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de Oliveira AD, Dos Santos AR, de Oliveira LC, Nogueira Neto JF. The relevance of the optional use of fasting in laboratory measurements that make up the lipid profile: A systematic literature review. J Pharm Biomed Anal 2024; 240:115925. [PMID: 38154369 DOI: 10.1016/j.jpba.2023.115925] [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: 05/08/2023] [Revised: 10/28/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
The objective of this study was to evaluate the impact of fasting easing on laboratory measurements of the lipid profile, in order to contribute to the fidelity of interpretation of laboratory results. Starting in October 2022, a Systematic Literature Review (SRL) was carried out, using articles indexed in the electronic databases PubMed/MEDLINE, EMBASE, Scopus, LILACS and Cochrane Library, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Group (PRISMA). This RSL was registered with PROSPERO, under registration number CRD42022370007. For inclusion, articles had to be original and developed in humans. After evaluating the methodological quality and analyzing the risk of bias, we obtained 16 articles published between 1994 and 2021, providing data on a total of 398,709 individuals, aged between 3 and 93 years. According to the selected studies, lipid profile measurements performed with flexible fasting, in addition to bringing benefits to patients and the pre-analytical system of the clinical laboratory, are more suitable for determining cardiovascular risk, mainly through the assessment of values obtained in the determination of triglycerides. It is therefore concluded that the optional use of fasting must be established through medical advice. In addition, laboratory methods and readings must be readjusted to this reality, informing through the report the parameters related to the lipid profile with and without the use of a 12-hour fast.
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Affiliation(s)
- Aliene Dias de Oliveira
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil.
| | - Amanda Ribeiro Dos Santos
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil
| | - Lívia Costa de Oliveira
- National Cancer Institute José Alencar Gomes da Silva - INCA, Palliative Care Unit, 274, Visconde de Santa Isabel Street, Vila Isabel, Rio de Janeiro, RJ 20560-121, Brazil
| | - José Firmino Nogueira Neto
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil
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Raja V, Aguiar C, Alsayed N, Chibber YS, ElBadawi H, Ezhov M, Hermans MP, Pandey RC, Ray KK, Tokgözoglu L, Zambon A, Berrou JP, Farnier M. Non-HDL-cholesterol in dyslipidemia: Review of the state-of-the-art literature and outlook. Atherosclerosis 2023; 383:117312. [PMID: 37826864 DOI: 10.1016/j.atherosclerosis.2023.117312] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
Dyslipidemia refers to unhealthy changes in blood lipid composition and is a risk factor for atherosclerotic cardiovascular diseases (ASCVD). Usually, low-density lipoprotein-cholesterol (LDL-C) is the primary goal for dyslipidemia management. However, non-high-density lipoprotein cholesterol (non-HDL-C) has gained attention as an alternative, reliable goal. It encompasses all plasma lipoproteins like LDL, triglyceride-rich lipoproteins (TRL), TRL-remnants, and lipoprotein a [Lp(a)] except high-density lipoproteins (HDL). In addition to LDL-C, several other constituents of non-HDL-C have been reported to be atherogenic, aiding the pathophysiology of atherosclerosis. They are acknowledged as contributors to residual ASCVD risk that exists in patients on statin therapy with controlled LDL-C levels. Therefore, non-HDL-C is now considered an independent risk factor or predictor for CVD. The popularity of non-HDL-C is attributed to its ease of estimation and non-dependency on fasting status. It is also better at predicting ASCVD risk in patients on statin therapy, and/or in those with obesity, diabetes, and metabolic disorders. In addition, large follow-up studies have reported that individuals with higher baseline non-HDL-C at a younger age (<45 years) were more prone to adverse CVD events at an older age, suggesting a predictive ability of non-HDL-C over the long term. Consequently, non-HDL-C is recommended as a secondary goal for dyslipidemia management by most international guidelines. Intriguingly, geographical patterns in recent epidemiological studies showed remarkably high non-HDL-C attributable mortality in high-risk countries. This review highlights the independent role of non-HDL-C in ASCVD pathogenesis and prognosis. In addition, the need for a country-specific approach to dyslipidemia management at the community/population level is discussed. Overall, non-HDL-C can become a co-primary or primary goal in dyslipidemia management.
