: 10.1111/jdi.12967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 10/02/2018] [Accepted: 10/26/2018] [Indexed: 12/18/2022] Open
Abstract
AIMS/INTRODUCTION Relationships between cardiometabolic risk and glycemia have rarely been studied in people under clinical evaluation and treatment for cardiometabolic risk and with prediabetes. We investigated relationships between glycemia and cardiometabolic risk factors in clinic participants with prediabetes. MATERIALS AND METHODS This was a cross-sectional analysis of data collected at a center in Thailand. Clinic attendees were at high risk of diabetes or cardiovascular disease, with hemoglobin A1c (HbA1c) 39-<48 mmol/mol or fasting plasma glucose (FPG) 5.6-<7.0 mmol/L. The relationships between glycemia and cardiometabolic risk factors were explored. RESULTS Of 357 participants, two or more insulin resistance-related metabolic disturbances were present in 84%; 61% took a statin and 75% an antihypertensive agent. Independently of age, sex, adiposity, medication use, possible non-alcoholic fatty liver disease and sex-glycemia interaction, neither FPG nor HbA1c were associated with variation in any other cardiometabolic risk factors. High-density lipoprotein cholesterol decreased with HbA1c in women (female-HbA1c interaction, P = 0.03) but, unexpectedly, increased with FPG in men (male-FPG interaction, P = 0.02). CONCLUSIONS Overall, in Thai people treated for high cardiometabolic risk and with prediabetes defined by FPG and/or HbA1c, neither FPG nor HbA1c were associated with other cardiometabolic risk factors. However, according to sex, high-density lipoprotein cholesterol showed the expected relationship with glycemia in women, but the reverse in men.
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Affiliation(s)
- Weerachai Srivanichakorn
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
- Siriraj Diabetes CenterFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Ian F Godsland
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
| | - Chaiwat Washirasaksiri
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Pochamana Phisalprapa
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | | | - Pornpoj Pramyothin
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Tullaya Sitasuwan
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Lukana Preechasuk
- Siriraj Diabetes CenterFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Robert Elkeles
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
| | - K George MM Alberti
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
| | - Desmond G Johnston
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
| | - Nick S Oliver
- Diabetes, Endocrinology and Metabolic MedicineDepartment of MedicineImperial College LondonLondonUK
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11
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Liyanage GC, Lekamwasam S, Weerarathna TP, Liyanage CE. Effects of high-dose parenteral vitamin D therapy on lipid profile and blood pressure in patients with diabetic nephropathy: A randomized double-blind clinical trial. Diabetes Metab Syndr 2017; 11 Suppl 2:S767-S770. [PMID: 28606441 DOI: 10.1016/j.dsx.2017.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/31/2017] [Indexed: 12/31/2022]
Abstract
AIMS Aim of this study was to determine the effect of high dose vitamin D given to patients with early diabetic renal disease on systolic and diastolic blood pressure, total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG) and high density lipoproteins (HDL) in a randomized controlled trial MATERIALS AND METHOD: Patients with early diabetic nephropathy were recruited. Selected patients were allocated to two groups by Block randomization method. Treatment group received 50,000 IU of vitamin D3 intramuscularly and the control group was given an equal volume of distilled water (0.25mL) monthly for six months. Blood and urine were collected at the baseline for biochemical analyses and blood pressure was measured. After six months all the measurements done at the baseline were repeated. RESULTS Of 155 patients invited, 85 were randomly assigned to two groups. No significant differences were found between treatment and control groups at the baseline. Vitamin D therapy significantly reduced DBP, total cholesterol and LDL but the between group differences were not significant. There was an increase in HDL cholesterol level in the treatment group while there was no change in the control group Between groups difference was significant (P=<0.001). CONCLUSIONS There was a significant improvement of serum HDL level with six months therapy of high dose vitamin D in patients with early diabetic nephropathy.
