Reference intervals of serum lipid profile in healthy Indian school children and adolescents

ObjectiveTo develop age and sex specific reference intervals of serum lipid parameters in healthy Indian children in the age group of 6–17 years.ParticipantsStudy subjects were selected from the schools of Delhi. Children with BMI either in overweight or obese category were excluded to generate reference intervals. The final analysis included 3076 children with BMI in normal range for age.ResultsThe mean ± SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of lipid parameters are presented. All these parameters were significantly higher in girls than in boys. About 89.2% subjects had total cholesterol in acceptable range while 9.1% had borderline elevated and 1.5% had elevated TC. Optimal serum triglyceride levels were seen in 45.1% subjects while optimal levels of HDL cholesterol were seen in 0.3% subjects only.ConclusionsReference intervals of serum lipid parameters for healthy Indian children (6–17 years) are presented.     

Serum lipoprotein profile in infectious hepatitis.

There is absence of pre-beta and alpha-lipoproteins in the acute stage of infectious hepatitis. With improvement both clinically and biochemically there is appearance of both lipoproteins, with complete reversal to normal lipoprotein pattern in the end.     

Serum lipid and lipoprotein levels in normal Chinese

Serum lipid and lipoprotein levels in normal healthy Chinese adults were determined. The average serum total lipid, cholesterol, triglyceride and phospholipid levels were 568 ± 96, 181 ± 34, 90 ± 35 and 181 ± 28 mg/100 ml, respectively. Serum cholesterol in Chinese appeared to be significantly lower than that in Caucasians. The possible cause of this difference is discussed in terms of variations of dietary intake between these ethnic groups.     

Plasma lipid and lipoprotein profile in elderly female runners

Plasma lipid and lipoprotein profiles were compared in elderly female runners (RU: n= 15, aged 66 ± 5 years, body fat 20 ± 4%, training distance 35 ± 15 km week¹, V?O_2max 36 ± 4 ml kg¹ min¹, mean ± SD) and age-matched untrained women (UT: n= 28, 66 ± 4 years, body fat 26 ± 6%, V?O_2max 26 ± 3 ml kg¹ min¹). There were insignificant differences in total cholesterol (RU: 5·04 ± 0·60 vs. UT: 5·48 ± 0·85 mmol 1¹), HDL-cholesterol (RU: 1·97 ± 0·41 vs. UT: 1·91 ± 0·36 mmol 1¹) and LDL-cholesterol (RU: 2·72 ± 0·59 vs. UT: 3·03 ± 0·80 mmol 1¹) between the two groups. Plasma triglyceride concentration of the runners was significantly lower than that of the untrained women (RU: 0·80 ± 0·27 vs UT: 1·14 ± 0·36 mmol 1¹, P < 0·01). No difference was observed in the LDL-cholesterol/HDL-cholesterol ratio between the two groups (RU: 1·45 ± 0·51 vs UT: 1·64 ± 0·53 units). These results suggest that regularly performed running of 35 km week¹ in elderly women does not further elevate their HDL-cholesterol level which is already high compared to the levels found in elderly men. However, elderly female runners appear to be protected against age-related increases in the levels of triglyceride and LDL-cholesterol.     

Plasma lipid and lipoprotein profile in elderly male long-distance runners

Summary. The purpose of this study was to evaluate plasma lipid and lipoprotein profiles in 30 elderly male long-distance runners (aged 66 ± 5 years, body fat 12 ± 2%, mean ± SD) by comparing them with 30 middle-aged untrained men (43 ±8 years, 17 ±3%), 30 middle-aged endurance-trained men (45 ±8 years, 12 ± 2%) who were matched for training distance to the elderly runners, and 15 elderly sedentary persons (65 ± 4 years, 16 ± 4%). Both elderly and middle-aged runners averaged 43 km/week in the latest year. Maximal oxygen uptake in the elderly runners (48 ± 5 ml/kg/min) was 60% higher than in age-matched untrained men, but 15% lower than in middle-aged runners. Plasma high-density lipoprotein cholesterol (HDLC) was significantly higher in the elderly runners than in their age-matched counterparts (77 vs. 59 mg/dl), but not different from the middle-aged runners. The middle-aged runners had lower plasma low-density lipoprotein cholesterol (LDLC) concentrations than their untrained counterparts (114 vs. 129 mg/dl), whereas LDLC level in the elderly runners was almost identical to that of the age-matched untrained men (127 vs. 119 mg/dl). Total cholesterol concentration in the elderly runners (219 mg/dl) was 11% higher than in the age-matched untrained men, whereas there was no difference between the middle-aged trained and untrained men. The remarkable reduction of the LDLC/ HDLC ratio in the elderly runners, therefore, is attributable to the elevated HDLC rather than lowered LDLC compared with the age-matched sedentary men (1·7 vs. 2·2). The elderly runners had plasma triglyceride concentrations similar to those of the middle-aged runners, and lower than those of the sedentary men. These results suggest that regularly performed endurance exercise favourably modifies the lipid and lipoprotein profile, and may thus reduce the risk of developing coronary heart disease for elderly men.     

