The association between eosinophil count,serum lipids and metabolic syndrome in Taiwanese

BackgroundEosinophil count, dyslipidemia, and metabolic syndrome (MetS) are associated with systemic inflammation. We conducted this large population-based study to investigate the association between elevated eosinophil count, serum lipids, and MetS in the Taiwanese population.MethodsA cross-sectional study of 10,357 adults who underwent health checkups at Shin Kong Wu Ho-Su Memorial Hospital in Taiwan between January 2006 and December 2016 was conducted. MetS was defined according to criteria modified by the International Diabetes Federation specifically for the Chinese population. The measurement of serum lipids included high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (ApoA-I), and apolipoprotein B (ApoB). Pearson's correlation and linear regression were used to determine the association of eosinophil count with waist circumference, blood pressure, fasting glucose, and serum lipids. Multivariate logistic regression analysis was used to determine the odds ratio of MetS and abnormal serum lipid levels in each eosinophil count quartile.ResultsEosinophil count was positively associated with triglycerides levels and negatively associated with HDL-C levels; however, it was not significantly associated with ApoA-I and ApoB. The odds ratio of MetS increased significantly across eosinophil count quartiles. The adjusted odds ratios of MetS for the second, third, and fourth quartiles were 1.28, 1.38, and 1.42, respectively, with reference to the first quartile.ConclusionsHigh eosinophil count is an independent risk factor for MetS. Hypertriglyceridemia and hypo-HDL-cholesterolemia might partly contribute to this result.     

Relation of cholesterol and lipoprotein parameters with carotid artery plaque characteristics: the Atherosclerosis Risk in Communities (ARIC) carotid MRI study

Objective

There is a paucity of data regarding relations of apolipoproteins (apolipoprotein B [ApoB] and apolipoprotein A-1 [Apo A-1]), lipoprotein particle measures (low-density lipoprotein particle concentration [LDLp] and high-density lipoprotein particle concentration [HDLp]), and lipoprotein cholesterol measures (low-density lipoprotein cholesterol [LDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and high-density lipoprotein cholesterol [HDL-C]) with atherosclerotic plaque burden, plaque eccentricity, and lipid-rich core presence as a marker of high-risk plaques.

Methods

Carotid artery magnetic resonance imaging was performed in 1670 Atherosclerosis Risk in Communities study participants. Vessel wall and lipid cores were measured; normalized wall index (NWI), standard deviation (SD) of wall thickness (measure of plaque eccentricity) were calculated; and lipid cores were detected in vessels with ≥1.5 mm thickness. Fasting concentrations of cholesterol, ApoB and Apo A-1, and LDLp and HDLp were measured.

Results

Measures of plaque burden (carotid wall volume, wall thickness, and NWI) were positively associated with atherogenic cholesterol and lipoproteins (p < 0.05 for total cholesterol, LDL-C, non-HDL-C, ApoB, and LDLp), but not with HDL-C, Apo A-1, or HDLp. SD of wall thickness was associated with total cholesterol (p 0.01) and non-HDL-C (p 0.02). Although measures of atherogenic or anti-atherogenic cholesterol or lipoprotein were not individually associated with detection of a lipid-rich core, their ratios (total cholesterol/HDL-C, non-HDL-C/HDL-C, and LDLp/HDLp) were associated with lipid-rich core presence (p ≤ 0.05).

Conclusion

Extent of carotid atherosclerosis is associated with atherogenic cholesterol and lipoproteins. Atherogenic/anti-atherogenic cholesterol or particle ratios were associated with presence of a detectable lipid-rich core.     

