Dyslipidemia and Associated Cardiovascular Risk Factors among Young Nepalese University Students

Dyslipidemia and its associated factors among adult cardiac patients at Ambo university referral hospital, Oromia region, west Ethiopia

BACKGROUND

Cardiovascular disease is a cluster of illnesses that affect the heart and blood vessels. Dyslipidemia is the most common risk factor for cardiovascular disease, causing more than 4 million deaths each year worldwide. However, there is very little evidence concerning the prevalence and pattern of dyslipidemia among cardiac patients in Ethiopia.

METHODS

Hospital-based cross-sectional study was conducted from June to September 2022 at Ambo University referral hospital. Data on socio-demographic, clinical and anthropometric features were collected from adults with cardiac diseases using a convenient sampling technique. Lipid profiles and uric acid were measured from overnight fasting blood. The national cholesterol education program adult treatment panel (NCEP-ATP) III criteria was used to define dyslipidemia.

RESULTS

A total of 269 participants were enrolled and the overall 76.6% [95% confidence interval (CI):72.1-81] of patients had at least one dyslipidemia. The prevalence of total cholesterol (TC) ⩾200 mg/dl, triglyceride (TG), LDL-cholesterol and HDL-cholesterol < 40 mg/dl were 38.9%, 44.6%, 29.4%, and 53.5%, respectively. Age > 54 was associated with TC and TG dyslipidemia, adjusted odds ratio (aOR) and (95% CI) were 2.6(1.4-4.8) and 2.4(1.2-4.7), respectively. While, a family history of heart disease, sedentary lifestyle and obesity were associated with TC dyslipidemia, aOR (95%CI) were 1.9(1.1-3.5), 1.4 (1.4-14.6) and 6.7 (1.4-32.5), respectively. In addition, diabetetes mellitus and abdominal obesity were significantly associated with TG dyslipidemia, aOR (95%CI) were 1.9(1.0-3.6) and 2.6(1.16-5.8), respectively. Moreover, uric acid was positively correlated with TC and TG level.

CONCLUSIONS

The results indicate that more than 75% of the cardiac patients had at least one dyslipidemia. This reflects the need for regular monitoring of lipid profiles and intensive counseling in this population to mitigate further cardio-metabolic complications.

Difficulty of falling asleep and non-high-density lipoprotein cholesterol level among Canadian older adults: a cross-sectional analysis of the Canadian Longitudinal Study for Aging baseline data

OBJECTIVE

To examine whether difficulty of falling asleep (DoFA) is associated with non-high-density lipoprotein cholesterol (non-HDL-C) level among Canadian older adults.

METHODS

26,954 individuals aged 45–85 years from the baseline data of the Canadian Longitudinal Study for Aging were included in this study. DoFA was categorized into five groups by answer to the question “Over the last month, how often did it take you more than 30 min to fall asleep?” Response options are “Never, < 1 time/week, 1−2 times/week, 3−5 times/week, or 6−7 times/week”. Non-HDL-C, the difference of total cholesterol and HDL-C, were categorized into five categories based on these cut-offs (< 2.6 mmol/L, 2.6−3.7 mmol/L, 3.7−4.8 mmol/L, 4.8−5.7 mmol/L, and ≥ 5.7 mmol/L). Ordinal logistic regression (logit link) continuation ratio models were used to estimate the odds of higher non-HDL-C levels for DoFA status. Adjusted means of non-HDL-C by DoFA status were estimated by general linear models. All analyses were sex separately using analytic weights to ensure generalizability.

