Butyrylcholinesterase activity in young men and women: association with cardiovascular risk factors

ObjectiveWe investigated the relationship between butyrylcholinesterase (BuChE) and cardiovascular risk factors in young male and female.Design and methodsThe study comprised 1512 healthy subjects, 18–25 years of age. In fasting sera the concentrations of BuChE and cardiovascular risk factors were estimated.ResultsAnalysis of variance indicated significant increase in body mass index (BMI), total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL) (p < 0.05) and albumin (p < 0.001) with BuChE activity increment in males. In females glucose and albumin (p < 0.05) increased with BuChE activity. Negative but not significant correlation between BuChE and high-density lipoprotein cholesterol (HDL-C) was detected for both genders.ConclusionThe tendency towards overweight in young male could explain our results on BMI as an independent risk factor for higher BuChE in young male. Glucose as an independent risk factor for higher BuChE activity in females indicates that BuChE may be a predictor of diabetes.     

Impact of bezafibrate and atorvastatin on lipoprotein subclass in patients with type III hyperlipoproteinemia: result from a crossover study

BackgroundWe elucidated the difference between the effects of bezafibrate and atorvastatin in hypertriglyceridemia with apoE2/2 and 3/3.MethodsAn open randomized crossover study consisted of a 4-week treatment period with bezafibrate (400 mg daily) or atorvastatin (10 mg daily) and a 4-week wash-out period.ResultsBezafibrate significantly decreased serum concentrations of triglyceride (apoE2/2, E3/3: ?49.2%, ?39.0%) and significantly increased high-density lipoprotein (HDL) cholesterol (+ 28.5%, + 26.1%) in both apoE phenotypes but did not change serum concentrations of low-density lipoprotein (LDL) cholesterol. Atorvastatin significantly decreased serum concentrations of LDL cholesterol (? 34.0%, ?30.0%) and triglyceride (? 27.6%, ?25.8%) in both apoE phenotypes but did not change HDL cholesterol concentrations. Changes in cholesterol in lipoprotein subfractions were not different between apoE2/2 and E3/3. Bezafibrate changed cholesterol distribution from small- to large-sized LDL and from large- to small-sized HDL. On the other hand, atorvastatin decreased cholesterol in all apoB-containing lipoprotein subfractions but did not change any of the HDL subfractions.ConclusionBezafibrate and atorvastatin improve atherogenic dyslipidemia in considerably different ways. Extrapolating from the present data, we presume that the combination of these drugs may contribute to reduce LDL-C/HDL-C ratio effectively as well as lowering concentrations of serum triglyceride.     

A cross-sectional study of the association between heat shock protein 27 antibody titers, pro-oxidant-antioxidant balance and metabolic syndrome in patients with angiographically-defined coronary artery disease

ObjectiveTo investigate the association between serum antibody titers to Hsp27 (anti-Hsp27) and pro-oxidant–antioxidant balance (PAB) in patients with angiographically-defined coronary artery disease (CAD) with or without the metabolic syndrome (MS).DesignSubjects (n = 243) were classified into MS+ (n = 161) and MS? (n = 82) subgroups, based on the AHA/NHBLI criteria.ResultsSerum anti-Hsp27 titers were found to be significantly higher in the MS+ vs. MS? group. However, no significant difference was observed in serum PAB values. When assessed for individual components of MS, increased serum anti-Hsp27 was found to be higher in subgroups with elevated triglycerides, elevated blood pressure and reduced high-density lipoprotein cholesterol (HDL-C). Subgroups of patients with elevated triglycerides had higher PAB values. HDL-C was the only significant predictor of anti-Hsp27 in the population as a whole.ConclusionThe evidence from this investigation indicates the presence of elevated anti-Hsp27 in patients with concurrent CAD and MS compared to those with CAD alone.     