Non-traditional lipid profiles and the risk of stroke: A systematic review and meta-analysis

AimsAn increasing number of studies on non-traditional lipid profiles have been investigated in recent years. However, the associations between non-traditional lipid profiles and the risk of stroke remained inconsistent. Therefore, this meta-analysis aimed to evaluate the associations between non-traditional lipid profiles and the risk of stroke and clarify the dose–response relations.Data synthesisWe performed a systematic literature search in PubMed, Embase, and Web of Science databases until 1 November 2022 for relevant studies. Relative risks and 95% confidence intervals were pooled by random-effects or fixed-effects models. A total of 26 full-text studies with 676678 participants and 18057 stroke cases were eligible for the final study. We found a positive association between the risk of stroke and total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio (RR = 1.19,95%CI = 1.00–1.40, I² = 74.6%), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio (RR = 1.24,95%CI = 1.10–1.41, I² = 62.8%) or low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio (RR = 1.24, 95%CI = 1.11–1.39, I² = 49.4%). When focusing on the stroke subtype, a more significant association was observed between the risk of ischemic stroke and four non-traditional lipid profiles. In dose–response analysis, we found a linear association between TC/HDL-C ratio and the risk of stroke (RR = 1.16,95%CI = 1.07–1.26).ConclusionsElevated non-traditional lipid profiles were associated with an increased risk of ischemic stroke. The linear association showed the risk of stroke increased by 16% when the pooled RR of TC/HDL-C ratio per 1-unit increased.Registration number in prosperoCRD42022321251.     

Association of non-HDL-C/HDL-C ratio and its dynamic changes with incident type 2 diabetes mellitus: The Rural Chinese Cohort Study

BackgroundWe aimed to evaluate the association of the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and its dynamic changes with incident type 2 diabetes mellitus (T2DM).MethodsA total of 11,487 nondiabetic participants ≥18 years old in rural China were recruited in 2007–2008 and followed up in 2013–2014. A Cox proportional-hazards model was used to assess the risk of incident T2DM by quartiles of baseline non-HDL-C/HDL-C ratio and dynamic absolute and relative changes in non-HDL-C/HDL-C ratio, estimating hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsRisk of incident T2DM was increased with quartiles 2, 3, and 4 versus quartile 1 of baseline non-HDL-C/HDL-C ratio (HR 1.46 [95% CI 1.08–1.98], 1.51 [1.12–2.03], and 2.16 [1.62–2.88], P_trend < 0.001). As compared with stable non-HDL-C/HDL-C ratio during follow-up, an absolute gain in non-HDL-C/HDL-C ratio was associated with increased risk of T2DM (HR 1.67 [95% CI 1.25–2.24] for quartile 3 and 2.00 [1.52–2.61] for quartile 4). A relative increase in non-HDL-C/HDL-C ratio was also associated with increased risk of T2DM (HR 1.56 [95% CI 1.19–2.04] for quartile 3 and 1.97 [1.49–2.60] for quartile 4). Subgroup analyses showed that the association of non-HDL-C/HDL-C ratio with T2DM risk remained consistent.ConclusionsIncreased non-HDL-C/HDL-C ratio is associated with increased risk of incident T2DM among rural Chinese adults, so the index may be an important indicator for identifying individuals at T2DM risk.     

Differential effects of hyperhomocysteinemia on the lipid profiles and lipid ratios between patients with and without coronary artery disease: A retrospective observational study

This study aimed to investigate the differential effects of hyperhomocysteinemia (HHcy) on lipid profiles and lipid ratios between patients with coronary artery disease (CAD) and without CAD. The data of 872 CAD patients and 774 non-CAD controls were extracted from the information system of hospitalized patients. Serum homocysteine (Hcy), total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) AI, and ApoB concentrations were detected. HHcy was defined as a serum level of Hcy ≥ 15 μmol/L. The CAD patients had lower levels of HDL-C and ApoAI and higher levels of Hcy than the controls (P < .05). Serum TGs and HDL-C were negatively correlated with Hcy in controls. Serum HDL-C and ApoAI were negatively correlated with Hcy, and the ratios of TC/HDL-C, TG/HDL-C, LDL/HDL-C, and ApoB/ApoAI were positively correlated with Hcy in the CAD patients (P < .05). Although the trends for HHcy to decrease the lipid profiles were not different between the CAD and controls (P_interaction > 0.05), CAD with HHcy had lower HDL-C and ApoAI levels than those of subjects with normal Hcy; controls with HHcy had lower TC, LDL-C, and ApoB levels than those of subjects with normal Hcy (P < .05). There were different HHcy trends affecting the ratios of TC/HDL-C and LDL/HDL-C between the CAD patients and controls (P_interaction for TC/HDL-C = 0.025; P_interaction for LDL/HDL-C = 0.033). CAD patients with HHcy had a higher ratio of TC/HDL-C (P = .022) and LDL/HDL-C (P = .045) than those of patients with normal Hcy, but in the controls, the subjects with HHcy exhibited a trend toward a decreased ratio of TC/HDL-C (P = .481) and LDL/HDL-C (P = .303). There were differential effects of HHcy on the lipid ratios between CAD and non-CAD patients. HHcy was related to higher ratios of TC/HDL-C and LDL/HDL-C in patients with CAD.     

