Plasma Lipids, Lipoprotein Metabolism and HDL Lipid Transfers are Equally Altered in Metabolic Syndrome and in Type 2 Diabetes

The role of triglycerides in predicting new-onset arthritis in the general population over 45 years old: evidence from the China health and retirement longitudinal study

Background

Arthritis is a common degenerative joint disease with a high prevalence especially in the elderly population. Due to its strong association with chronic pain and dysfunction, arthritis has become an important challenge in public health. Recent studies have shown that triglyceride (TG) levels, as key metabolic markers, may play an important role in the pathogenesis of arthritis, and its associated inflammatory response may accelerate joint degeneration and inflammatory process.

Objective

Based on the above findings, the aim of this study was to investigate the association between baseline TG levels and the incidence of arthritis in adults aged 45 years and older, utilizing data from the China Health and Retirement Longitudinal Study(CHARLS).

Methods

This study utilized the CHARLS from 2011 to 2018, which included 7,551 participants aged 45 years and older. The association between TG levels and new-onset arthritis was assessed by logistic regression modeling, adjusting for demographic and health-related variables. The potential role of HDL-C, LDL-C, and BMI in the TG-arthritis association was further assessed by mediation analysis, which decomposed the association into direct and indirect effects.

Results

During the study period, 3,363 participants (44.5%) developed arthritis. Higher TG levels were significantly associated with arthritis risk, with an 8% increase in arthritis risk for each interquartile range (IQR) increase in TG (OR=1.08; 95% CI, 1.039-1.137.) Interquartile analyses of TG levels showed a significant dose-response trend (P trend <0.05), suggesting that the risk of arthritis tended to rise progressively with higher TG levels. Mediation analysis further revealed that HDL-C mediated approximately 43.5% of the TG-arthritis association, suggesting an important role of HDL-C in the metabolic pathway of arthritis development.

Conclusion

Elevated TG levels were significantly associated with an increased risk of arthritis, and this association was partially mediated by HDL-C. The findings suggest that interventions targeting reduced TG levels and enhanced HDL function may have potential value in arthritis prevention. Future studies should focus on lipid metabolism intervention strategies to reduce arthritis risk and delay disease progression, providing a new scientific basis for arthritis management.

Developing a risk model for early diagnosis of metabolic syndrome in Chinese adults aged 40 years and above based on BMI/HDL-C: a cross-sectional study

BACKGROUND

This study aimed to compare the diagnostic accuracy of four indicators, including waist-to-height ratio (WHTR), vascular adiposity index (VAI), TG/HDL-C, and BMI/HDL-C for metabolic syndrome (MS) in Chinese adults aged 40 years and above. Additionally, the study aimed to develop an efficient diagnostic model displayed by a nomogram based on individual's BMI and circulating HDL-C level.

METHODS

A cross-sectional study was conducted on 699 participants aged 40 years and above. Quartiles of BMI/HDL-C, TG/HDL-C, VAI, and WHTR were used as independent variables, and metabolic syndrome was used as the dependent variable. Logistic regression was conducted to explore the impact of each parameter on the risk of MS. The areas under the receiver operating characteristics were compared to determine the accuracy of the indicators in diagnosing MS in the participants. Logistic regression was run to construct the nomograms, and the performance of the nomogram was assessed by a calibration curve.

RESULTS

MS subjects had higher levels of BMI, BFM, PBF, VFA, AMC, WC, SCR, TG, and insulin, but lower LDH and HDL-C levels than the subjects without MS. The BMI/HDL-C ratio was positively correlated with the prevalence of MS and its components. The final diagnostic model included five variables: gender, BFM, WC, TG, and BMI/HDL-C. The model showed good calibration and discrimination power with an AUC of 0.780. The cut-off value for the nomogram was 0.623 for diagnosing MS.

CONCLUSIONS

BMI/HDL-C ratio was an independent risk factor for MS in Chinese adults. BMI/HDL-C was significantly correlated with MS and its components. BMI/HDL-C was the most powerful diagnostic indicator compared to other indicators, including TG/HDL-C, VAI and WHTR for diagnosing MS. The nomogram drawn based on the diagnostic model provided a practical tool for diagnosing MS in Chinese adults.

Association of lipid profile with decompensation, liver dysfunction, and mortality in patients with liver cirrhosis

BACKGROUND AND AIMS

Lipid metabolism is often disrupted in liver cirrhosis. The present study aimed to evaluate the impact of lipid profile on decompensation events, severity of liver dysfunction, and death in patients with liver cirrhosis.

METHODS

In a cross-sectional study, 778 patients with lipid profile data were enrolled, and then were divided into 240 and 538 patients with and without liver cirrhosis, respectively. In a cohort study, 314 cirrhotic patients with lipid profile data, who were prospectively followed, were enrolled. Lipid profile included total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), triglycerides (TG), and lipoprotein(a).

RESULTS

In the cross-sectional study, cirrhotic patients with decompensation events had significantly lower levels of TC and lipoprotein(a) than those without; and cirrhotic patients with Child-Pugh class B and C had significantly lower levels of TC, HDL-c, LDL-c, and lipoprotein(a) than those with Child-Pugh class A. In the cohort study, there was an inverse association of survival with TC, HDL-c, and lipoprotein(a) levels; after adjusting for MELD score, TC (Hazard Ratio [HR] = 1.703, P = 0.034) and HDL-c (HR = 2.036, P = 0.005), but not lipoprotein(a) (HR = 1.377, P = 0.191), remained a significant predictor of death; when TC, HDL-c, lipoprotein(a), and MELD score were included in the multivariate Cox regression analysis, HDL-c (HR = 1.844, P = 0.024) was the only independent predictor of death.

CONCLUSIONS

Decreased levels in specific components of lipid profile indicate more decompensation events, worse liver function, and reduced survival in liver cirrhosis. MELD score combined with HDL-c should be promising for the assessment of outcomes of cirrhotic patients.

Adiposity and fat metabolism during combined fasting and lactation in elephant seals

Animals that fast depend on mobilizing lipid stores to power metabolism. Northern elephant seals (Mirounga angustirostris) incorporate extended fasting into several life-history stages: development, molting, breeding and lactation. The physiological processes enabling fasting and lactation are important in the context of the ecology and life history of elephant seals. The rare combination of fasting and lactation depends on the efficient mobilization of lipid from adipose stores and its direction into milk production. The mother elephant seal must ration her finite body stores to power maintenance metabolism, as well as to produce large quantities of lipid and protein-rich milk. Lipid from body stores must first be mobilized; the action of lipolytic enzymes and hormones stimulate the release of fatty acids into the bloodstream. Biochemical processes affect the release of specific fatty acids in a predictable manner, and the pattern of release from lipid stores is closely reflected in the fatty acid content of the milk lipid. The content of the milk may have substantial developmental, thermoregulatory and metabolic consequences for the pup. The lactation and developmental patterns found in elephant seals are similar in some respects to those of other mammals; however, even within the limited number of mammals that simultaneously fast and lactate, there are important differences in the mechanisms that regulate lipid mobilization and milk lipid content. Although ungulates and humans do not fast during lactation, there are interesting comparisons to these groups regarding lipid mobilization and milk lipid content patterns.