Association of R230C ABCA1 gene variant with low HDL-C levels and abnormal HDL subclass distribution in Mexican school-aged children

BackgroundThe effect of ABCA1 genetic variation on HDL-C levels has been widely documented, although studies in children are scarce. We recently found a frequent non-synonymous ABCA1 variant (R230C) exclusive to populations with Native American ancestry, associated with low HDL-C levels and other metabolic traits in adults.MethodsWe genotyped R230C variant in 1253 healthy unrelated Mexican school-aged children aged 6–15 years (595 boys and 658 girls) to seek associations with HDL-C levels and other metabolic traits. HDL subclass distribution was analyzed in a subgroup of 81 age, gender and BMI-matched children.ResultsIndividuals carrying the C230 allele showed a significantly lower HDL-C levels (P = 2.9 × 10^? 8), and higher TC/HDL-C ratio, BMI, BMI z-score and percent fat mass (P = 0.001, 0.049, 0.032 and 0.039, respectively). HDL size was smaller in R230C heterozygotes as compared to R230R homozygotes (P < 0.05). Moreover, the proportion of HDL_2b was lower, while the proportion of HDL_3a and HDL_3b particles was higher in R230C heterozygous and/or C230C homozygous individuals as compared to R230R homozygotes (P < 0.05).ConclusionsOur data suggest that the R230C ABCA1 gene variant plays an important role in HDL-C level regulation and HDL subclass distribution in healthy Mexican school-aged children.     

Comparison of different anthropometric indices for identifying dyslipidemia in school children

BackgroundAnthropometric indices have been associated with dyslipidemia.ObjectiveTo compare the abilities of BMI, waist circumference (WC) and WC/height to identify children's dyslipidemia.MethodsStudents 1261 (639 male) age 9.5 ± 2.1 years. were examined for anthropometry and lipid levels. Triglycerides ≥ 1.69 mmol/L and high-density lipoprotein cholesterol (HDL-C) < 0.91 mmol/L were considered abnormal per American Heart Association.ResultsThe prevalence of abnormal triglycerides was 4.1% and HDL-C 8.1%. The areas under the receiver operator curves (ROC) were: BMI = 0.87, WC = 0.83, and WC/height = 0.84 in predicting both low HDL-C and high triglycerides. Multiple regression analyses showed that the odds ratios (OR) were highest for WC [6.5], followed by WC/height [5.4], and BMI [4.9], for dyslipidemia.ConclusionsThe results suggest that WC, WC/height, and BMI similarly predicted dyslipidemia, using ROC analyses. However, regression analyses showed that WC followed by WC/height was most predictive of dyslipidemia.     

Elevated levels of myeloperoxidase, white blood cell count and 3-chlorotyrosine in Taiwanese patients with acute myocardial infarction

ObjectivesInflammation, a major risk factor for acute myocardial infarction (AMI), is associated with leukocytic activation, secretion of myeloperoxidase (MPO) and generation of the oxidative damage marker, 3-chlorotyrosine (3-Cl-Tyr). To study their association with AMI and their value in diagnosis of AMI, white blood cell (WBC) count, plasma MPO, plasma 3-Cl-Tyr, and conventional risk factors such as cardiac troponin I and CK-MB were examined in AMI patients during the onset of chest pain.MethodsAfter obtaining informed consent, blood samples were collected from 77 AMI patients during the onset of chest pain and from 53 normal controls. The samples were analyzed for WBC count using SE-9000 automated analyzer. Plasma MPO was measured by an enzyme-linked immunosorbent assay. Plasma levels of 3-Cl-Tyr, a product of MPO, were analyzed by HPLC coupled with Coularray electrochemical detection.ResultsThe WBC, plasma MPO and 3-Cl-Tyr levels were significantly elevated in AMI patients than in normal controls (p < 0.001). The levels of WBC, MPO and 3-Cl-Tyr alone were strongly associated with the prevalence of AMI. Plasma MPO was correlated with 3-Cl-Tyr (r = 0.389, p < 0.01) and WBC counts (r = 0.405, p < 0.01) respectively. The ROC curve analyses suggested that MPO had the best specificity and sensitivity among these oxidative stress-related markers.ConclusionPlasma MPO value should be considered as a better marker for early diagnosis of AMI, as compared with WBC count or 3-Cl-Tyr.     

