Serum Lipoprotein‐Associated Phospholipase A2 and C‐Reactive Protein Levels in Association With Periodontal Disease and Hyperlipidemia

Background: The aim of this study is to evaluate the levels of serum lipoprotein‐associated phospholipase A₂ (Lp‐PLA₂) and high‐sensitivity C‐reactive protein (hsCRP) in association with periodontal disease and hyperlipidemia. Methods: A total of 123 subjects with hyperlipidemia and 68 systemically healthy controls were included in the study. Subjects with hyperlipidemia were divided into two groups: the suggested‐diet (HD) and prescribed‐statin (HS) groups and then into three subgroups: the healthy (HDh and HSh), gingivitis (HDg and HSg), and periodontitis (HDp and HSp) groups. Periodontal parameters were recorded and included the plaque index, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and percentage of sites with bleeding on probing (BOP). Fasting venous blood samples were obtained, and serum lipid, Lp‐PLA₂, and hsCRP levels were evaluated. Results: Median values for the GI, PD, BOP(%), and CAL in the HSg group were statistically significantly higher than those in the HDg and systemically healthy with gingivitis (Cg) groups. The HSp group had higher percentages of BOP compared to those of the chronic periodontitis and HDp groups. The HDg group had higher serum Lp‐PLA₂ and hsCRP levels compared to those of the Cg and HSg groups. The ratio of total cholesterol to high‐density lipoprotein cholesterol (TC/HDL) was significantly associated with the GI, PD, and BOP(%) in both groups with hyperlipidemia. Serum Lp‐PLA₂ and hsCRP levels were significantly correlated with TC/HDL, the GI, PD, and BOP(%) in the HD group. Conclusions: Serum Lp‐PLA₂ and hsCRP levels may play an important role in the association between periodontal disease and hyperlipidemia, and the control of these mediators may affect the inflammatory control of patients with hyperlipidemia and periodontal disease.     

急性缺血性脑卒中患者低密度脂蛋白胆固醇/淋巴细胞比值与颈动脉斑块稳定性及狭窄程度的相关性

目的 探讨急性缺血性脑卒中(AIS)患者低密度脂蛋白胆固醇/淋巴细胞(LDL-C/LYM)与颈动脉斑块稳定性及狭窄程度的相关性。方法 选取2021年4月至2022年4月就诊于青海省人民医院神经内科的336例AIS患者为研究对象,根据超声结果将患者分为无斑块组(42例)、稳定斑块组(63例)和易损斑块组(231例);根据狭窄度将患者分为无狭窄组(42例)、轻度狭窄组(177例)、中度狭窄组(67例)和重度狭窄组(50例),比较各组之间一般资料、低密度脂蛋白胆固醇、淋巴细胞计数、LDL-C/LYM等差异。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验、Kruskal-Wallis H检验或χ²检验进行组间比较。采用Spearman相关分析LDL-C/LYM值与颈动脉狭窄程度的相关性。采用多因素logistic回归分析颈动脉斑块易损性的危险因素。结果 稳定斑块组和易损斑块组年龄、高血压病与糖尿病史、D-二聚体和LDL-C/LYM值均高于无斑块组(均P＜0.05)。易损斑块组糖尿病史、总胆固醇、低密度脂蛋白胆固醇和LDL-C/LYM值的水平高于稳定斑块组,而淋巴细胞水平降低 (均P＜0.001)。多因素logistic回归分析显示,糖尿病史与LDL-C/LYM值是颈动脉斑块易损性的独立危险因素(OR=1.948,95%CI 1.01~3.77,P=0.048;OR=4.543,95%CI 1.10~18.69,P=0.036)。受试者工作特征(ROC)曲线分析显示,LDL-C/LYM值对诊断斑块稳定性的曲线下面积(AUC)为0.676(95%CI 0.605～0.748;P＜0.001),最佳临界值为1.54,灵敏度为61.5%,特异度为69.8%。Spearman相关性分析显示,LDL-C/LYM值与斑块的狭窄程度呈正相关(r=0.654;P＜0.001)。结论 LDL-C/LYM值增高是AIS患者颈动脉斑块易损性的独立危险因素,与颈动脉斑块狭窄程度呈正相关。     