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Affiliation(s)
- Gayani C Liyanage
- Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Sri Lanka.
| | - Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka
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12
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Weerarathna TP, Herath HMM, Liyanage G. Prevalence of low HDL cholesterol and its associations among Sri Lankan patients with diabetes mellitus on statin therapy. Diabetes Metab Syndr 2017; 11 Suppl 1:S253-S256. [PMID: 28057504 DOI: 10.1016/j.dsx.2016.12.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 12/16/2016] [Indexed: 11/26/2022]
Abstract
AIMS We aimed to study the prevalence and associations of suboptimal high density lipoproteins level, a characteristic feature in diabetic dyslipidemia among patients under statin therapy. MATERIALS AND METHODS From a database of 2416 patients, data on age, gender, duration of diabetes, body mass index (BMI) and waist circumference (WC), low density lipoproteins (LDL), triglyceride, high density lipoproteins (HDL) were obtained. Prevalence of suboptimal HDL (<40mg/dL in males and <50mg/dL in females) and its association with gender, age, duration of diabetes, BMI and WC were studied. RESULTS The mean (SD) age of the sample (n=2416) was 53 (10) years and 64.2% of them (n=1550) were males. Prevalence of suboptimal HDL was 17.6%. Regression analysis revealed female gender, (OR 7.73, 95% CI 5.99-9.97) younger age (OR 0.98, 95% CI 0.97-0.99), higher BMI (OR1.05. 95% CI 1.00-1.2) and LDL level over 100mg/dL (OR 1.004, 95% CI 1.00-1.007) had significant associations with suboptimal HDL. CONCLUSIONS Every sixth diabetic patient on statins has suboptimal HDL level. Females, younger and obese diabetic individuals should be more focused on achieving optimal HDL cholesterol levels.
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Affiliation(s)
| | | | - Gayani Liyanage
- Department of Pharmacology, Faculty of Medicne, PO Box 70, Galle, Sri Lanka.
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13
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Kaya A, Onat A, Yüksel H, Can G, Yüksel M, Ademoğlu E. Lipoprotein(a)-activated immunity, insulin resistance and new-onset diabetes. Postgrad Med 2017. [PMID: 28633585 DOI: 10.1080/00325481.2017.1342508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Some evidence suggests that serum lipoprotein[Lp](a) may be inversely linked to type-2 diabetes. We aimed to determine in nondiabetic people the relationship of serum [Lp](a) with insulin resistance and new-onset diabetes (NOD). MATERIALS AND METHODS Population-based middle-aged adults (n = 1685) were categorized by fasting glucose and stratified to gender, having excluded prevalent diabetic subjects. NOD (n = 90) occurred over a median 5 years' follow-up. RESULTS Subjects that subsequently developed NOD, derived both from the normoglycemia and impaired fasting glucose (IFG) groups,were distinguished, among others, primarily by significantly elevated serum gamma glutamyltransferase, reduced Lp(a) (by 31%) and, compared to IFG, by low total cholesterol levels. Partial correlation of Lp(a) with homeostatic model assessment (HOMA) was inverse in normoglycemic men; such correlation, neutral in normoglycemic women, proved inverse in IFG (r = -0.17). Circulating Lp(a) in individuals with paired measures increased significantly (1.55-fold) in the period from baseline up to NOD. Multivariable-adjusted logistic regression analysis for NOD in combined sexes indicated independent and additive prediction by serum Lp(a), albeit inverse in direction (RR 0.84, [95%CI 0.72; 0.97]). CONCLUSION Lp(a) is significantly reduced in the period preceding NOD and is inversely associated with HOMA index, observations consistent with underlying autoimmune activation.