Plasma concentrations but not serum concentrations of brain-derived neurotrophic factor are related to pro-inflammatory cytokines in patients undergoing major abdominal surgery

ObjectivesTo investigate peripheral brain-derived neurotrophic factor (BDNF) concentrations in the perioperative period, their relationship with transforming growth factor-β1 (TGF-β1 tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-6 genetics.Design and methodsProspective, observational study. BDNF, TGF-β1, IL-6 and TNF-α were analysed at baseline (T0), 5 h (T1), 24 h (T2) and 5 days (T3) after surgery, in 21 patients. The IL-6 ? 174 G/C polymorphism was genotyped.ResultsSerum BDNF concentrations decreased (P = 0.048), correlated with TGF-β1 (r = 0.610 at T1, r = 0.493 at T2, r = 0.554 at T3). Plasma BDNF concentrations raised (P = 0.049), correlated with IL-6 and TNF-α at T1 (r = 0.495 and r = 0.441, respectively). BDNF response was predictable from TNF-α and IL-6 concentrations and the IL-6 ? 174 G/C genotype.ConclusionSerum and plasma BDNF concentrations could relate to platelet activation and inflammatory response, respectively. IL-6 genetics played a role in the BDNF acute response.     

Gamma-glutamyl transferase level predicts the development of hypertension in Hong Kong Chinese

BackgroundPlasma activities of alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase, and γ-glutamyl transferase (GGT) are often increased in cardiometabolic diseases. We investigated if hypertension is associated with increased activities of these plasma markers.MethodsWe included 235 hypertensive and 708 normotensive subjects (mean age 47.3 ± 9.6 and 58.0 ± 10.2 years respectively) from the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS-2) in 2000–2004 who had drank < 1/week. In the follow-up study in 2005–2008 (CRISPS-3), 126 out of the 708 subjects had developed hypertension.ResultsRaised plasma ALT (OR = 1.22 per SD of log-transformed level, P = 0.045) and GGT (OR = 1.38 per SD of log-transformed level, P = 0.001) levels were associated with hypertension at baseline in CRISPS-2 after adjusting for covariates. Among subjects not on anti-hypertensive medications, plasma ALP, ALT and GGT were related to blood pressure (P < 0.01). In subjects normotensive at CRISPS-2, plasma GGT, but not ALP, ALT and AST, was an independent predictor of new-onset hypertension at CRISPS-3 (OR = 1.38 per SD of log-transformed level, P = 0.020 and OR = 2.68 for 3rd tertile vs. 1st tertile, P = 0.004) after adjusting for covariates.ConclusionsAmong the 4 plasma markers, increased GGT activity is the strongest predictor for existing and new-onset hypertension in Hong Kong Chinese.     

Carotid intima media thickness is related positively to plasma pre ß-high density lipoproteins in non-diabetic subjects

BackgroundLipid-poor or lipid-free high density lipoprotein (HDL) particles, designated pre ß-HDL, stimulate removal of cell-derived cholesterol to the extracellular compartment, which is an initial step in the reverse cholesterol transport pathway. Pre ß-HDL levels may be elevated in subjects with established cardiovascular disease. We determined the relationship of carotid intima media thickness (IMT), a marker of subclinical atherosclerosis, with pre ß-HDL in subjects without clinically manifest cardiovascular disease.MethodsIMT and plasma pre ß-HDL, assayed by crossed immuno-electrophoresis, were determined in 70 non-diabetic subjects (aged 56 ± 9 years; non-smokers only; 27 women).ResultsIMT was correlated positively with pre ß-HDL, both expressed as plasma apolipoprotein (apo) A-I concentration (r = 0.271, p = 0.023) and as% of apo A-I (r = 0.341, p = 0.004). In contrast, IMT was correlated inversely with HDL cholesterol (r = ? 0.253, p = 0.035). IMT was also related positively to pre ß-HDL after adjustment for age, sex, systolic blood pressure (in apoA-I concentration, ß = 0.203, p = 0.043; in% of plasma apoA-I, ß = 0.235, p = 0.023). IMT remained associated with pre ß-HDL after additional adjustment for either body mass index, plasma glucose, cholesterol, triglycerides, HDL cholesterol, apoA-I and apoB.ConclusionSubclinical atherosclerosis may relate to higher plasma pre ß-HDL independently of apoA-I and HDL cholesterol levels.     