Apolipoproteins, cardiovascular risk and statin response in type 2 diabetes: the Collaborative Atorvastatin Diabetes Study (CARDS)

Aims/hypothesis  Controversy surrounds whether the ratio of apolipoprotein B (ApoB) to apolipoprotein A-I (ApoA-I) is the best lipoprotein discriminator of CHD risk in non-diabetic populations, but the issue has never been investigated in type 2 diabetes. Methods  In 2,627 participants without known vascular disease in the Collaborative Atorvastatin Diabetes Study, ApoB, ApoA-I, LDL-cholesterol (LDLC) and HDL-cholesterol (HDLC) were assayed at baseline. Results  There were 108 CHD and 59 stroke endpoints over 3.9 years. The ApoB:A-I ratio at baseline was the lipoprotein variable most closely predicting CHD risk both by comparison of the hazard ratio for a 1 SD change or tertiles of frequency distribution. The areas under the receiver–operator curve for the ApoB:ApoA-I and the LDLC to HDL-HDLC ratios, although not significantly different from each other, were greater (p = 0.0005 and p = 0.0125 respectively) than that of non-HDLC:HDLC. The 27% decrease in the ApoB:ApoA-I ratio on atorvastatin predicted a 32% (95% CI 5.4–51.2%) risk reduction in CHD, close to the 36% decrease observed. Neither the ApoB:ApoA-I nor any other lipoprotein concentration or ratio predicted the stroke outcome. Conclusions/interpretation  Overall, the ApoB:ApoA-I ratio improved on the non-HDLC:HDLC ratio in predicting CHD, but, depending on the assessment chosen, its superiority over LDLC:HDLC may be marginal. The statin-induced decrease in stroke risk may not be lipoprotein mediated. Trial registration: ClinicalTrials.gov NCT00327418 Funding: The study was supported by unrestricted grants from Diabetes UK, the Department of Health and Pfizer to the University of Manchester and to University College, London. An erratum to this article can be found at     

Interrelationships among common predictors of cardiovascular diseases in patients of OSA: A large-scale observational study

Background and aimsThe apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) and insulin resistance has been recognized as common cardiovascular diseases (CVD) risk factors. However, whether they were biomarkers for 10-year CVD risk in obstructive sleep apnea (OSA) had been rarely studied. Besides, interrelationships between the ApoB/ApoA-I, insulin resistance and OSA remain unclear.Methods and resultsA total of 4010 subjects were finally included. Anthropometric, fasting biochemical, and polysomnographic parameters were collected. 10-year Framingham CVD risk score (FRS) was calculated for each subjects. The relationships between insulin resistance, OSA risk and the ApoB/ApoA-I was evaluated through logistic regressions analysis, restricted cubic spline (RCS) analysis and mediation analysis. ApoB/ApoA-I, HOMA-IR and AHI were all risk factors for high10-year CVD risk as assessed by FRS (odds ratios (OR) = 5.365, 1.094, 1.010, respectively, all P < 0.001)). The fully adjusted OR (95% confidence intervals) for both OSA [1 (reference), 1.308 (1.027–1.665), 1.517 (1.178–1.953), and 1.803 (1.371–2.372)] and insulin resistance [1 (reference), 1.457 (1.173–1.711), 1.701 (1.369–2.113), 2.051(1.645–2.558)] increased from the first to the fourth quartiles of the ApoB/ApoA-I. The RCS mapped a nonlinear dose–effect relationship between the ApoB/ApoA-I and risk of insulin resistance and OSA. Mediation analyses showed HOMA-IR explain 9.7%, 4.7% and 10.8% of the association between apnea-hypopnea index, oxygen desaturation index, micro-arousal index and ApoB/ApoA-I, respectively.ConclusionsOur study revealed that ApoB/ApoA-I, insulin resistance and OSA were risk factors for CVD. Insulin resistance may serve as a potential mediator in OSA-related lipoprotein disorders and further increase CVD risk.     

Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes

Aims/hypothesis  

The apolipoprotein B (ApoB):apolipoprotein A (ApoA)-I ratio may be a better indicator of cardiovascular disease (CVD) risk in people with type 2 diabetes than traditional lipid risk markers (LDL-cholesterol, HDL-cholesterol and triacylglycerol), but whether the ApoB:ApoA-I ratio should be used to indicate lipid-lowering therapy is still debated.     

Usefulness of lipoprotein ratios in assessing carotid atherosclerosis in Japanese type 2 diabetic patients

ObjectiveIt is indicated that total/HDL cholesterol and LDL/HDL cholesterol ratios have more predictive power for cardiovascular disease compared to classic lipid parameters. However, there have been few reports about the usefulness of these indices for the assessment of early stage atherosclerosis in Japanese type 2 diabetic subjects.MethodsWe examined the relation between various lipid parameters and carotid atherosclerosis in 934 type 2 diabetic subjects without apparent atherosclerotic diseases (males, 71.7%; age, 59.6 ± 10.5 years (mean ± SD)). Serum concentrations of total cholesterol (TC), HDL cholesterol (HDL-C), and triglyceride were measured. LDL cholesterol (LDL-C) level was calculated using the Friedewald formula. The presence of carotid plaque and intima-media thickness (IMT) were evaluated by ultrasonography.ResultsA stepwise multivariate regression analysis demonstrated that HDL-C (β = ?0.110, p < 0.001), TC/HDL-C (β = 0.132, p < 0.001) and LDL-C/HDL-C ratios (β = 0.132, p < 0.001) were independent determinants of IMT even after adjustment of other conventional risk factors. However, there was no significant correlation between IMT and TC, triglyceride, LDL-C, and non-HDL-C levels. TC/HDL-C and LDL-C/HDL-C ratios and non-HDL-C levels were significantly higher, but HDL-C levels were significantly lower in patients with carotid plaque than those without it (p < 0.05). There was no significant difference between the groups regarding TC, LDL-C, and triglyceride levels. Furthermore, TC/HDL-C (OR; 1.34, p < 0.001) and LDL-C/HDL-C (OR; 1.54, p < 0.001) ratios showed a positive and linear relationship with the prevalence of carotid plaque, whether covariates were adjusted or not.ConclusionsTC/HDL-C and LDL-C/HDL-C ratios are useful as a tool to assess the risk of early stage atherosclerosis in Japanese type 2 diabetic patients.     

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

Aims/hypothesis Measurement of plasma apolipoprotein (Apo) B may improve prediction of cardiovascular risk, as it provides a measure of the total number of atherogenic particles. The aim of this population-based study was to compare the association of non-HDL-cholesterol, ApoB and the ApoB:ApoA-I ratio with cardiovascular mortality in people with type 2 diabetes.Subjects and methods We assessed the association of lipids, lipoprotein lipids and apolipoproteins with 11-year mortality from cardiovascular disease in the population-based cohort of the Casale Monferrato Study (1,565 people with diabetes; median age 68.9 years), and determined the effect of age (≤70 and >70 years) on these relationships.Results On the basis of 341 deaths from cardiovascular disease in 10,809 person-years of observation, there was a decreasing trend in risk adjusted for multiple factors across quartiles of total cholesterol, and LDL- and non-HDL-cholesterol in people aged >70 years, but no trend in those aged ≤70 years. Age did not affect the protective effect of HDL-cholesterol. ApoB and ApoB:ApoA-I were associated with outcome in people in both age groups independently of non-HDL-cholesterol. After adjustment for multiple factors, including non-HDL-cholesterol, the hazard ratios for ApoB:ApoA-I in the upper vs lower quartile were 2.98 (95% CI 1.15–7.75; p for trend=0.009) for people aged ≤70 years and 1.94 (95% CI 1.20–3.13; p for trend=0.003) for those aged >70 years.Conclusions/interpretation In this cohort of Mediterranean subjects with diabetes, ApoB and the ApoB:ApoA-I ratio were associated with cardiovascular disease mortality independently of non-HDL-cholesterol. Our findings support the recommendation that ApoB and ApoA-I should be measured routinely in all people with diabetes, particularly in the elderly.     