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Affiliation(s)
- Ayşem Kaya
- a Section of Biochemistry, Institute of Cardiology , Istanbul University , Istanbul , Turkey
| | - Altan Onat
- b Department of Cardiology , Istanbul University , Istanbul , Turkey
| | - Hüsniye Yüksel
- b Department of Cardiology , Istanbul University , Istanbul , Turkey
| | - Günay Can
- c Department of Public Health, Cerrahpaşa Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Murat Yüksel
- d Department of Cardiology , Dicle University , Diyarbakir , Turkey
| | - Evin Ademoğlu
- e Department of Biochemistry, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey
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14
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Amor AJ, Catalan M, Pérez A, Herreras Z, Pinyol M, Sala-Vila A, Cofán M, Gilabert R, Ros E, Ortega E. Nuclear magnetic resonance lipoprotein abnormalities in newly-diagnosed type 2 diabetes and their association with preclinical carotid atherosclerosis. Atherosclerosis 2016; 247:161-9. [PMID: 26921744 DOI: 10.1016/j.atherosclerosis.2016.02.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/15/2016] [Accepted: 02/12/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Atherogenic dyslipidemia is common in type 2 diabetes (T2DM) and predicts cardiovascular disease, but information on the association of its components with atherosclerosis is scarce. We aimed to assess differences in the lipoprotein profile in newly-diagnosed T2DM and matched control individuals and their associations with preclinical carotid atherosclerosis. METHODS In a case-control study, we evaluated lipoprotein profiles by nuclear magnetic resonance (NMR) spectroscopy and determined carotid intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) by B-mode ultrasonography. RESULTS We assessed 96 T2DM patients (median age 63 years, 44% women, 19% smokers, 54% hypertension, 38% dyslipidemia) and 90 non-diabetic controls matched for age, sex, and cardiovascular risk factors. In T2DM VLDL-particles (mainly large and enriched in cholesterol and triglycerides) were increased, and large HDL-particles (enriched in triglycerides and depleted in cholesterol) were reduced (p < 0.05; all comparisons). Regarding associations with preclinical atherosclerosis, VLDL triglyceride content (odds ratio [OR], 8.975; 95% confidence interval [CI], 2.330-34.576), total number of VLDL particles (OR, 2.713; CI, 1.601-4.598) and VLDL size (OR, 2.044; CI, 1.320-3.166), and the ratio cholesterol/triglycerides in HDL (OR, 0.638; CI, 0.477-0.852) were associated with plaque burden (≥3 plaques) independently of confounders, including conventional lipid levels. CONCLUSION NMR-assessed advanced lipoprotein profile identifies lipid abnormalities associated with newly-diagnosed T2DM and preclinical atherosclerosis that are not captured by the traditional lipid profile. At this early stage of diabetes, NMR lipoproteins could be useful to identify candidates for a more comprehensive cardiovascular risk prevention strategy.
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Affiliation(s)
- Antonio J Amor
- Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Marta Catalan
- Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain
| | - Antonio Pérez
- Endocrinology and Nutrition Department, Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red "Diabetes y Enfermedades Metabólicas Asociadas" (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain
| | - Zoe Herreras
- Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain
| | - Montserrat Pinyol
- Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain
| | - Aleix Sala-Vila
- Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Montserrat Cofán
- Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Rosa Gilabert
- Vascular Unit, Centre de Diagnòstic per l'Imatge, IDIBAPS, Hospital Clínic, Barcelona, Spain
| | - Emilio Ros
- Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Emilio Ortega
- Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.
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15
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Unniachan S, Bash LD, Khovidhunkit W, Sri RZT, Vicaldo E, Recto C, Ambegaonkar BM. Prevalence of lipid abnormalities and attainment of normal lipid levels among patients with dyslipidaemia: a pooled analysis of observational studies from five Asian countries. Int J Clin Pract 2014; 68:1010-9. [PMID: 24666791 DOI: 10.1111/ijcp.12407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS Guidelines emphasise the importance of low-density lipoprotein cholesterol (LDL-C) goals for cardiovascular risk reduction. Given the importance of association between high-density lipoprotein (HDL-C) and triglycerides (TG) normal levels and cardiovascular risk, there is an additional need to further evaluate diverse dyslipidaemic populations. METHODS A retrospective longitudinal observational study of patients aged ≥ 35 years on lipid-modifying therapy (LMT) for ≥ 12 months was conducted from patient records pooled from five Asian countries (Malaysia, Korea, Hong Kong, Thailand and Philippines). The prevalence of lipid abnormalities and goal attainment was assessed 12 months before and after LMT initiation. RESULTS Among 3256 patients (mean age - 58.6 years, 50.4% men), 65.4% were high-risk patients and 88% were on statin therapy. At baseline 94.7% of all patients had at least one abnormal lipid value elevated, LDL-C (86.2%) being the most prevalent. Non-smokers [OR (95% CI): 1.42 (1.08-1.87)], non-diabetics [2.35 (1.96-2.82)], non-cardiovascular disease patients [1.77 (1.42-2.21)] and those from Korea [2.56 (1.83-3.59)] were more likely to attain LDL-C goals. On the contrary, women [0.82 (0.68-0.98)], subjects with FRS > 20% [0.56 (0.41-0.77)] those from Malaysia [0.55 (0.39-0.77)] and the Philippines [0.18 (0.12-0.28)] were less likely to reach LDL-C goals. Fewer characteristics were independently associated with reaching normal levels of HDL-C and TG and attaining at least two normal lipid levels. CONCLUSIONS While current LMT reduced the prevalence of dyslipidaemia, a third of patients still failed to achieve target/normal levels. We highlight country differences and the importance of improving therapy to attain multiple lipid goals/normal levels.