Low-density lipoprotein apheresis therapy with a direct hemoperfusion column: a Japanese multicenter clinical trial

Low-density lipoprotein (LDL) apheresis has been applied to patients with familial hypercholesterolemia (FH) with coronary artery disease (CAD). To examine the efficacy and safety of a new type of LDL adsorption column (KLD01, Kaneka, Osaka, Japan), which deals with whole blood without separating plasma, the new system was evaluated in a multicenter trial. The present study included 33 FH patients with CAD (24 males, 9 females, 57 +/- 13 years) who were treated five times with a mean interval of 2.12 +/- 0.60 weeks between treatments. We studied the removal efficacies for serum LDL cholesterol, Lipoprotein(a) (Lp(a)) and triglyceride, the times for the preparation of the system and for treatment, symptoms, and the biochemical data. The scheduled treatments were completed by 31 patients. Serum levels of LDL cholesterol, Lp(a) and triglycerides were all significantly reduced with KLD01; 61.5 +/- 6.2%, 72.4 +/- 5.9% and 69.5 +/- 9.7%, respectively. The times for both setting up the column system (26 +/- 7 min) and treatment (138 +/- 20 min) were shorter with KLD01 than conventional methods. Adverse reactions occurred in eight cases (17 episodes), but the patients fully recovered immediately after each apheresis therapy session. We conclude that the new type of LDL adsorption column, one that deals with whole blood, is a promising apheresis therapy for FH patients in view of its efficacy, reduced time for treatment, and safety.     

Comparative analysis of the effects of hubble-bubble (Sheesha) and cigarette smoking on respiratory and metabolic parameters in hubble-bubble and cigarette smokers

OBJECTIVES AND BACKGROUND: Hazard of smoking tobacco is believed to be minimized by smoking hubble-bubble (HB) instead of cigarettes. Our aims were to (i) develop an assay for estimating nicotine and cotinine; and (ii) evaluate the effect of smoking on respiratory and metabolic parameters in cigarette and HB smokers. METHODS: Urine samples were collected from 152 volunteer smokers (75 cigarette and 77 HB) as well as from 16 healthy controls. We optimized an HPLC method for the determination of nicotine and cotinine. Subjects were asked to complete a chronic respiratory symptoms questionnaire and to undergo spirometry. Fasting blood samples were collected for the determination of their lipid profile. RESULTS: The intra-assay coefficients of variation for nicotine and cotinine were 16.6% and 6.6%, respectively. The mean of cotinine in cigarette smokers (1321.4 ng/mL) was significantly (P = 0.008) higher than the mean cotinine (677.6 ng/mL) in HB smokers. The mean nicotine level in cigarette smokers (1487.3 ng/mL) was significantly (P < 0.0001) higher than the mean nicotine (440.5 ng/mL) in HB smoker. The urinary cotinine and nicotine levels of the control subjects were lower than the detection levels of the assay. The mean high-density lipoprotein cholesterol was lower in cigarette smokers (0.99 mmol/L) compared with HB smoker smokers (1.02 mmol/L) but this was not significant (P = 0.28). Spirometric values were comparable among the three groups but the chronic respiratory symptoms in the smoking groups appeared at an earlier age in the HB smokers compared with the cigarettes smokers (P < 0.05). CONCLUSION: Smoking HB does not reduce the risk of tobacco exposure and it's potentially harmful metabolites on health.     