Closing the anion gap: contribution of D-lactate to diabetic ketoacidosis

BackgroundA high anion gap in diabetic ketoacidosis (DKA) suggests that some unmeasured anions must contribute to the generation of the anion gap. We investigated the contribution of d-lactate to the anion gap in DKA.MethodsDiabetic patients with and without DKA and high anion gap were recruited. Plasma d-lactate was quantified by HPLC. Plasma methylglyoxal was assayed by liquid chromatography-tandem mass spectrometry.ResultsThe plasma fasting glucose, β-hydroxybutyrate, and blood HbA1c levels were highly elevated in DKA. Plasma anion gap was significantly increased in DKA (20.59 ± 6.37) compared to either the diabetic (7.50 ± 1.88) or the control group (6.53 ± 1.75) (p < 0.001, respectively). Moreover, plasma d-lactate levels were markedly increased in DKA (3.82 ± 2.50 mmol/l) compared to the diabetic (0.47 ± 0.55 mmol/l) or the control group (0.25 ± 0.35 mmol/l) (p < 0.001, respectively). Regression analysis demonstrated that d-lactate was associated with acidosis and anion gap (r = 0.686, p < 0.001).ConclusionsPlasma d-lactate levels are highly elevated and associated with metabolic acidosis and the high anion gap in DKA. Laboratory monitoring of d-lactate will provide valuable information for assessment of patients with DKA.     

Rapid simultaneous determination of voriconazole and its N-oxide in human plasma using an isocratic high-performance liquid chromatography method and its clinical application

ObjectivesThe aim of this study was to develop a simultaneous determination method for voriconazole (VRCZ) and its N-oxide (VNO) in human plasma and to apply it to clinical samples.Design and methodsPlasma specimens were deproteinized with acetonitrile and then injected into an HPLC-UV system. VRCZ and VNO were separated on an ODS column filled with 2.3-μm particles using an isocratic mixture of acetonitrile/methanol/phosphate buffer 25/10/65 (v/v/v). Plasma concentrations of VRCZ and VNO in 25 patients were determined.ResultsBoth VRCZ and VNO were linear (r > 0.999) over the concentration ranges of 0.1–8.0 mg/L. The run time for quantification of the analytes was 4 min. Interindividual variation in the plasma concentration of VRCZ that ranged from less than 0.1 to 6.96 mg/L was observed. VNO concentrations weakly depended on VRCZ dosage.ConclusionsThe present method can contribute to the optimization of antifungal therapy using VRCZ.     

Association between plasma adiponectin and high-density lipoprotein cholesterol in postmenopausal women

ObjectivesWe investigated the association of plasma adiponectin and high-density lipoprotein cholesterol (HDL-C) in postmenopausal women.Design and methodsThis was a cross-sectional study of 563 postmenopausal women with and 1029 without low HDL-C. Lipid profile, glucose, adiponectin, IL-1β, IL-6, and TNF-α concentrations were measured.ResultsPlasma adiponectin levels increased with age in elderly women. Plasma adiponectin levels were lower in subjects with low HDL-C (< 50 mg/dl), when compared with normal HDL-C subjects. In multiple stepwise linear regression analysis, adiponectin was a significant independent predictor of HDL-C concentration with body mass index, total cholesterol, and triglycerides. Values in the third and fourth quartile of adiponectin were associated with decreased odds ratio for low HDL-C (0.62; 95% CI, 0.44–0.87, 0.40; 95% CI, 0.27–0.58, respectively) when compared with values in the lowest quartile after multivariable adjustment.ConclusionsAdiponectin was significantly associated with HDL-C concentration in postmenopausal women. These findings suggest that high adiponectin levels may have a protective effect on atherosclerosis with increasing HDL-C in postmenopausal women.     