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Affiliation(s)
- S Unniachan
- School of Public Health, UMDNJ, Piscataway, NJ, USA
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16
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Walia GK, Gupta V, Aggarwal A, Asghar M, Dudbridge F, Timpson N, Singh NS, Kumar MR, Kinra S, Prabhakaran D, Reddy KS, Chandak GR, Smith GD, Ebrahim S. Association of common genetic variants with lipid traits in the Indian population. PLoS One 2014; 9:e101688. [PMID: 24991929 PMCID: PMC4081649 DOI: 10.1371/journal.pone.0101688] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 06/10/2014] [Indexed: 12/22/2022] Open
Abstract
Genome-wide association studies (GWAS) have been instrumental in identifying novel genetic variants associated with altered plasma lipid levels. However, these quantitative trait loci have not been tested in the Indian population, where there is a poorly understood and growing burden of cardiometabolic disorders. We present the association of six single nucleotide polymorphisms in 1671 sib pairs (3342 subjects) with four lipid traits: total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). We also investigated the interaction effects of gender, location, fat intake and physical activity. Each copy of the risk allele of rs964184 at APOA1 was associated with 1.06 mmol/l increase in triglycerides (SE = 0.049; p = 0.006), rs3764261 at CETP with 1.02 mmol/l increase in both total cholesterol (SE = 0.042; p = 0.017) and HDL-C (SE = 0.041; p = 0.008), rs646776 at CELSR2-PSRC1-SORT1 with 0.96 mmol/l decrease in cholesterol (SE = 0.043; p = 0.0003) and 0.15 mmol/l decrease in LDL-C levels (SE = 0.043; p = 0.0003) and rs2954029 at TRIB1 with 1.02 mmol/l increase in HDL-C (SE = 0.039; p = 0.047). A combined risk score of APOA1 and CETP loci predicted an increase of 1.25 mmol/l in HDL-C level (SE = 0.312; p = 0.0007). Urban location and sex had strong interaction effects on the genetic association of most of the studied loci with lipid traits. To conclude, we validated four genetic variants (identified by GWAS in western populations) associated with lipid traits in the Indian population. The interaction effects found here may explain the sex-specific differences in lipid levels and their heritability. Urbanization appears to influence the nature of the association with GWAS lipid loci in this population. However, these findings will require replication in other Indian populations.
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Affiliation(s)
- Gagandeep Kaur Walia
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India (PHFI), New Delhi, India
- * E-mail: (GKW); (VG)
| | - Vipin Gupta
- Department of Anthropology, University of Delhi, Delhi, India
- * E-mail: (GKW); (VG)
| | - Aastha Aggarwal
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India (PHFI), New Delhi, India
| | - Mohammad Asghar
- Department of Anthropology, Rajiv Gandhi University, Itanagar, Arunachal Pradesh, India
| | - Frank Dudbridge
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nicholas Timpson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | - M. Ravi Kumar
- Centre for Cellular and Molecular Biology, Hyderabad, Telangana, India
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, New Delhi, India
| | | | | | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Shah Ebrahim
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India (PHFI), New Delhi, India
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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17
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Metabolic profile before and after short-term overfeeding with a high-fat diet: a comparison between South Asian and White men. Br J Nutr 2014; 111:1853-61. [PMID: 24506887 DOI: 10.1017/s0007114514000014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
For the same BMI, South Asians have a higher body fat percentage and an adverse metabolic profile compared with whites. The objective of the present study was to determine the metabolic profiles of South Asian and white men matched for body fat percentage in response to short-term overfeeding with a high-fat diet. A total of ten healthy non-diabetic South Asian men matched for body fat percentage with ten white men were included in the study. A weight-maintenance diet (containing 30 % fat, 55 % carbohydrate and 15 % protein) was provided for 3 d followed by 4 d of overfeeding (150 % of energy requirement) with a high-fat diet (60 % fat, 25 % carbohydrate and 15 % protein). Before and after the overfeeding period, plasma