A Comparison of Lipids and apoB in Asian Indians and Americans

Background and aims:Apolipoprotein B (apoB) integrates and extends the information from the conventional measures of atherogenic cholesterol and triglyceride. To illustrate how apoB could simplify and improve the management of dyslipoproteinemia, we compared conventional lipid markers and apoB in a sample of Americans and Asian Indians.Methods:Data from the US National Health and Nutrition Examination Survey (NHANES) (11,778 participants, 2009–2010, 2011–2012), and the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) cohort study in Delhi, India (4244 participants), 2011 were evaluated. We compared means and distributions of plasma lipids, and apo B using the Mann–Whitney U test and Fisher’s exact test. A p value of < 0.05 was considered significant.Results:The plasma lipid profile differed between Asian Indians and Americans. Plasma triglycerides were greater, but HDL-C lower in Asian Indians than in Americans. By contrast, total cholesterol, non-HDL-C, and LDL-C were all significantly higher in Americans than Asian Indians. However, apoB was significantly higher in Asian Indians than Americans. The LDL-C/apoB ratio and the non-HDL-C/apoB ratio were both significantly lower in Asian Indians than Americans.Conclusion:Whether Americans or Asian Indians are at higher risk from apoB lipoproteins cannot be determined based on their lipid levels because the information from lipids cannot be integrated. ApoB, however, integrates and extends the information from triglycerides and cholesterol. Replacing the conventional lipid panel with apoB for routine follow ups could simultaneously simplify and improve clinical care.     

Influence of triglyceride concentration on the relationship between lipoprotein cholesterol and apolipoprotein B and A-I levels

A sample of 2,103 men aged 47 to 76 years from the Québec Cardiovascular Study cohort was examined to quantify the influence of plasma triglyceride (TG) levels on the relationship between plasma lipoprotein cholesterol and either apolipoprotein A-I (apo A-I) or apo B concentrations. Regression analyses between high-density lipoprotein cholesterol (HDL-C) and apo A-I through TG tertiles showed highly significant correlations (.62 < or = r < or = .75, P < .0001) in all TG tertiles between these 2 variables. The associations for plasma apo B versus low-density lipoprotein cholesterol (LDL-C) and non-HDL-C levels were also studied on the basis of TG concentrations, and correlation coefficients between either LDL-C or non-HDL-C and apo B were essentially similar among TG tertiles (.78 < or = r < or = .85 and .83 < or = r < or = .86 for LDL-C and non-HDL-C, respectively, P < .0001). Regression analyses also showed that lower HDL-C levels were found for any given apo A-I concentration among men in the 2 upper TG tertiles, whereas lower LDL-C concentrations were observed at any given apo B level among subjects in the upper TG tertile. We further investigated whether there were synergistic alterations in the HDL-C/apo A-I and LDL-C/apo B ratios as a function of increasing plasma TG. A significant association was noted between these 2 ratios (r = .37; P < .0001). Mean HDL-C/apo A-I and LDL-C/apo B ratios were then calculated across quintiles of plasma TG concentrations. Increased TG concentrations were first associated with a reduced HDL-C/apo A-I ratio, followed by a decreased LDL-C/apo B ratio. These results suggest that a relatively modest increase in TG may rapidly alter the relative cholesterol content of HDL particles. Finally, the cholesterol content of the non-HDL fraction appears to be influenced less by TG levels than HDL-C and LDL-C fractions. Thus, the plasma apo B-containing lipoprotein cholesterol level may provide a better index of number of atherogenic particles than the LDL-C concentration, particularly in the presence of hypertriglyceridemia (HTG).     