A lipid and lipoprotein profile of treated and untreated diabetics.

A group of 149 diabetics and 98 healthy subjects without evidence of diabetes or ischaemic heart disease were studied. Untreated diabetics under 40 years old and 40 years of age and over showed statistically raised fasting serum turbidity, triglycerides, and raised beta and pre-beta lipoprotein levels but not raised cholesterol levels over the age and sex matched normal subjects. Further, some 63% of all diabetics showed a distinct split pre-beta lipoprotein pattern as seen on polyacrylamide disc electrolphoresis as compared with 17% in the control group. Raised lecithin and phosphatidylethanolamine (PE) levels were found in male diabetics and raised PE levels in young diabetic women. In patients under treatment with insulin, chlorpropamide, or phenformin the diabetes was well controlled in most cases, but these patients did not have significantly lower lipid levels. Diabetics on a low carbohydrate diet showed improvement in triglycerides and pre-beta lipoprotein levels, but beta lipoproteins were not lowered. It is suggested that diabetics may benefit by the inclusion of clofibrate in the treatment.     

Serum butyrylcholinesterase activity and phenotype associations with lipid profile in stroke patients

Background

Butyrylcholinesterase (BuChE) catalyzes the hydrolysis of acetylcholine and other choline esters and is also involved in lipid metabolism. The purpose of this study was to investigate any association between BuChE serum phenotype and activity and lipid profile of ischemic stroke patients.

Methods

We determined serum BuChE activities and phenotypes, and levels of total cholesterol (TC), LDL-C, HDL-C and triacylglyerol (TG) in 33 patients with acute ischemic stroke within 12 h of the onset of the attack and 29 controls.

Results

The mean (± SD) serum BuChE activity and the BuChE of U/A phenotype in the stroke individuals were significantly lower and higher than that of the control (315 (± 124) IU/L. vs. 384 (± 99) IU/L, p = 0.02, t = − 2.4 and 21.2% vs.3.4%, p = 0.026 respectively).

Conclusions

Our results showed that a negative correlation between BuChE activity with TC level, in addition the frequency of BuChE phenotypes with low activity is high in stroke patients, who have high levels of cholesterol, may have increased susceptibility to stroke.     

Comparison of parents of children and the elderly in a rural community.

A comparison of parents and the elderly on three variables--support, depression, and satisfaction are presented. The subjects were 201 elderly and 198 parents of children in a rural community. The findings support that the elderly who receive pensions are caring for young children.     

Comparison of the lipid profile and lipoprotein(a) between sedentary and highly trained subjects.

BACKGROUND: There is consolidated evidence that physical activity exerts beneficial effects on several chronic conditions and longevity, on the basis of its proposed biological effects, especially on lipid profiles. However, debate continues regarding the intensity of activity required for good health, as vigorous physical activity might overwhelm advantageous changes. In addition, little is known so far on the effect of a vigorous and regular aerobic training regimen on emerging markers of cardiovascular risk, such as lipoprotein(a), total/high-density lipoprotein cholesterol ratio and the atherogenic index of plasma. METHODS: To further investigate this topic, an extensive lipid profile, in accordance with the most recent guidelines issued by the American Heart Association (AHA)/American College of Cardiology (ACC) and the National Cholesterol Education Program (NCEP), was evaluated in 60 healthy male sedentary controls and in a wide population of professional endurance athletes, including 40 male professional cross-country skiers and 102 male professional road cyclists. RESULTS: Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides, TC low-density lipoprotein cholesterol (LDL-C) ratio and the atherogenic index of plasma were significantly lower in both categories of professional athletes, whereas the mean HDL-C concentration was significantly higher. The concentration of lipoprotein(a) did not differ significantly between the groups. When compared to current NCEP or AHA/ACC goals, the percentage of patients with undesirable values was statistically different for all parameters tested, apart from lipoprotein(a). According to multiple stepwise logistic regression analysis, lower TC/HDL-C ratio in professional skiers and lower TC/HDL-C ratio and TC in professional cyclists were significantly associated with increased aerobic physical activity. CONCLUSIONS: Results of this case-control study confirm that elevated aerobic energy expenditure might be associated with a highly favorable stabilization of most traditional and emerging cardiovascular risk predictors. Therefore, a substantial increase in aerobic physical activity within the population might be recommended to reverse adverse lipid abnormalities, especially in subjects with a higher cardiovascular risk.     