glucose, insulin, TAG, NEFA, total cholesterol and HDL-cholesterol concentrations were determined. Glucose clearance was calculated using a 2 h oral glucose tolerance test. The results revealed that in South Asian and white men, respectively, overfeeding with a high-fat diet decreased plasma TAG concentrations by 0·4 (sd 0·6) and 0·4 (sd 0·5) mmol/l (P diet= 0·008; P ethnicity= 0·24), increased HDL-cholesterol concentrations by 0·12 (sd 0·1) and 0·14 (sd 0·2) mmol/l (P diet= 0·001; P ethnicity= 0·06) and decreased glucose clearance by 48·8 (sd 53·5) and 37·2 (sd 34·2) ml/min per m2 body surface (P diet= 0·004; P ethnicity= 0·18). There was a significant interaction between diet and ethnicity with regard to the changes in total and LDL-cholesterol concentrations (P= 0·01 and 0·007, respectively), which trended towards a larger increase in South Asian subjects than in white subjects. Despite a similar body fat percentage, short-term overfeeding with a high-fat diet had more adverse effects on the lipid profile of South Asians than on that of whites.
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18
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Zhang Y, Gan W, Tian C, Li H, Lin X, Chen Y. Association of PPP1R3B polymorphisms with blood lipid and C-reactive protein levels in a Chinese population (PPP1R3B C ). J Diabetes 2013; 5:275-81. [PMID: 23343124 DOI: 10.1111/1753-0407.12028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 01/09/2013] [Accepted: 01/21/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genetic variants of PPP1R3B, a gene encoding a critical protein involved in hepatic glycogen metabolism, were recently reported to be associated with plasma levels of lipids and C-reactive protein (CRP) among populations of mostly European descent. The aim of the present study was to investigate whether the PPP1R3B variants are associated with plasma levels of lipids and inflammation factors in Chinese Han. METHODS Five single nucleotide polymorphisms (SNPs) of the PPP1R3B gene were genotyped and their associations with plasma lipids and CRP were determined in 1636 Chinese Han from Shanghai. RESULTS Three SNPs, namely rs2126259, rs9987289, and rs19334, were significantly associated with plasma levels of low-density lipoprotein-cholesterol, and rs2126259 and rs9987289 were further significantly associated with total cholesterol. The remaining two SNPs (rs189798 and rs330919) were significantly associated with plasma CRP levels, but not with plasma lipid levels. CONCLUSION Genetic polymorphisms of the PPP1R3B gene may contribute to variations in plasma lipids and CRP levels among Chinese Han individuals.
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Affiliation(s)
- Yongxian Zhang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Graduate School of the Chinese Academy of Sciences, Shanghai, China
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Qorbani M, Kelishadi R, Farrokhi-Khajeh-Pasha Y, Motlagh M, Aminaee T, Ardalan G, Asayesh H, Shafiee G, Taslimi M, Poursafa P, Heshmat R, Larijani B. Association of anthropometric measures with cardiovascular risk factors and metabolic syndrome in normal-weight children and adolescents: the CASPIAN III study. Obes Facts 2013; 6:483-92. [PMID: 24157679 PMCID: PMC5644726 DOI: 10.1159/000356011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 05/04/2013] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This nationwide study was conducted to determine the association of anthropometric measures with cardiovascular risk factors and metabolic syndrome (MetS) in Iranian normal-weight children and adolescents. METHODS We analyzed the data of 3,565 children and adolescents (50.3% boys), aged 10-18 years, with a normal BMI (5th-84th percentile) obtained from the third survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN III) study. The diagnostic criteria for MetS were defined by the International Diabetes Federation consensus. RESULTS The prevalence of MetS for 10- to 13.9-year-old boys, 14- to 18-year-old boys, 10- to 13.9-year-old girls, and 14- to 18-year-old girls were 1.4, 2.8, 2.3, and 3.3%, respectively. After adjustment for age and sex, each unit increase in BMI (within normal range) and waist circumference increased the odds of MetS from 6 to 72% and from 1 to 20%, respectively. The dominant pattern of dyslipidemia among the participants was high triglycerides and low high-density lipoprotein cholesterol. CONCLUSION This study complements recent research about the high frequency of metabolic risk factors among normal-weight individuals in the pediatric age group.
