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Mardi P, Abdi F, Ehsani A, Seif E, Djalalinia S, Heshmati J, Shahrestanaki E, Gorabi AM, Qorbani M. Is non-high-density lipoprotein associated with metabolic syndrome? A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:957136. [PMID: 36176470 PMCID: PMC9514792 DOI: 10.3389/fendo.2022.957136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Novel atherogenic lipid indices, including non-high-density lipoprotein cholesterol (non-HDL-C) which is calculated by subtracting the HDL-C value from the total cholesterol level, atherogenic index (ratio between triglycerides (TG) and HDL-C concentrations (TG/HDL-C)), and Diff-C (calculated by subtracting low-density lipoprotein (LDL-C) from non-HDL-C), have been known as valuable predictors of dyslipidemia and subsequent cardiovascular diseases. Previous studies have reported the potential association of novel atherogenic lipid indices with metabolic syndrome (MetS). This meta-analysis aimed to assess the pooled association of novel atherogenic lipid indices with MetS or its components. METHODS A systematic search was conducted through PubMed, Scopus, and Web of Science (WoS) databases from January 2000 until March 2021 to evaluate the association of novel atherogenic lipid indices, including non-HDL-C, atherogenic index, and the difference between non-HDL-C and LDL-C (Diff-C) with MetS. Observational studies were included without any language restriction. As exclusive studies evaluating the association of non-HDL-C with metabolic syndrome (MetS) were eligible to be included in quantitative analyses, a random-effect meta-analysis was performed to pool the odds ratios (ORs). A stratified meta-analysis was performed based on the definition of MetS [Adult Treatment Panel (ATP) and International Diabetes Federation (IDF)] and the studied population. RESULTS Overall, 318 studies were retrieved from an initial systematic search. After screening, 18 and five studies were included in the qualitative and quantitative syntheses, respectively. Qualitative synthesis revealed an association between non-HDL-C, Diff-C, and atherogenic index with MetS and its components. Stratified meta-analysis showed that an increased non-HDL-C level was associated with an increased odds of MetS based on ATP criteria (OR: 3.77, 95% CI: 2.14-5.39) and IDF criteria (OR: 2.71, 95% CI: 1.98-3.44) in adults (OR: 3.53, 95% CI: 2.29-4.78) and in children (OR: 2.27, 95% CI: 1.65-2.90). CONCLUSION Novel atherogenic lipid indices, including atherogenic index, Diff-c, and non-HDL-C, are strongly associated with increased odds of MetS and its components. The indices could be considered as potential predictors of MetS and its components in clinical practice.
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Affiliation(s)
- Parham Mardi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Abdi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Ehsani
- University of Medical Sciences, Tehran, Iran
| | - Ehsan Seif
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Heshmati
- Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Shahrestanaki
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Armita Mahdavi Gorabi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Armita Mahdavi Gorabi, ; Mostafa Qorbani,
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Armita Mahdavi Gorabi, ; Mostafa Qorbani,
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Abstract
PURPOSE OF REVIEW Cardiovascular (CV) disease is a major cause of mortality in type 2 diabetes mellitus (T2D). Dyslipidemia is prevalent in children with T2D and is a known risk factor for CVD. In this review, we critically examine the epidemiology, pathophysiology, and recommendations for dyslipidemia management in pediatric T2D. RECENT FINDINGS Dyslipidemia is multifactorial and related to poor glycemic control, insulin resistance, inflammation, and genetic susceptibility. Current guidelines recommend lipid screening after achieving glycemic control and annually thereafter. The desired lipid goals are low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, high-density lipoprotein cholesterol (HDL-C) > 35 mg/dL, and triglycerides (TG) < 150 mg/dL. If LDL-C remains > 130 mg/dL after 6 months, statins are recommended with a treatment goal of < 100 mg/dL. If fasting TG are > 400 mg/dL or non-fasting TG are > 1000 mg/dL, fibrates are recommended. Although abnormal levels of atherogenic TG-rich lipoproteins, apolipoprotein B, and non-HDL-C are commonly present in pediatric T2D, their measurement is not currently considered in risk assessment or management.
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Affiliation(s)
- Bhuvana Sunil
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Alabama at Birmingham, CPPII M30, 1601 4th Ave S, Birmingham, AL, 35233, USA
| | - Ambika P Ashraf
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Alabama at Birmingham, CPPII M30, 1601 4th Ave S, Birmingham, AL, 35233, USA.
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Oliosa PR, Zaniqueli DDA, Barbosa MCR, Mill JG. Relação entre composição corporal e dislipidemias em crianças e adolescentes. CIENCIA & SAUDE COLETIVA 2019; 24:3743-3752. [DOI: 10.1590/1413-812320182410.17662017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/07/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo Verificou-se a relação entre diferentes índices antropométricos e os lipídios plasmáticos. Os dados foram coletados de 2014 a 2016 em 854 escolares (6-18 anos). Foram aferidas a circunferência da cintura (CC), o percentual de gordura corporal (%G) por bioimpedância, o índice de massa corporal (IMC) e relação da cintura/estatura (RCE). Em sangue coletado em jejum mediu-se o colesterol total (CT), HDLc, e triglicerídeos e calculou-se o colesterol não HDL (Não HDLc). Os dados são apresentados por média ± desvio padrão, porcentagens. A comparação de médias foi feita pelo teste t ou ANOVA seguida de teste de Tukey. A associação entre variáveis foi testada por regressão linear. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal do Espírito Santo. Meninos obesos tinham CT, Não HDLc e LDLc mais elevados do que os eutróficos. Em meninas este achado foi apenas para o Não HDLc. Crianças com o %G e RCE inadequados apresentaram LDLc e Não HDLc maiores (p < 0,001), os quais associaram-se positivamente (p < 0,001) com as frações lipídicas (CT e Não HDLc). O excesso de gordura corporal elevou em 21% a probabilidade de ocorrência de colesterol acima da referência (170 mg/dL). O excesso de gordura corporal associou-se com o perfil lipídico aterogênico (maior Não HDLc), principalmente em meninos.