Clinical profile of rural community hospital inpatients in Sweden – a register study

ObjectivePatients in Sweden’s rural community hospitals have not been clinically characterised. We compared characteristics of patients in general practitioner-led community hospitals in northern Sweden with those admitted to general hospitals.DesignRetrospective register study.SettingCommunity and general hospitals in Västerbotten and Norrbotten counties, Sweden.PatientsPatients enrolled at community hospitals and hospitalised in community and general hospitals between 1 January 2010 and 31 December 2014.Outcome measuresAge, sex, number of admissions, main, secondary and total number of diagnoses.ResultsWe recorded 16,133 admissions to community hospitals and 60,704 admissions to general hospitals. Mean age was 76.8 and 61.2 years for community and general hospital patients (p < .001). Women were more likely than men to be admitted to a community hospital after age adjustment (odds ratio (OR): 1.11; 95% confidence interval (CI): 1.09–1.17). The most common diagnoses in community hospital were heart failure (6%) and pneumonia (5%). Patients with these diagnoses were more likely to be admitted to a community than a general hospital (OR: 2.36; 95% CI: 2.15–2.59; vs. OR: 3.32: 95% CI: 2.77–3.98, respectively, adjusted for age and sex). In both community and general hospitals, doctors assigned more diagnoses to men than to women (both p<.001).ConclusionsPatients at community hospitals were predominantly older and women, while men were assigned more diagnoses. The most common diagnoses were heart failure and pneumonia. Our observed differences should be further explored to define the optimal care for patients in community and general hospitals.

Key points

• The patient characteristics at Swedish general practitioner-led rural community hospitals have not yet been reported. This study characterises inpatients in community hospitals compared to those referred to general hospitals.
  • • Patients at community hospitals were predominantly older, with various medical conditions that would have led to a referral to general hospitals elsewhere in Sweden.
  • • Compared to men, women were more likely to be admitted to community hospitals than to general hospitals, even after adjustment for age. To the best of our knowledge, this pattern has not been reported in other countries with community hospitals.
  • • In both community hospitals and general hospitals, doctors assigned more diagnoses to men than to women.

     

Serum lipoprotein profile in patients with cancer. A comparison with non-cancer subjects

The association of cancer with low serum total cholesterol is well established. Less clear is the relationship of cancer with the cholesterol distribution among the different lipoprotein classes. Conflicting results have been reported on low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and serum triglyceride levels in different types of tumor. Total serum cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and serum triglycerides were analyzed in 530 patients with newly diagnosed cancer (97 with hematological malignancies, 92 with tumor of the lung, 108 of the upper digestive system, 103 of colon, 32 of breast, and 98 of the genitourinary system) and in 415 non-cancer subjects. Anthropometric (body mass index) and biochemical (serum albumin) indices of nutritional status were also determined in all subjects. Total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, serum albumin, and body mass index were significantly lower in cancer than in non cancer-subjects. The lowest values of total cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were recorded in patients with hematological malignancies and the highest in patients with breast tumor. All the cancer groups, with the exception of women with breast cancer, showed significantly lower total cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol than age- and sex-matched non-cancer subjects. Multiple regression analysis with low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides as dependent variables and sex, age, body mass index, albumin, and cancer (dummy variable) as independent variables, showed that cancer was independently associated with low levels of low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol and with high values of serum triglycerides. Total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, serum triglycerides, body mass index and serum albumin were significantly lower in patients with metastatic than in patients with non-metastatic solid tumor. The significant difference in low-density lipoprotein-cholesterol and serum triglycerides between patients with metastatic and non-metastatic cancer was lost when lipoprotein cholesterol and serum triglyceride levels were adjusted for nutritional variables. The lipid profile in cancer patients is characterized by low low-density lipoprotein-cholesterol, low high-density lipoprotein-cholesterol and relatively high serum triglycerides. The abnormality is a common feature of both hematological and solid tumors and is not entirely explained by poor nutrition.     

Hypertension,lipoprotein subclasses and lipid transfer proteins in obese children and adolescents

Background: Obesity-related childhood hypertension is associated with disturbances of serum lipids, but less is known about distribution of lipoprotein subclasses and activities of proteins involved in reverse cholesterol transport in hypertensive obese children. Our objective was to determine low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subclasses distribution and activities of lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) in hypertensive and non-hypertensive obese children.

Methods: A total of 40 hypertensive and 25 non-hypertensive obese children were enrolled. Lipoprotein subclasses were assessed by polyacrylamide gradient gel electrophoresis. LCAT and CETP activities were determined as a rate of formation and a rate of transfer of cholesteryl esters.