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Affiliation(s)
- Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yasin Farrokhi-Khajeh-Pasha
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Isfahan, Iran
| | - Mohammad Motlagh
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tahere Aminaee
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Gelayol Ardalan
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Isfahan, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Taslimi
- Bureau of Health and Fitness, Ministry of Education and Training, Tehran, Iran
| | - Parinaz Poursafa
- Environment Department, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Isfahan, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Isfahan, Iran
- *Dr. Ramin Heshmat, Endocrinology and Metabolism Research Center (EMRC), Dr. Shariati Hospital, North Kargar St., Tehran 14114 (Iran),
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Isfahan, Iran
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[Poorer diabetes control among the immigrant population than among the autochthonous population]. GACETA SANITARIA 2012; 27:19-25. [PMID: 22465053 DOI: 10.1016/j.gaceta.2011.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/23/2011] [Accepted: 12/27/2011] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Ethnic differences are known to exist in the prevalence of diabetes, but little is known about possible differences in the degree of diabetes control among ethnic groups. The aim of this study was to determine whether there are differences in diabetes detection and control between immigrants and the autochthonous population in our health region. METHODS We performed a cross-sectional, observational, population-based study of all patients diagnosed with diabetes mellitus type 2 registered and treated in 2010. We analyzed diabetes quality indicators and used multivariate logistic regression models adjusted for age, sex and number of visits. The adjustment method was forced and the absence of collinearity was identified through the ROC curve and Hosmer and Lemeshow's test. RESULTS There were 77,999 autochthonous patients (6,846 diabetics) and 30,748 immigrant patients (415 diabetics). A total of 8.78% of the autochthonous patients were diabetic versus 1.35% of immigrants (p <0.001). HbA1c <7.5% was found in 68.04% of the native population compared with 54.76% of immigrants. The probability of achieving optimal HbA1c control was 27% lower in immigrants (adjusted OR=0.73), while the probability of achieving good HbA1c control was 30% lower in the immigrant cohort. The model showed moderate discrimination (ROC =0.65 and Hosmer and Lemeshow's contrast, p>0.05). CONCLUSIONS Diabetes control and quality indicators are poorer in some immigrant groups.
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Deng B, Luo T, Huang Y, Shen T, Ma J. Prevalence and determinants of hyperlipidemia in moderate altitude areas of the Yunnan-Kweichow plateau in Southwestern China. High Alt Med Biol 2012; 13:13-21. [PMID: 22429228 PMCID: PMC3308708 DOI: 10.1089/ham.2011.1037] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Accepted: 09/13/2011] [Indexed: 02/02/2023] Open
Abstract
The objective of the current study was to determine the prevalence and determinants of hyperlipidemia among the populations living at moderate altitude on the Yunnan-Kweichow Plateau in Southwestern China. We randomly recruited 1415 people for this study. These subjects underwent a physical examination and a comprehensive questionnaire regarding their daily habits and diets. Furthermore, blood samples from the participants were collected for assessing the lipid profile. We found that 49.3% of participants (95% CI: 46.7-51.9%) suffered from hyperlipidemia. The prevalence in men was significantly higher than that in women (53.6% vs. 44.7%, p<0.01). The prevalence of hypercholesterolemia was 23.3% and of hypertriglyceridemia was 34.1%. Low HDL-C showed a prevalence of 17.5% and high LDL-C of 9.0%. The prevalence of hyperlipidemia also increased with age, as did the prevalence of high TC, TG, and LDL-C. Hyperlipidemic subjects tended to be older and have a higher BMI and WHR than the normolipidemic subjects in the study cohort (p<0.05). The hyperlipidemic subjects, both men and women, tended to dine out often and consume more animal-based foods and alcohol. In addition, the hyperlipidemic men in our cohort consumed more salted food then their normolipidemic counterparts (p<0.01). Normolipidemic subjects of both sexes were also found to prefer a vegetarian diet (p<0.01). Age, alcohol consumption, a preference for meat and animal products, regular dining out, and BMI were found to be the main determinants of hyperlipidemia in women, whereas a prevalence of salted food was observed to be related to hyperlipidemia in men from the Yunnan-Kweichow Plateau subpopulation under study (p<0.05). The average daily energy, and protein and fat intakes of the sampled subjects were also higher than the levels set by the Chinese Recommendation Nutrient Intakes (RNI), while hyperlipidemic subjects had an even higher average daily intake of total fat, cholesterol, and lower dietary fiber compared with the normolipidemic subjects in the study group (p<0.05). In conclusion, this study reveals a higher prevalence of hyperlipidemia, hypercholesterolemia, hypertriglyceridemia, increased BMI and WHR values in men, as well as a slightly higher prevalence of low HDL-C and high LDL-C in women from Yunnan-Kweichow Plateau. The incidence of hyperlipidemia also increased with age, as did the prevalence of an abnormal TC, TG, LDL-C, and WHR in our study cohort. A high BMI, and less healthy living habits and dietary preferences thus play significant roles in the onset of hyperlipidemia.