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Affiliation(s)
- Vikrama Raja
- Abbott Products Operations AG, Basel, Switzerland
| | - Carlos Aguiar
- Department of Cardiology, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | | | | | - Hussein ElBadawi
- Internal Medicine Department, Wayne State University, Detroit, MI, USA; Metabolic Unit, My Clinic International, Jeddah, Saudi Arabia
| | - Marat Ezhov
- National Medical Research Center of Cardiology n.a. ac. E.I. Chazov, Moscow, Russia
| | | | | | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, UK
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Lin TK, Dispenza TC. Cholesterol Screening in Children: Is a Universal Approach Working? Curr Atheroscler Rep 2023; 25:579-590. [PMID: 37594601 DOI: 10.1007/s11883-023-01129-8] [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] [Accepted: 07/02/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW Ample evidence supports that an individual's lifetime risk of atherosclerotic cardiovascular disease correlates to long-term, cumulative exposure to circulating cholesterol levels, beginning in childhood. Selective screening strategies based on family history fail to identify many children with hypercholesterolemia. Universal cholesterol screening in childhood is a worthwhile goal. However, cholesterol screening rates through childhood remain low. RECENT FINDINGS Mounting evidence clarifies the barriers to cholesterol screening in children. Specific strategies to foster universal screening in childhood have been proposed. SUMMARY We present an overview of the present state of childhood cholesterol screening, summarizing historical and contemporary guidelines and collating evidence of low adherence to current guidelines. We contend that novel approaches to universal cholesterol screening in childhood are warranted, and we present potential opportunities for improvement. We call for new and universal pediatric cholesterol screening guidelines.
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Affiliation(s)
- Tracie K Lin
- Penn State Health Children's Hospital, Division of Pediatric Cardiology, 600 University Drive, Hershey, PA, 17033, USA
| | - Thomas C Dispenza
- Penn State Health Children's Hospital, Division of Pediatric Cardiology, 600 University Drive, Hershey, PA, 17033, USA.
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Imataka G, Yui K, Shiko Y, Kawasaki Y, Sasaki H, Shiroki R, Yoshihara S. Urinary and Plasma Antioxidants in Behavioral Symptoms of Individuals With Autism Spectrum Disorder. Front Psychiatry 2021; 12:684445. [PMID: 34539458 PMCID: PMC8446379 DOI: 10.3389/fpsyt.2021.684445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
The balance between antioxidant capacity and oxidative stress-induced free radicals may be crucial in the pathophysiological development factor of autism spectrum disorder (ASD). We measured the following urinary and plasma biomarker levels of oxidative stress and antioxidants. As urinary biomarkers, (1) hexanoyl-lysine (HEL), which is a new biomarker of oxidative stress, (2) the total antioxidant capacity (TAC), and (3) 8-hydroxy-2'-deoxyguanosine (8-OHdG), as a product of oxidative modifications to DNA; and the plasma levels of (4) the antioxidant protein superoxide dismutase (SOD), which is the crucial defense again oxygen reactive species, and (5) transferrin and (6) ceruloplasmin, which are biomarkers of iron and copper neurotransmission and oxidant-antioxidant systems. We examined the relationship between these urinary and plasma biomarkers and behavioral symptoms in 19 individuals with ASD (mean age, 10.8 ± 5.2 years) and 10 age-matched healthy controls (mean age, 14.2 ± 7.0 years). Behavioral symptoms were estimated using the Aberrant Behavior Checklist (ABC). Urinary TAC levels were significantly lower, whereas urinary HEL levels were significantly increased in the ASD group as compared with the control group. The five ABC subscale and total scores were significantly raised in the autism group than in the control group. The results of a linear regression analysis revealed that plasma SOD levels may be a more accurate predictor of differences in ABC scores between individuals with ASD and control individuals. The present study firstly revealed the important findings that the cooperation between the urinary antioxidant TAC and plasma SOD levels may contribute to the ABC subscale scores of stereotypy. Urinary TAC activity and antioxidant protein SOD may be associated with incomplete mineral body store and antioxidant-related transcription factor and browning reactions. Consequently, a critical imbalance between TAC urinary levels and plasma SOD levels may be an important contributor to autistic behavioral symptoms.