Relationships between cholesterol homoeostasis and triacylglycerol-rich lipoprotein remnant metabolism in the metabolic syndrome

The dysmetabolic syndrome of insulin resistance and visceral obesity is characterized by elevated plasma concentration of triacylglycerol-rich lipoprotein (TRL) remnants that may be related to increased cardiovascular risk. Perturbed hepato-intestinal cholesterol metabolism may play a contributory role in this abnormality. We therefore investigated the association between plasma markers of cholesterol absorption and synthesis with TRL remnant metabolism in 35 men with the metabolic syndrome (MS). Plasma campesterol:cholesterol and lathosterol:cholesterol ratios were measured as estimates of cholesterol absorption and synthesis respectively. Remnant metabolism was assessed by measuring remnant-like particle-cholesterol (RLP-C), apolipoprotein (apo)B-48 and the fractional catabolic rate (FCR) of a labelled remnant-like emulsion. Compared with controls, subjects with the MS had significantly lower plasma campesterol:cholesterol ratio, but higher lathosterol:cholesterol ratio ( P <0.05). Plasma RLP-C and apoB-48 concentrations were also higher ( P <0.01) and the remnant-like emulsion FCR was lower ( P <0.05). The plasma campesterol:cholesterol ratio was inversely correlated ( P <0.05) with plasma triacylglycerols ( r =-0.346), RLP-C ( r =-0.443), apoB-48 ( r =-0.427) and plasma lathosterol:cholesterol ratio ( r =-0.366); the campesterol:cholesterol ratio was also positively correlated with the remnant-like emulsion FCR ( r =0.398, P <0.05). In multiple regression analysis, the significant correlations between plasma campesterol:cholesterol ratio and plasma triacylglycerols, RLP-C, apoB-48 and FCR of the remnant-like emulsion were independent of age, dietary energy and plasma lathosterol. Our findings suggest that in subjects with the MS alterations in cholesterol absorption and synthesis may be closely linked with the kinetic defects in TRL metabolism.     

Plasma adiponectin as an independent predictor of early death after acute intracerebral hemorrhage

BackgroundHyperadiponectinemia or hypoadiponectinemia is associated with different diseases. There is a paucity of data on circulating plasma adiponectin concentrations in human intracerebral hemorrhage (ICH). We investigated the plasma adiponectin concentrations in patients with intracerebral hemorrhage, and analyzed the correlation of adiponectin with the severity of brain injury and early mortality after ICH.MethodsThirty controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Their concentrations were measured by enzyme-linked immunosorbent assay.ResultsAfter ICH, plasma adiponectin level of the patients increased immediately within 6 h, peaked within 24 h, plateaued at day 2, and decreased gradually thereafter. It was substantially higher than that in the controls in a period of 7 days. A multivariate analysis showed plasma adiponectin level was an independent predictor for 1-week mortality (odds ratio, 1.199; 95% CI: 1.035–1.389; P = 0.015) and that it was associated with Glasgow coma scale (GCS) score (t = ? 3.596, P = 0.001) and plasma C-reactive protein level (t = 4.194, P < 0.001). A receiver operating characteristic curve identified that a plasma adiponectin level > 16.4 μg/ml predicted the 1-week mortality of patients with a sensitivity of 65.6% and a specificity of 90.7% (AUC, 0.789; 95% CI: 0.688–0.870). The predictive value of adiponectin concentration was significantly lower than that of GCS score (P = 0.007) and hematoma volume (P = 0.022). Adiponectin could not improve the predictive values of GCS score (P = 0.317) and hematoma volume (P = 0.226).ConclusionsAdiponectin is an independent indicator of early death and may play an anti-inflammatory role after intracerebral hemorrhage.     