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Affiliation(s)
- Bingjun Deng
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Tingguang Luo
- People's Hospital of Yunxian County, Yunnan Province, People's Republic of China
| | - Yanfei Huang
- People's Hospital of Yunxian County, Yunnan Province, People's Republic of China
| | - Tianhang Shen
- People's Hospital of Yunxian County, Yunnan Province, People's Republic of China
| | - Jing Ma
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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Telomere length attrition, a marker of biological senescence, is inversely correlated with triglycerides and cholesterol in South Asian males with type 2 diabetes mellitus. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:895185. [PMID: 22474429 PMCID: PMC3303685 DOI: 10.1155/2012/895185] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 11/14/2011] [Accepted: 11/21/2011] [Indexed: 11/29/2022]
Abstract
South Asians have a higher risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) than white Caucasians, for a given BMI. Premature biological ageing, assessed by reduction in telomere length (TL), may be mediated by factors resulting from altered metabolic profiles associated with obesity. We hypothesise that ethnicity and metabolic status represent detrimental factors contributing to premature biological ageing. Therefore we assessed TL in two South Asian, age and BMI-matched cohorts [T2DM (n = 142) versus non-T2DM (n = 76)] to determine the effects of BMI, gender, lipid and CVD profile on biological ageing. Genomic DNA was obtained from the UKADS cohort; biochemical and anthropometric data was collected and TL was measured by quantitative real-time PCR. Our findings indicated a gender-specific effect with reduced TL in T2DM men compared with non-T2DM men (P = 0.006). Additionally, in T2DM men, TL was inversely correlated with triglycerides and total cholesterol (r = −0.419, P < 0.01; r = −0.443, P < 0.01). In summary, TL was reduced amongst South Asian T2DM men and correlated with triglycerides and total cholesterol. This study highlights enhanced biological ageing among South Asian, T2DM men, which appears to be tracked by changes in lipids and BMI, suggesting that raised lipids and BMI may directly contribute to premature ageing.
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Khovidhunkit W, Silaruks S, Chaithiraphan V, Ongphiphadhanakul B, Sritara P, Nimitphong H, Benjanuwattra T, Ambegaonkar BM. Prevalence of dyslipidemia and goal attainment after initiating lipid-modifying therapy: a Thai multicenter study. Angiology 2012; 63:528-34. [PMID: 22222187 DOI: 10.1177/0003319711432451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous studies focused on attaining low-density lipoprotein cholesterol (LDL-C) goals after lipid-modifying therapy (LMT), but data on achieving normal levels of triglyceride and high-density lipoprotein cholesterol (HDL-C) are limited. We reviewed medical records of patients initiated on LMT. High risk was defined as patients with coronary heart disease, diabetes, or 10-year Framingham risk >20%. Among 806 patients enrolled, 429 were at high risk. Prior to initiation of LMT, 66%, 35%, and 44% overall and 69%, 35%, and 45% in the high-risk group had elevated LDL-C, elevated triglyceride, and low HDL-C, respectively. After 12 months of LMT, 21%, 32%, and 39% overall and 26%, 25%, and 43% in the high-risk group still had elevated LDL-C, elevated triglyceride, and low HDL-C, respectively. Approximately 1 of 5 patients continued to experience elevated LDL-C coupled with elevated triglyceride and/or low HDL-C. In conclusion, a substantial proportion of patients initiated on LMT continued to have lipid abnormalities.