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Liu J, Gibson D, Stearne K, Dobbin SW. Skipping breakfast and non-high-density lipoprotein cholesterol level in school children: a preliminary analysis. Public Health 2019; 168:43-46. [PMID: 30685597 DOI: 10.1016/j.puhe.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/16/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of the study is to examine whether the increased levels of non-high-density lipoprotein cholesterol (non-HDL-c) are associated with skipping breakfast among school children. STUDY DESIGN A cross-sectional survey was conducted among 539 school children aged 8-12 years from the Niagara Region of Canada. METHODS Non-fasting finger blood was taken for total cholesterol (total-c) and HDL-c measurements. Non-HDL-c was calculated as the difference between total-c and HDL-c. The information of skipping breakfast in a week was obtained from a questionnaire, which was categorized into three groups, i.e., none, 1-3 times and 4 + times. Demographic information and other related variables were described by the three breakfast-skipping groups. RESULTS Approximately 44% of children (n = 182) reported skipping breakfast. There were significant differences between the three groups in the means of total-c, non-HDL-c, body mass index, waist circumference, proportions of overall health excellent, eating dinner with parent and skipping breakfast that affects learning (P < 0.05). The number of days of skipping breakfast was weakly correlated to the level of non-HDL-c (r = 0.145, P < 0.0001). Multiple regression results indicated that every one more time of skipping breakfast would increase approximately 0.05 mmol/L level of non-HDL-c (P < 0.01), on average, after adjusting for those aforementioned potential confounding variables. The adjusted mean levels of non-HDL-c were 2.77, 2.94 and 3.07 mmol/L for none, skipping 1-3 times and skipping 4 + times of breakfast, respectively; the mean differences between none and the other two groups were statistical significant (P < 0.05). CONCLUSION Non-HDL-c levels is positively associated with the number of skipping breakfast among school children, and further research is needed to confirm this relationship.
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Affiliation(s)
- J Liu
- Brock University, St. Catharines, Ontario, Canada.
| | - D Gibson
- Healthy Heart Schools' Program, Heart Niagara Inc., Niagara Falls, Ontario, Canada
| | - K Stearne
- Healthy Heart Schools' Program, Heart Niagara Inc., Niagara Falls, Ontario, Canada
| | - S W Dobbin
- Healthy Heart Schools' Program, Heart Niagara Inc., Niagara Falls, Ontario, Canada
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Sultan S, Dowling M, Kirton A, DeVeber G, Linds A, Elkind MSV. Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors. Pediatr Neurol 2018; 78:46-54. [PMID: 29229232 PMCID: PMC5776751 DOI: 10.1016/j.pediatrneurol.2017.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/27/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk factors for pediatric stroke are poorly understood and require study to improve prevention. Total cholesterol and triglyceride values peak to near-adult levels before puberty, a period of increased stroke incidence. The role of lipids in childhood arterial ischemic stroke has been minimally investigated. METHODS We performed a cross-sectional analysis of lipid and Lp(a) concentrations in children with arterial ischemic stroke in the International Pediatric Stroke Study to compare the prevalence of dyslipidemia and high- or low-ranking lipid values in our dataset with reported population values. We analyzed sex, body mass index, race, ethnicity, family history, and stroke risk factors for associations with dyslipidemia, high non-high-density lipoprotein cholesterol, and hypertriglyceridemia. RESULTS Compared with the National Health and Nutrition Examination Survey, a higher proportion of children ≥5 years with arterial ischemic stroke had dyslipidemia (38.4% versus 21%), high total cholesterol (10.6% versus 7.4%), high non-high-density lipoprotein cholesterol (23.1% versus 8.4%), and low high-density lipoprotein cholesterol (39.8% versus 13.4%). The lipid values that corresponded to one standard deviation above the mean (84th percentile) in multiple published national studies generally corresponded to a lower ranking percentile in children aged five years or older with arterial ischemic stroke. Dyslipidemia was more likely associated with an underweight, overweight, or obese body mass index compared with a healthy weight. Ethnic background and an acute systemic illness were also associated with abnormal lipids. CONCLUSIONS Dyslipidemia and hypertriglyceridemia may be more prevalent in children with arterial ischemic stroke compared with stroke-free children.
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Affiliation(s)
- Sally Sultan
- Department of Pediatrics, Columbia University Medical Center, New York, New York.
| | - Michael Dowling
- Department of Pediatrics and Neurology & Neurotherapeutics, Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Gabrielle DeVeber
- Division of Neurology and Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alexandra Linds
- Division of Neurology, Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
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