RESULTS

The proportions of DoFA in five categories were 41.6%, 25.7%, 13.6%, 9.4%, 9.7% for females and 52.9%, 24.9%, 10.5%, 6.1%, 5.6% for males, respectively. After adjustment of demographical and other covariates (such as depression, comorbidity, sleeping hour, etc.) compared to those who reported never having DoFA, the ORs (95% CIs) of higher levels of non-HDL-C for those whose DoFA status in < 1 time/week, 1−2 times/week, 3−5 times/week, and 6−7 times/week were 1.12 (1.05−1.21), 1.09 (0.99−1.18), 1.20 (1.09−1.33), 1.29 (1.17−1.43) in females and 1.05 (0.98−1.13), 0.95 (0.87−1.05), 1.21 (1.08−1.37), 0.97 (0.85−1.09) in males, respectively. The adjusted means of non-HDL-C among the five DoFA status were 3.68 mmol/L, 3.73 mmol/L, 3.74 mmol/L, 3.82 mmol/L, 3.84 mmol/L for females and 3.54 mmol/L, 3.58 mmol/L, 3.51 mmol/L, 3.69 mmol/L, 3.54 mmol/L for males, respectively.

CONCLUSIONS

The results of this study have identified a risk association pattern between DoFA status and non-HDL-C levels in females but not in males. Further research is needed to confirm these findings.

Prevalence of hyperlipidemia and its associated factors in university students in Colombia

The present study aimed to determine the prevalence of hyperlipidemia and its associated factors in the students of the Faculty of Health of Universidad Santiago de Cali in 2017. A descriptive cross-sectional study was performed in a sample of 361 students, with an average age of 21 (16-40) years. A sociodemographic survey was conducted, and blood samples and lipid profiles were obtained. The participants were predominantly female (77%), single (92.5%), and young adults (62.3%) and with an average socioeconomic level (55.1%). The overall prevalence of hyperlipidemia was 33.8%, with the following risk values: triglyceride (TG), 12.8%; hypercholesterolemia, 16.1%; high density lipoprotein cholesterol (cHDL), 15.0%; and low-density lipoprotein cholesterol (cLDL), 42.2%. Using the theory of the logistic regression models and chi-square likelihood ratio tests, the factors that were significantly associated with the risk of hyperlipidemia were male sex and consumption of alcoholic beverages (P-value < 0.05). In the two-way ANOVA, it was observed that the interaction of these two factors for TG was significant (P-value < 0.05), being higher in men who consume intoxicating beverages (Tukey's test, P value <0.05). Regarding cHDL and cLDL, only sex presented a significant effect on their values (P-value < 0.05), while for total cholesterol, none was significant (P-value > 0.05). The results obtained indicate the importance of early detection of blood lipid levels in young people to prevent the early development of noncommunicable diseases.

Management of Dyslipidemia in Individuals with Low-to-Moderate Cardiovascular Risk: Role of Nutraceuticals

Cardiovascular diseases (CVDs) are the leading cause of premature deaths globally and in Ukraine. Dyslipidemia is a recognized risk factor for the development of CVD. Therefore, early detection and appropriate management of dyslipidemia are essential for the primary prevention of CVDs. However, currently, there is a lack of Ukraine-specific guideline recommendations focusing on the management of dyslipidemia in individuals with low-to-moderate CV risk, thus creating an urgent need for structured and easily implementable clinical recommendations/guidelines specific to the country. An expert panel of cardiologists, endocrinologists, and family physicians convened in Ukraine in March 2019. The expert panel critically reviewed and analyzed the current literature and put forth the following recommendations for the management of dyslipidemia in individuals with low-to-moderate risk of CVDs specific to Ukraine: (1) family physicians have the greatest opportunities in carrying out primary prevention; (2) lipid-lowering interventions are essential for primary prevention as per guidelines; (3) a number of nutraceuticals and nutraceutical combinations with clinically established lipid-lowering properties can be considered for primary prevention; they also have a suggested role as an alternative therapy for statin-intolerant patients; (4) on the basis of clinical evidence, nutraceuticals are suggested by guidelines for primary prevention; (5) red yeast rice has potent CV-risk-lowering potential, in addition to lipid-lowering properties; (6) in patients with low-to-moderate cardiovascular risk, a nutraceutical combination of low-dose red yeast rice and synergic lipid-lowering compounds can be used as integral part of guideline-recommended lifestyle interventions for effective primary prevention strategy; (7) nutraceutical combination can be used in patients aged 18 to 75+ years; its use is particularly appropriate in the age group of 18-44 years; (8) it is necessary to attract the media (websites, etc.) to increase patient awareness on the importance of primary prevention; and (9) it is necessary to legally separate nutraceuticals from dietary supplements. These consensus recommendations will help physicians in Ukraine effectively manage dyslipidemia in individuals with low-to-moderate CV risk.