Correlations of six related pyrimidine metabolites and diabetic retinopathy in Chinese type 2 diabetic patients

BackgroundDiabetic retinopathy (DR), a kind of diabetic microvascular complication, is the leading cause of visual impairment in adults aged 30 to 65 years. Despite rapid research progress, robust predictors to assess prospectively with high precision the risk for DR in individuals with diabetes are still lacking. We investigated the relationship between pyrimidine metabolites and disease, and find out the potential biomarkers for diagnosis.MethodsThe study group consisted of 116 subjects who were divided to 3 groups: control (n = 41), type 2 diabetes without retinopathy (DM, n = 37), and with retinopathy (DR, n = 38). Biochemical and clinical parameters, concentrations of related metabolites, including of cytosine, cytidine, uridine, thymine, thymidine and 2′-deoxyuridine were measured in plasma of all participants.ResultsThere was a significant increase of concentrations of cytosine (p = 0.010), cytidine (p < 0.001) and thynidine (p < 0.001) with DR compared to DM. The concentration of uridine, thymine and 2′-deoxyuridine did not change.ConclusionsThe concentrations of cytosine, cytidine and thynidine may be useful for monitoring the progression of DR and evaluating the treatment. And cytidine has good sensitivity and specificity for diagnosis.     

Pro-inflammatory and atherogenic circulating factors in non-alcoholic fatty liver disease associated to metabolic syndrome

BackgroundIt is not elucidated if liver fat deposits associated to metabolic syndrome (MS) aggravate the atherogenic state. We evaluated, in MS patients, if the presence of non-alcoholic hepatic steatosis (HS) determines differences in inflammatory markers and VLDL characteristics.MethodsSeventy-five patients with MS were divided into 2 groups depending on the presence or absence of HS, assessed by ultrasound. Lipid profile, free fatty acids (FFA), VLDL composition, adiponectin, tumor necrosis factor-alpha (TNF-α), high sensitivity C-reactive protein (hs-CRP), and soluble adhesion molecules (sVCAM-1 and sICAM-1) were measured.ResultsHS patients presented increased triglycerides levels, HOMA-IR and FFA. Patients with HS showed a reduction in adiponectin (p = 0.04) and increase in hs-CRP (p = 0.02), independently of insulin-resistance (IR). FFA correlated positively with TNF-α (p = 0.04) and inversely with adiponectin (p = 0.01). hs-CRP correlated with all inflammatory markers, independently of IR: TNF-α (r = 0.34, p = 0.02), sVCAM-1 (r = 0.29 p = 0.03), sICAM-1 (r = 0.56, p = 0.01), adiponectin (r = ?0.34, p = 0.04). HS patients presented higher VLDL mass and number of particles. Adiponectin correlated with VLDL cholesterol content (r = ?0.47, p = 0.04), independently of IR. VLDL, once secreted, would suffer from changes, becoming more atherogenic.ConclusionsSimple HS would play an important role increasing cardiovascular risk, independently of IR. hs-CRP may represent a useful biomarker of this condition.     

Measurement of B-type natriuretic peptide by two assays utilizing antibodies with different epitope specificity

ObjectivesTo compare plasma BNP values determined by a conventional-type and a novel-type of BNP assays.Design and MethodsPlasma samples (n = 94) from HF patients were analyzed by the novel-type “Single Epitope Sandwich” (SES assay prototype) and the conventional-type Siemens ADVIA Centaur BNP assays. Both assays were calibrated using recombinant proBNP (expressed in E. coli).ResultsThe SES assay measured 1.2- to 7.2-fold (2.1 ± 0.9; mean, SD) greater BNP concentrations compared to the Siemens assay. A subset of six samples (6.4%) demonstrated the largest (3- to 7.2-fold higher) difference.ConclusionsThe SES prototype assay appears to more accurately measure the absolute concentrations of BNP immunoreactive forms.     

High density lipoprotein-anionic peptide factor effect on reverse cholesterol transport in type 2 diabetic patients with and without coronary artery disease

ObjectivesTo verify if HDL3 Anionic Peptide Factor (HDL3-APF) is as an apolipoprotein that promotes the reverse cholesterol transport.Design and methodsWe investigated a possible association between plasma HDL3-APF concentration, cholesterol efflux from Fu5AH cells and cholesteryl ester transfer protein (CETP) activity in type 2 diabetic patients with coronary artery disease (CAD) (n = 36), those without CAD (n = 20), and 37 healthy subjects.ResultsPlasma APF concentrations were decreased in diabetics with CAD compared to controls (p < 0.01). Cellular cholesterol efflux was decreased in diabetics without and with CAD, (p < 0.01 and p < 0.001 respectively). CETP activity was significantly elevated in all patient groups. Multiple linear regression analysis shows that cholesterol efflux was independently and positively related only to APF concentrations in controls.ConclusionsAPF is likely to be a key independent factor for promoting cellular cholesterol efflux in healthy subjects. However this association is altered in type 2 diabetes.     