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Affiliation(s)
- George Imataka
- Department of Pediatrics, Dokkyo Medical University, Mibu, Japan
| | - Kunio Yui
- Department of Urology, Fujita Health University, Toyoake, Japan
| | - Yuki Shiko
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hitomi Sasaki
- Department of Urology, Fujita Health University, Toyoake, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Health University, Toyoake, Japan
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Yui K, Imataka G, Sasaki H, Shiroki R. The role of lipid peroxidation in individuals with autism spectrum disorders. Metab Brain Dis 2020; 35:1101-1108. [PMID: 32643093 DOI: 10.1007/s11011-020-00585-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/01/2020] [Indexed: 12/21/2022]
Abstract
The role of malondialdehyde-modified low-density lipoprotein (MDA-LDL), an oxidized LDL, in the pathophysiology of autism spectrum disorder (ASD) is unclear. We studied association between MDA-LDL and behavioral symptoms in 11 individuals with ASD and 7 age -matched normal controls. Behavioral symptoms were assessed using the Aberrant Behavior Checklists (ABC). Because small sample size in this study, three measures were conducted: first, employment of adaptive Lasso for enhancing the accuracy of prediction and interpretability; second, calculation of coefficient of variation for an appropriate selection of plasma variables; and third, selection of good candidates of plasma variables. Plasma levels of MDA-LDL, eicosapentaenoic acid, docosahexaenoic acid (DHA) and DHA/arachidonic acid ratios were significantly higher, while plasma superoxide dismutase (SOD) levels were significantly lower in the ASD group than in the control group. The total ABC scores were significantly higher in the ASD group than in the control group. Multiple linear regression analysis and the adaptive Lasso revealed association of increased plasma DHA levels with the ABC total scores and increased plasma MDA-LDL levels. Such association between DHA and plasma MDA-LDL levels may contribute to behavior in individuals with ASD.
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Affiliation(s)
- Kunio Yui
- Department of Urology, Fujita Medical University School of Medicine, Aichi, 470-1192, Japan.
| | - George Imataka
- Department of Pediatrics, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Hitomi Sasaki
- Department of Urology, Fujita Medical University School of Medicine, Aichi, 470-1192, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Medical University School of Medicine, Aichi, 470-1192, Japan
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Kuo CC, Su PH, Sun CW, Liu HJ, Chang CL, Wang SL. Early-life arsenic exposure promotes atherogenic lipid metabolism in adolescence: A 15-year birth cohort follow-up study in central Taiwan. ENVIRONMENT INTERNATIONAL 2018; 118:97-105. [PMID: 29859944 DOI: 10.1016/j.envint.2018.05.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Inorganic arsenic (iAs) exposure potentially causes diabetes and cardiovascular diseases in adults. However, its effect on glucose and lipid metabolism in early life remains unknown. OBJECTIVE We evaluated the associations between early-life arsenic exposure and profiles of glucose and lipids in a 15-year birth cohort in central Taiwan. METHODS We studied 237 adolescents through 5 waves of follow-up interviews and examinations at ages of approximately 2, 5, 8, 11, and 14 y. We obtained at least one follow-up urine measurement for arsenic species and blood sample collection up to 14 y of age and identified group-based trajectories of serial iAs by semiparametric mixture modeling. Multiple linear and logistic regressions were performed to assess the effect of the arsenic exposure trajectory on serum fasting glucose, total cholesterol (TCHO), triglycerides (TGs), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL). RESULTS Three trajectories of postnatal arsenic exposure were identified, namely stable-low (31.4%), stable-high (48.2%), and rising-high (20.4%) groups. Compared with the stable-low trajectory group, the percent changes in TCHO and LDL was 14% (95% confidence interval 4-24%) and 23% (9-38%) for the group with "rising-high" trajectory and was 8% (-1-16%) and 16% (4-29%) for the group with "stable-high" trajectory. The rising-high group was also associated with an increase in the TCHO/HDL ratio by 14% (95% CI 3%-25%). The adjusted odds ratios of high developmental trajectories of TCHO, TG, LDL, and non-HDL levels were 4.0 (95% CI 1.2-13.7), 12.2 (2.2-67), 7.3 (1.8-30), and 3.6 (0.9-14.6), respectively, in the rising-high group (reference: stable-low group). CONCLUSION Our findings suggest that conversion to an atherogenic lipid profile in adolescents may be associated with early-life exposure to environmental arsenic, particularly during the pre-adolescent period. An environmental modification approach for preventing As-related cardiovascular disease is recommended to begin early in life.
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Affiliation(s)
- Chin-Chi Kuo
- Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University, Taichung, Taiwan; Big Data Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Pen-Hua Su
- Department of Pediatrics, Chung Shan Medical University, Taichung, Taiwan
| | - Chien-Wen Sun
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Huei-Ju Liu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chaw-Liang Chang
- Department of Pediatrics, Cathay General Hospital, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Kubo T, Furujo M, Takahashi K, Hyodo Y, Tsuchiya H, Hattori M, Fujinaga S, Urayama K. Effects of Growth Hormone Treatment on Lipid Profiles. Indian J Pediatr 2018; 85:261-265. [PMID: 29127617 DOI: 10.1007/s12098-017-2509-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/20/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess the effects of growth hormone (GH) on lipid profiles in children and whether the effect is pharmacological. METHODS The authors determined serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and low-density lipoprotein cholesterol (LDL-C) every year during 3-y GH treatment in 48 GH deficient (GHD) short children and 22 children with short stature born small for gestational age (SGA). RESULTS The abnormally high levels of TC, non-HDL-C, and LDL-C showed a high frequency in GHD short children compared with epidemiological studies in Japan. The high prevalence of high level of TC was also shown in SGA short children. Three-year GH treatment decreased serum TC, non-HDL-C, and LDL-C levels in both patient groups. CONCLUSIONS GH treatment is clearly a pharmacological therapy in SGA short children and so may also be in GHD short children at the Japanese standard therapeutic dose. Taken together, GH improves lipid profiles, and its effect has the possibility of medical properties.