Results: Despite of comparable values of serum lipid parameters, a shift toward smaller LDL and HDL subclasses was observed in hypertensive compared to normotensive obese children. Activities of LCAT were similar, but proatherogenic CETP activities were significantly higher in the hypertensive group (p?= 0.036). LCAT/net CETP ratio inversely correlated with relative proportion of small, dense LDL particles (ρ =??0.423; p?= 0.025) in the group with hypertension.

Conclusions: The results of our study demonstrated a tendency toward altered distribution of lipoprotein subclasses in favor of more proatherogenic particles in childhood hypertension. Also, hypertensive obese children had increased proatherogenic CETP activity.     

Managing osteoporosis in a rural community

Managing long-term conditions, such as osteoporosis in a rural community, presents particular challenges. This article describes how a specialist service identified patients at high risk of fragility fracture and raised awareness of bone health.     

Teen sexuality in a rural community

A survey of adolescents and adults was conducted to assess the causes of the teen pregnancy problem in one rural community. Thirty teens and 34 adults were interviewed and asked to respond to questions related to teen sexuality/pregnancy. The goal of the analysis was to determine differences between and similarities among adults' and teens' perceptions of teen sexuality. Results showed few significant differences between the two groups. Nonsignificance, therefore, was significant.     

Lipid values in a rural community

In 1987 the population of a rural community in Tyrol aged 20 to 74 years was screened for plasma lipids (cholesterol, HDL cholesterol and triglycerides). The mean cholesterol value was 205.8 mg/dl (5.31 mml/l) in men and 207.9 mg/dl (5.37 mmol/l) in women. These values seem to be the lowest so far recorded for population-based cholesterol values in Austria. This might be partly explained by an intensive risk factor intervention programme which has been implemented in this community throughout the past ten years. HDL cholesterol was significantly higher in women (63.7 mg/dl or 1.64 mmol/l) than in men (51.1 mg/dl or 1.32 mmol/l). The opposite was true for non-fasting triglycerides, with mean values of 186.3 mg/dl (2.1 mmol/l) in men, and 122.1 mg/dl (1.4 mmol/l) in women.     

Serum lipid profile,oxidative status,and paraoxonase 1 activity in hyperemesis gravidarum

The aim of this study was to investigate lipid profile, paraoxonase 1 (PON1) activity, and oxidative stress status in the serum of hyperemesis gravidarum (HG) patients. Thirty‐six HG cases and 36 normal pregnants were included in the study. Serum total cholesterol (TC), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), apoproteins A1 (apo A1) and B (apo B), malondialdehyde (MDA), and total antioxidant activity (TAO) values and PON1 and arylesterase activities were determined. Although serum TC, TG, LDL‐C, and apo B levels were not different among; the groups (P>0.05), HDL‐C (P=0.01) and apo A1 (P=0.007) levels were lower in HG patients than in normal pregnants. HG group had significantly lower serum PON1 (P=0.03) and arylesterase activities (P=0.03) compared with the control group. Additionally, mean TAO values were lower (P=0.01) and MDA levels were higher (P=0.02) in HG group than in the healthy pregnants. A significant negative correlation between PON1 and MDA was found in HG group (r=?0.33, P<0.05). The findings of this study have revealed that HG may be one of the conditions in which oxidant and antioxidant balance is impaired. J. Clin. Lab. Anal. 23:105–109, 2009. © 2009 Wiley‐Liss, Inc.     

Insulin and HOMA in Spanish prepubertal children: relationship with lipid profile

OBJECTIVE: The effects of insulin or insulin resistance on the lipid profile seem to change with age. The aim of this study was to analyze insulin levels and an insulin resistance index and to investigate the relationship between these and the lipid profile in a population-based sample of Spanish prepubertal children. METHODS: 1048 (524 boys and 524 girls) randomly selected prepubertal children were studied. Children were 6 to 8 years old with a mean age of 6.7. Plasma lipid, FFA and insulin levels were measured. The homeostatic model assessment (HOMA) was calculated as an indicator of insulin resistance. RESULTS: When analyzing percentile values of insulin, HOMA and FFA by sex, we observed that girls had significantly higher insulin concentrations than boys (except at the 10th percentile) and significantly higher FFA (except at the 90th percentile) with no significant differences between sexes for HOMA. Multivariate regression analyses showed that insulin was positively associated with glucose, triglycerides and apoB in boys but not in girls, and negatively associated with FFA in both genders. CONCLUSIONS: We report here data about the distribution of insulin in the Spanish prepubertal population. The higher levels of insulin in prepubertal girls could indicate that girls start to be more insulin resistant than boys at this age, although other manifestations of insulin resistance are not yet detectable.