Serum Ischemia-Modified Albumin, Fibrinogen, High Sensitivity C- Reactive Proteins in Type-2 Diabetes Mellitus without Hypertension and Diabetes Mellitus with Hypertension: A Case-Control Study

Background

The objective of this study was to determine the levels of serum ischemia-modified albumin (IMA), fibrinogen (FIB) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) patients with hypertension (HT) (DMT2HTN) and without HT (DMT2). Also, their association with certain biochemical and physical factors were studied to identify possible risk factors that lead to cardiovascular complications.

Methods

Fasting blood samples were collected from 35 DMT2 or DMT2HTN patients each to analyze differences in serum and plasma levels of IMA, hs-CRP, FIB, total cholesterol (TC), high and low density lipoproteins (HDL and LDL), triglyceride (TG), hemoglobin A1c (HbA1C), glycated hemoglobin and creatinine.

Results

In DMT2 and DMT2HTN patients, IMA, hs-CRP, FIB, TC, TG, HDL, LDL, glycated hemoglobin and creatinine levels, including body mass index (BMI) and waist-to-hip ratio (WHR), were significantly higher relative to healthy controls. In addition, the levels of IMA, hs-CRP and FIB levels showed a strong link to BMI, WHR, TC, TG, LDL and glycated hemoglobin. Lastly, both DMT2 and DMT2HTN patients demonstrated a significant reduction in HDL.

Conclusion

DMT2 and DMT2HTN patients have a greater risk of developing cardiovascular related complications. This study suggests that quantifying hs-CRP, IMA and FIB levels can help diagnose the risk of developing complications during the early stages of metabolic and cardiovascular disease. Overall, the specific risk factors may be used for early identification of cardiovascular complications to decrease mortality and morbidity in T2DM patients.

Non-HDL cholesterol level and depression among Canadian elderly—a cross-sectional analysis of the baseline data from the CLSA

To explore whether non-high-density-lipoprotein cholesterol (non-HDL-c) is associated with depression, a total of 26 819 Canadians aged 45–85 from the Canadian Longitudinal Study on Aging (CLSA) were included in analysis. Non-HDL-c, the difference between total-c and HDL-c, was categorized into five levels, i.e., <2.6, 2.6 to <3.7, 3.7 to <4.8, 4.8 to 5.7, and ≥5.7 mmol/L. History of clinical depression was collected by questionnaire at an in-home interview, and current potential depression status was determined by CES-D10 (Center for Epidemiological Studies Depression Scale 10 questions version) score, i.e., ≥10 vs. <10. Logistic continuation ratio model for ordinal data was used to estimate the odds of being at or above a higher non-HDL-c category for depression status. Compared with those without clinical depression history and currently undepressed, the adjusted odds ratios (95% CI) were 1.09 (1.02, 1.17) for those without clinical depression history but currently depressed, 1.05 (0.98, 1.12) for those had clinical depression history but currently undepressed, and 1.21 (1.10, 1.32) for those had clinical depression history and currently depressed. The average of non-HDL-c for four depression groups were 3.64, 3.71, 3.69, and 3.82 mmol/L, respectively, and group 4 was statistically higher than others ( p < 0.001). In conclusion, people with both current depression and a history clinical depression are at an increased risk of having high level of non-HDL-c.