Relationship between ApolipoproteinB 100/ApoA1 ratio and coronary artery disease in elderly

Background Less studies were done to compare the lipid ratios including ApoB100 / ApoA1, LDL-C / HDL- C,TC / HDL-Cin elderly. So the study was to investigate the relationship between Apolipoprotein B100 / ApoA1 ratio and coronary artery disease (CAD) in elderly. Methods 498 participants aged over 65 years with chest pain had been subsumed from Sep. 2009 to April 2011 of Guangdong General Hospital. Clinic informations of gender, age, history of hypertension, diabetes mellitus, smoking was collected. Simultaneously, serum lipids should be phlebotomized in 24 hours after be inpatient. ApoB100 / ApoA1 ratio, LDL-C / HDL-C ratio. TC / HDL-C ratio, non-HDL-C were calculated using the above data. Accroding to the mean of ApoB100 / ApoA1 ratio, ApoB100, non-HDL-C, all individuals were divided into two groups: high level group and low level group, while all individuals were divided into two groups whether the level of LDL-C was achieve 2.06 mmol / L. We classified the participants into CAD group and non-CAD group on the basis of CAG. The incidence of CAD was compared between the two groups of four different lipid indicators. The ability of estimating CAD was described by Reciever Operating Characteristic curve(ROC curve). Result There were significantly statistical differences in the incidence of CAD between the high level group and low level group of ApoB100 / ApoA1 ratio (75.0% vs. 55.9%, χ2 = 19.681, P < 0.001). By logistic regression analysis, odds ratio of ApoB100 / ApoA1 ratio was 2.142, 95% CI (1.437, 3.195)(P < 0.001). The AUC (area under curve) of ApoB100 / ApoA1 ratio were 0.66. There were significant for diagnosis of CAD (P < 0.001). Conclusion The ApoB100 / ApoA1 ratio was an independent risk factor of CAD in elderly population, and it is better than traditional lipid indicators, and can be used for the ability of estimating CAD.     

Association of glycosylated hemoglobin level with lipid ratio and individual lipids in type 2 diabetic patients

ObjectiveTo study the correlation of lipid ratios and individual lipid indexes of patients with type 2 diabetes with glycosylated hemoglobin (HbA_1c).MethodsSamples were collected from 128 type 2 diabetic patients (aged 19–90 years; male 72, female 56). The sera were analyzed for HbA_1c, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). According to the HbA_1c level, the patients were divided into three groups, group A (HbA_1c <7%, n=31), group B (7%?HbA_1c?10%, n=48), and group C (HbA_1c >10%, n=49). The correlation of HbA_1c with lipid ratios &; individual lipid indexes were analyzed.ResultsWith the increased level of HbA_1c, LDL-C had a significantly increasing trend (P<0.05); whereas TC went up with the increased HbA_1c, without any significant differences between three groups. There was no significant correlation between HbA_1c and TG or HDL-C. With the increased level of HbA_1c, TC/HDL-C, LDL-C/HDL-C ratios were gradually increased, with significant differences among groups (P<0.05). The lipid ratios, especially LDL-C/HDL-C ratio was more susceptible to impaired lipid metabolism in T2DM patients than individual lipid.ConclusionsLDL-C/HDL-C ratio is helpful in assessing and reducing the risk of cardiovascular disease caused by impaired lipid metabolism in type 2 diabetic patients.     

Efficacy and Safety of Tolvaptan in Heart Failure Patients with Sustained Volume Overload despite the Use of Conventional Diuretics: A Phase III Open-Label Study

Objective  

The objective of this study was to assess the proportion of patients with type 2 diabetes mellitus (T2DM) attaining individual and combined targets of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), non-HDL-C, and apolipoprotein B (ApoB) after treatment with rosuvastatin (R) + fenofibric acid (FA) compared with corresponding-dose R monotherapy.     