Metabolic syndrome in older people in Taiwan: a hospital-based study

Background: The aim of this study was to investigate the prevalence of metabolic syndrome in older people in Taiwan. Methods: This was a hospital‐based, cross‐sectional study. We retrospectively analysed subjects receiving self‐referred health examination at one medical centre in Taiwan from 2000 to 2004. In all, 696 older people without any acute illness were enrolled in this study, 352 men (50.6%) and 344 women (49.4%). The mean age was 70.2 ± 4.6 years (age range 65–87). Metabolic syndrome was estimated according to the criteria proposed by National Cholesterol Education Program Adult Treatment Panel III in 2001 and by International Diabetes Foundation in 2005, with the cut‐off values of the waist circumference greater than or equal to either 90 or 80 cm for men or women, respectively. Results: Among this group, 94% of the individuals presented with at least one condition of metabolic syndrome. The prevalence of metabolic syndrome defined by National Cholesterol Education Program Adult Treatment Panel III was 44.1% and was higher in women than in men (52.6 vs 35.8%, P < 0.001). Defined by International Diabetes Foundation, the prevalence was also 44.1% and was higher in women than in men (55.5 vs 33.0%, P < 0.001). Conclusion: The prevalence of metabolic syndrome remains relatively high in Taiwanese older people.     

DM2患者检测non-HDL-C、AIP和BIL的意义

目的：探讨DM2患者血清非高密度脂蛋白胆固醇（non-HDL-C）、致动脉硬化指数（AIP）和胆红素（BIL）的临床意义。方法：采用全自动生化分析仪测定77例DM2患者fBG、TC、TG、HDL-C、TBIL、DBIL,计算出non-HDL-C、AIP及间接胆红素（NDBIL）,与65例正常对照组比较。结果：DM2组的血清TG、non-HDL-C和AIP水平显著高于正常对照组（P〈0.01）;而TBIL、NDBIL和HDL-C水平显著低于正常对照组（P〈0.01）;TC和DBIL与正常对照组相比无显著性差异。结论：DM2患者的高non-HDL-C、高AIP和低胆红素使得体内抗氧化活性减低,氧化LDL形成增多,增加了DM患者并发动脉粥样硬化的危险性。     

Efficacy and tolerability of ezetimibe 10 mg/day coadministered with statins in patients with primary hypercholesterolemia who do not achieve target LDL-C while on statin monotherapy: A Canadian, multicentre, prospective study--the Ezetrol Add-On Study

BACKGROUND: For patients who have above-target low-density lipoprotein cholesterol (LDL-C) levels while on statin monotherapy, coadministration of a cholesterol absorption inhibitor with the statin may decrease serum LDL-C levels and improve overall lipid profiles. OBJECTIVES: To assess the effectiveness and safety of ezetimibe 10 mg/day coadministered with a statin in patients with primary hypercholesterolemia who have higher than recommended LDL-C levels while on statin monotherapy. METHODS: A six-week, prospective, multicentre study of eligible patients who had above-target LDL-C levels while on monotherapy with any statin, regardless of dose, for a minimum of four weeks. All patients were treated for six weeks with 10 mg ezetimibe daily coadministered with their current statins. RESULTS: A total of 1141 patients were screened, 953 (83.5%) fulfilled the study inclusion criteria and 837 (87.8%) completed the study. Reasons for withdrawal included: lost to follow-up (50 patients [5.2%]); protocol violations (45 patients [4.7%]); adverse events (19 patients [2.0%]); and withdrawal of consent (two patients [0.2%]). After six weeks of treatment, statistically significant (P = 0.001) mean reductions were observed in LDL-C (30.05%), total cholesterol (20.84%), triglycerides (10.16%), apolipoprotein B (19.84%) and the total cholesterol to high-density lipoprotein cholesterol ratio (19.88%). At six weeks, 674 patients (80.5%) achieved target LDL-C levels. Fifty predominantly mild, nonserious adverse events related to ezetimibe were reported by 32 patients (3.4%). Frequently reported adverse events included constipation (n = 7 [0.7% of patients]), diarrhea (n = 4 [0.4%]) and dizziness (n = 4 [0.4%]). CONCLUSION: Ezetimibe coadministered with statins is effective in reducing LDL-C in patients who do not attain target LDL-C levels while on statin monotherapy.