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Affiliation(s)
- Toshihide Kubo
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
| | - Mahoko Furujo
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Yuki Hyodo
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Hiroki Tsuchiya
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Mariko Hattori
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Shoko Fujinaga
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Kenji Urayama
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
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Shimodaira M, Hara M, Nakajima S, Tateishi T, Hisata T. The utility of body mass index as an indicator for lipid abnormalities in non-fasting children. J Pediatr Endocrinol Metab 2018; 31:283-288. [PMID: 29373322 DOI: 10.1515/jpem-2017-0522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many studies have reported the association between body mass index (BMI) and fasting lipid profiles in children. However, little information exists about the screening of dyslipidemia in the non-fasted state. This study assessed whether BMI can predict non-fasting lipid abnormalities in children. METHODS Using gender-separated analysis, 3895 boys and 3866 girls (aged 11-12 years) were investigated. Total cholesterol (TC), triglyceride (TG) and HDL-cholesterol (HDL-C) were measured, and non-HDL-C (=TC-[HDL-C]) was calculated. A BMI z-score was employed as the weight status. Gender-specific 95th percentiles of TC, TG and non-HDL-C were defined as "elevated", with the 5th percentiles of HDL-C defined as "reduced". RESULTS TG and non-HDL-C were positively, and HDL-C was negatively correlated with the BMI z-score in both genders. Both obese (2<BMI z-score) and overweight (1<BMI z-score≤2) were associated with the risks of elevated TG, non-HDL-C and reduced HDL-C. In both genders, a receiver operating characteristic curve demonstrated that the utility of predicting the above lipid abnormalities was moderate; the areas under the curve ranged from 0.60 to 0.70. The optimal cut-off for the BMI z-score for predicting elevated TG, non-HDL-C and reduced HDL-C were 0.52, 0.55 and 0.51 in boys and 0.34, 0.38 and 0.35 in girls, respectively. CONCLUSIONS The BMI could be an indicator of abnormalities of non-fasting TG, non-HDL-C and HDL-C in both genders.
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Affiliation(s)
- Masanori Shimodaira
- Department of Internal Medicine, Iida Municipal Hospital, 438 Yawata-machi, Iida, Nagano, 395-8502, Japan
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van der Gaag EJ, Wieffer R, van der Kraats J. Advising Consumption of Green Vegetables, Beef, and Full-Fat Dairy Products Has No Adverse Effects on the Lipid Profiles in Children. Nutrients 2017; 9:E518. [PMID: 28534861 PMCID: PMC5452248 DOI: 10.3390/nu9050518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 11/16/2022] Open
Abstract
In children, little is known about lipid profiles and the influence of dietary habits. In the past, we developed a dietary advice for optimizing the immune system, which comprised green vegetables, beef, whole milk, and full-fat butter. However, there are concerns about a possible negative influence of the full-fat dairy products of the diet on the lipid profile. We investigated the effect of the developed dietary advice on the lipid profile and BMI (body mass index)/BMI-z-score of children. In this retrospective cohort study, we included children aged 1-16 years, of whom a lipid profile was determined in the period between June 2011 and November 2013 in our hospital. Children who adhered to the dietary advice were assigned to the exposed group and the remaining children were assigned to the unexposed group. After following the dietary advice for at least three months, there was a statistically significant reduction in the cholesterol/HDL (high-density lipoproteins) ratio (p < 0.001) and non-HDL-cholesterol (p = 0.044) and a statistically significant increase in the HDL-cholesterol (p = 0.009) in the exposed group, while there was no difference in the BMI and BMI z-scores. The dietary advice has no adverse effect on the lipid profile, BMI, and BMI z-scores in children, but has a significant beneficial effect on the cholesterol/HDL ratio, non-HDL-cholesterol, and the HDL-cholesterol.
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Affiliation(s)
| | - Romy Wieffer
- Isala Zwolle, Dokter van Heesweg 2, Zwolle 8025 AB, The Netherlands.
| | - Judith van der Kraats
- Ziekenhuisgroep Twente, Hengelo, Geerdinksweg 141, Hengelo 7555 DL, The Netherlands.
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