Lipid ratio useful indicator in predicting risk of myocardial infarction in elderly normolipidemic patients: a report from a multi center study

ObjectiveTo evaluate the usefulness of lipid ratios in predicting coronary heart disease risk in normolipidaemic myocardial infarct (MI) patients and compare the findings with healthy controls.MethodsLipid profile was determined in 1 021 normolipidaemic myocardial infarct patients and was compared with 1 021 age/sex-matched controls. Total cholesterol (TC), triglycerides (TG) and HDL-cholesterol (HDL-C) were analyzed enzymatically using kits obtained from Randox Laboratories Limited, Crumlin, UK. Plasma LDL-cholesterol (LDL-C) was determined from the values of TC and HDL-C using the friedwald's formula. The values were expressed as mean±SD and data from patients and controls were compared using students' t-test.ResultsTC, TC/HDL-C ratio, TG, LDL-C, LDL-C/HDL-C ratio were higher in MI patients (P<0.001). HDL-C concentration was significantly lower in MI patients than controls (P<0.001). Higher ratio of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C was observed in acute myocardial infarct patients as compared with controls.ConclusionsEstablishment of lipid ratio from routine lipid profile assay could be very useful in predicting the future risk of acute mocardial infarction.     

Interactions of the apolipoprotein C-Ⅲ3238C>G polymorphism and alcohol consumption on serum triglyceride levels

Objectives Both apolipoprotein(Apo)C-Ⅲgene polymorphism and alcohol consumption have been associated with increased serum triglyceride(TG) levels,but their interactions on serum TG levels are not well known.The present study was undertaken to detect the interactions of the ApoC-Ⅲ3238C>G(rs5128) polymorphism and alcohol consumption on serum TG levels.Methods A total of 516 unrelated nondrinkers and 514 drinkers aged 15-89 were randomly selected from our previous stratified randomized cluster samples. Genotyping of the ApoC-Ⅲ3238C>G was performed by polymerase chain reaction and restriction fragment length polymorphism combined with gel electrophoresis,and then confirmed by direct sequencing.Interactions of the ApoC-Ⅲ3238C>G genotype and alcohol consumption was assessed by using a cross-product term between genotypes and the afore-mentioned factor.Results Serum total cholesterol(TC), TG,high-density lipoprotein cholesterol(HDL-C),ApoA-I and ApoB levels were higher in drinkers than in nondrinkers (P<0.05-0.001).There was no significant difference in the genotypic and allelic frequencies between the two groups. Serum TG levels in nondrinkers were higher in CG genotype than in CC genotype(P<0,01).Serum TC,TG,low-density lipoprotein cholesterol(LDL-C) and ApoB levels in drinkers were higher in GG genotype than in CC or CG genotype(P<0.01 for all).Serum HDL-C levels in drinkers were higher in CG genotype than in CC genotype(P<0.01).Serum TC, TG,HDL-C and ApoA-I levels in CC genotype,TC,HDL-C, ApoA-I levels and the ratio of ApoA-I to ApoB in CG genotype, and TC,TG,LDL-C,ApoA-I and ApoB levels in GG genotype were higher in drinkers than in nondrinkers(P<0.05-0.01).But the ratio of ApoA-I to ApoB in GG genotype was lower in drinkers than in nondrinkers(P<0.01). Multivariate logistic regression analysis showed that the levels of TC,TG and ApoB were correlated with genotype in non drinkers(P<0.05 for all).The levels of TC,LDL-C and ApoB were associated with genotype in drinkers(P<0.0     

Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome

BACKGROUND: Serum levels of circulating markers associated with cardiovascular morbidity are elevated in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). These factors are studied in patients mainly before the application of therapy with continuous positive airway pressure (CPAP), and the effects of CPAP treatment on them have not been thoroughly studied. Therefore, the aim of the study was to examine the effect of compliance to CPAP therapy on these factors. METHODS: Patients with newly diagnosed OSAHS, nonsmokers, without comorbidities or medication use, at baseline and during the follow-up period, were included. Serum cardiovascular risk factors (ie, high-sensitivity C-reactive protein [hs-CRP], homocysteine, total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol, apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were measured at baseline and 6 months after CPAP application. Patients were classified into the following three groups according to CPAP use: group 1 (n = 20), good compliance (>or= 4 h use per night); group 2 (n = 19), poor compliance (< 4 h use per night); and group 3 (n = 14), refusal of CPAP treatment. RESULTS: Fifty-three patients (47 male patients and 6 female patients; mean [+/- SD] age, 46.09 +/- 10.87 years) were included in the study. In all groups, body mass index remained stable. In group 1, significant decreases in the levels of hs-CRP (p = 0.03), homocysteine (p = 0.005), total cholesterol (p = 0.021), total cholesterol/HDL-C ratio (p = 0.018), and ApoB/ApoA-I ratio (p = 0.021) was observed. The patients in group 2 showed a decrease in homocysteine levels (p = 0.021) only, while no significant changes were observed in the patients in group 3. CONCLUSIONS: Good compliance to CPAP treatment lowers the serum levels of cardiovascular risk factors, indicating a beneficial effect on the overall cardiovascular risk.     

Causal effects of plasma lipids on the risk of atrial fibrillation: A multivariable mendelian randomization study

Background and aimsObservational studies have suggested that plasma lipids contribute substantially to cardiovascular disease, but “cholesterol paradox” in atrial fibrillation (AF) remains. We sought to investigate the causal effects of lipid profiles on the risk of AF.Methods and resultsTwo-sample Mendelian randomization (MR) framework was implemented to examine the causality of association. Summary estimations of genetic variants associated with low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides, lipoprotein-a [Lp(a)], apolipoprotein A1 (ApoA 1), and apolipoprotein B (ApoB) were 81, 99, 96, 61, 30, 10, and 23 single nucleotide polymorphisms, respectively. Genetic association with AF were retrieved from a genome-wide association study that included 1,030,836 individuals. The complications for AF were predefined as cardioembolic stroke (CES) and heart failure (HF). In the multivariable MR, the odds ratios for AF per standard deviation (SD) increase were 1.030 (95% confidence interval (CI) 0.979–1.083; P = 0.257) for LDL-cholesterol, 0.986 (95% CI 0.931–1.044; P = 0.622) for HDL-cholesterol, 0.965 (95% CI 0.896–1.041; P = 0.359) for triglycerides, 1.001 (95% CI 1.000–1.003; P = 0.023) for Lp(a), 1.017 (95% CI 0.966–1.070; P = 0.518) for ApoA1, and 1.002 (95% CI 0.963–1.043; P = 0.923) for ApoB. There was no evidence that other lipid components were causally associated with AF, CES, or HF, other than for a marginal association between triglycerides and HF.ConclusionsThis MR study provides robust evidence that high Lp(a) increases the risk of AF, suggesting that interventions targeting Lp(a) may contribute to the primary prevention of AF.     

The contribution of ApoB and ApoA1 measurements to cardiovascular risk assessment

LDL has been widely recognized as the major atherogenic lipoprotein and designated as the primary target for prevention of coronary heart disease (CHD); however, there is growing evidence that other triglyceride-rich lipoproteins, such as very low-density lipoprotein (VLDL) and intermediate density lipoprotein (IDL) carry atherogenic potential as well. This led to the designation of non-HDL cholesterol (HDL-C) (LDL + IDL + VLDL) as a secondary target of treatment for hyperlipidaemia. As each one of LDL, IDL and VLDL particles carries only one apolipoprotein B-100 (ApoB-100) molecule, the total ApoB value represents the total number of potentially atherogenic lipoproteins, whereas non-HDL-C provides the cholesterol content of these same lipoproteins. Recent data from epidemiological, observational and interventional studies suggest that non-HDL-C, apolipoproteins ApoA1 and ApoB may improve CHD risk assessment by identifying more high-risk individuals than the usual lipid profile alone. However, the targets for the optimal treatment of dyslipidaemia remain a subject of considerable debate. Further studies are needed to determine whether ApoB and ApoA1 are superior to conventional lipid parameters as predictors of cardiovascular disease or therapeutic targets of hyperlipidaemias. In this review, we summarize the current opinions on the use of ApoA1 and ApoB values as estimates of cardiovascular risk or as treatment goals in patients undergoing treatment for hyperlipidaemia.