Comparative study between anion-exchange HPLC and homogeneous assay methods in regard to the accuracy of high- and low-density lipoprotein cholesterol measurement

Objectives:A convenient method based on anion-exchange HPLC was recently developed to determine cholesterol levels of lipoproteins (HDL, LDL, IDL, VLDL, and chylomicron). The present study was performed to compare this HPLC method to homogenous assay in regard to measurement accuracy of HDL and LDL cholesterol.Design and methods:Serum samples (n = 105), including three samples from cholestasis patients, were measured by homogenous assay with Cholestest-LDL and CholestestN-HDL (Daiichi Chemicals, Tokyo) and by HPLC as reported previously (J Lipid Res 2003; 44: 1404–12).Results:The homogenous assay for HDL cholesterol correlated strongly with the HPLC method for HDL cholesterol (r = 0.976). Two samples from cholestasis patients could not be measured by homogenous assay but were measured by HPLC. The homogenous assay for LDL cholesterol correlated modestly with the HPLC method for LDL cholesterol (r = 0.823). Three outlier samples, from cholestasis patients with serum cholesterol levels > 17 mmol/L, were observed in this correlation analysis. Homogenous assay data showed that these LDL cholesterol levels were 15.2–34.7 mmol/L. However, HPLC data showed that these LDL cholesterol levels were 3.6–8.2 mmol/L, and that the major lipoprotein fractions were VLDL and IDL. The difference in LDL cholesterol levels (homogenous assay data minus HPLC data) was positively correlated with VLDL cholesterol levels.Conclusions:When measuring samples from cholestasis patients, homogenous assay may give inaccurate results. In contrast, the HPLC method is likely to be capable of accurately measuring HDL and LDL cholesterol levels without the involving VLDL.     

Changes in lipid measures and incident coronary heart disease: Tehran Lipid & Glucose Study

BackgroundData on the impact of changes in lipid measures on subsequent coronary heart disease (CHD) outcomes are not consistent.MethodsStudy was conducted in 4459 adults, aged ≥ 30 years, free of cardiovascular disease at baseline who attended two consecutive examinations first in 1999–2001 and second in 2001–2003, and were followed up until March 31, 2010. Multivariate Cox proportional hazard regression adjusted for baseline lipid measures and other risk factors was calculated for a 1 standard deviation (SD) change in total cholesterol (TC), log-transformed triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) (calculated using modified Friedewald formula), non-HDL-C, TC/HDL-C and log-transformed TG/HDL-C. Effect of change in dyslipidemia (TC ≥ 6.21 mmol/L or TG ≥ 2.26 mmol/L or HDL-C < 1.03 mmol/L or non-HDL-C ≥ 4.91 mmol/L) on incident CHD was examined, considering those with no dyslipidemia at baseline and follow-up as the reference group.ResultsDuring a mean follow-up of 9.5 years, 303 cases of CHD occurred. A 1-SD increase in TC, TG, non-HDL-C, TC/HDL-C and TG/HDL-C was associated with 14, 20, 19, 16 and 14% increase in risk of CHD event, respectively (all p values < 0.05); the corresponding risk for LDL-C was [1.12 (0.99–1.27), P = 0.07]. Participants with maintained dyslipidemia during follow-up had a significant risk for incident CHD [HR: 1.67(1.21–2.49)] compared to those with no dyslipidemia at baseline or follow-up.ConclusionChanges in TC, TG, and non-HDL-C, TC/HDL-C, TG/HDL-C were independent predictors of CHD events. Furthermore, maintained dyslipidemia was a strong predictor for CHD events.