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Affiliation(s)
- Weerapan Khovidhunkit
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
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Sherpa LY, Deji, Stigum H, Chongsuvivatwong V, Luobu O, Thelle DS, Nafstad P, Bjertness E. Lipid profile and its association with risk factors for coronary heart disease in the highlanders of Lhasa, Tibet. High Alt Med Biol 2011; 12:57-63. [PMID: 21452966 DOI: 10.1089/ham.2010.1050] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the prevalence of abnormal lipid levels and its association with selected coronary heart disease (CHD) risk factors in the Tibetan population living at 3660 meters above sea level in Lhasa, Tibet. Three hundred seventy one randomly selected male and female, aged 30 to 70 yr took part in the study. Based on the National Cholesterol Education Programme (NCED) adult treatment panel ATP-III 2004 criteria, the age-adjusted prevalence of hypertriglyceridemia was 12.0%; high triglycerides (TG), 33.4%; high low-density lipoprotein cholesterol (LDL-C), 4.8%; and low high-density lipoprotein cholesterol (HDL-C); 24.3%. After adjusting for age, sex, smoking, alcohol, physical activity, diet, hemoglobin (Hb) concentration, and systolic and diastolic blood pressure (BP), an increase in waist-to-hip ratio (WHR) by 0.1 unit was associated with a statistically significant increase in TG, total cholesterol (TC) and LDL-C by 0.25 mmol/L, 0.24 mmol/L, and 0.18 mmol/L, respectively. Female gender increased HDL-C by 0.18 mmol/L when compared with males. Age-adjusted prevalences of Framingham CHD risk score for males and females were 16.3% and 0.6%, respectively. This study demonstrated a high prevalence of hypertriglyceridemia in males, a higher prevalence of low HDL-C in females, and a high hypercholesterolemia prevalence in both genders. However, further longitudinal studies assessing CHD risk factors in high altitude natives are required.
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Affiliation(s)
- Lhamo Y Sherpa
- Section for Preventive Medicine and Epidemiology, Institute of Health and Society, University of Oslo, Oslo, Norway.
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Cardiovascular Disease in Asian Indians Living in the United States. CURRENT CARDIOVASCULAR RISK REPORTS 2011. [DOI: 10.1007/s12170-011-0171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Onat A, Hergenç G. Low-grade inflammation, and dysfunction of high-density lipoprotein and its apolipoproteins as a major driver of cardiometabolic risk. Metabolism 2011; 60:499-512. [PMID: 20580781 DOI: 10.1016/j.metabol.2010.04.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 04/12/2010] [Accepted: 04/19/2010] [Indexed: 12/30/2022]
Abstract
Dysfunction of high-density lipoprotein (HDL) particles that even become proinflammatory or lose atheroprotective properties is known through analyses of HDL isolated from diabetic subjects. Recently, high concentrations of HDL or apolipoprotein (apo) A-I in individuals with diabetes or coronary heart disease were found to reveal dysfunction in some population-based studies. Such dysfunction of HDL and its apos A-I, A-II, and C-III has been observed in a general population for the first time among Turkish adults. Functional defectiveness manifested itself by unexpected correlations with inflammatory biomarkers and, in long-term follow-up, by lack of protection against diabetes and coronary heart disease, accounting for the excess incidences in Turks. Female sex was more pronouncedly affected by this process that presumably exists in other ethnicities in South Asia, East Europe, and the Middle East. In contradistinction, in Western and East Asian population, only individuals with glucose intolerance or those at risk for cardiometabolic disease are considered to be or were documented in a review of clinical trials to have been affected by impaired function of HDL. High-density lipoprotein dysfunctionality is closely linked to obesity and low-grade inflammation yet seems to act partly independently of them. Cigarette smoking in overweight women with low-grade inflammation appears to offer limited protection against cardiometabolic risk. The great impact in public health of the dysfunction of protective serum proteins requires individual clinical recognition, appropriate preventive measures, and delineation of management, including with anti-inflammatory drugs.
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Affiliation(s)
- Altan Onat
- Turkish Society of Cardiology, Istanbul University, Istanbul 34098, Turkey.
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