Association of monocyte/high-density lipoprotein cholesterol ratio and the carotid intima-media thickness in diabetic patients

Association between oxidative balance score and serum cobalt level in population with metal implants: a cross-sectional study from NHANES 2015-2020

Background

Growing evidence indicates that metal implants influence the body's oxidative stress status, which in turn affects the degradation and stability of metal implants. The oxidative balance score (OBS) is a composite indicator, reflecting the overall oxidative balance of pro-and antioxidants of the human body. However, the associations between OBS and the level of metal ions on the population with metal implants remain to be elucidated.

Methods

We conducted a cross-sectional study using data from 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). Dietary and lifestyle factors closely associated with oxidative stress were quantified to calculate the OBS. Weighted multivariate logistic regression and smooth curve fittings were performed to examine the relationship between OBS and serum cobalt levels. Subgroup analyses were stratified by age and gender. In cases where non-linearity was detected, threshold effects were assessed using a two-piecewise linear regression model.

Results

A total of 549 participants were included in this analysis. The dietary OBS was negatively associated with serum cobalt level in fully adjusted model (β = -0.179, 95%CI: -0.358 to -0.001, P: 0.04918). Stratified by age and gender, negative correlation of OBS and dietary OBS with serum cobalt level was observed only in men and age over 70 years participants. Threshold effect analysis showed linear relationships between OBS, dietary OBS and cobalt level in males. There were non-linear relationships between OBS, dietary OBS and cobalt level in age over 70 years participants, with inflection points identified at 16.3 and 8.7 for OBS and dietary OBS, respectively.

Conclusion

Our study confirms the inverse relationships between oxidative stress and serum cobalt level in individuals with metal implants, highlighting the significance of optimizing OBS to mitigate the risk of metal ion toxicity. These findings emphasize the importance of maintaining an antioxidant diet and lifestyle, particularly as they offer greater protective effect for males and the elderly population.

Systematic review and meta-analysis assessing the status of carotid intima-media thickness and lipid profiles in type 2 diabetes mellitus

OBJECTIVES

Carotid intima-media thickness (CIMT) is a measurement for subclinical atherosclerosis and has been associated with overall cardiovascular diseases, especially in type 2 diabetes mellitus (T2DM). We aimed to assess the status of carotid health and lipid profile in T2DM.

DESIGN

This systematic review and meta-analysis synthesised data published from clinical studies.

DATA SOURCES

Google Scholar, PubMed and Scopus were searched from inception to 18 January 2024.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies conducted in patients with T2DM and those without T2DM were included. Studies conducted in T2DM adults evaluating carotid status and lipid profile were considered.

DATA EXTRACTION AND SYNTHESIS

Two authors independently used standardised methods to comprehensively search, screen and extract data from all relevant studies. The risk of bias was assessed using the Newcastle-Ottawa checklist. Meta-analysis was conducted using Review Manager and metaHun through random effects models. The random effect model was used due to high heterogeneity.

RESULTS

Evidence was analysed from 57 studies with a sample size of 29 502 (8254 T2DM and 21 248 people without T2DM). There was a significantly higher CIMT, with a standardised mean difference (SMD) of 1.01 (95% CI 0.75, 1.26, p<0.00001). Additionally, there was an elevated triglyceride (TG) (SMD=1.12, 95% CI 0.82, 1.41, p<0.00001), total cholesterol (TC), (SMD=0.24, 95% CI 0.02, 0.46, p=0.03) and low-density lipoprotein-cholesterol (LDL-C), (SMD=0.35, 95% CI 0.11, 0.59, p=0.004) in patients with T2DM compared with those without T2DM. Furthermore, a significant decrease in high-density lipoprotein cholesterol (HDL-C) was observed in the T2DM compared with people without T2DM, SMD=-0.79, 95% CI -0.96, -0.62, p<0.00001). Age, body mass index and hypertension were associated with increased CIMT and TG and decreased HDL-C in T2DM. Additionally, age, gender and hypertension were associated with an increased LDL-C in T2DM.

CONCLUSION

Our findings suggest that an increased CIMT is accompanied by increased TG, TC, LDL-C and HDL-C reduction in patients with T2DM.

PROSPERO REGISTRATION NUMBER

CRD42023451731.

Association of carotid intima-media thickness and dyslipidaemia in patients with type 2 diabetes: a protocol for systematic review and meta-analysis

INTRODUCTION

Patients with diabetes mellitus (DM) often present with comorbidities such as hypertension, dyslipidaemia, insulin resistance, obesity and hyperglycaemia, which increases their risk of cardiovascular diseases (CVDs)-related mortality. Carotid intima-media thickness (CIMT), a biomarker for subclinical atherosclerosis, has been associated with overall CVD, especially in type 2 DM (T2DM). Hence, this protocol for systematic review and meta-analysis aims to review existing literature on the association of CIMT and dyslipidaemia in patients with T2DM.

METHODS AND ANALYSIS

The proposed systematic review and meta-analysis will be conducted according to an updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guideline. A comprehensive search of peer-reviewed studies on Google Scholar, PubMed, Science Direct and Web of Sciences databases will be conducted up to 30 June 2023. A meta-analysis of data extracted from selected studies will be performed to explore the association between dyslipidaemia and CIMT in patients with diabetes. The effect estimates will be reported as standardised mean differences/Cohen's d and 95% CIs. A random effect model will be used in case of high heterogeneity whereas fixed-effect model will be used in the absence of heterogeneity. All statistical analysis will be performed using SPSS V.29.0 software. In cases of high heterogeneity, subgroup analysis will be performed based on study design, countries of publication and body mass index to identify potential sources of heterogeneity. Publication bias will be assessed graphically via funnel plots and statistically using Egger's regression test. Sensitivity analysis will also be performed to evaluate the stability of the overall effect size and the grading of recommendations assessment, development and evaluation will be used to grade the quality of analysed evidence.

ETHICS AND DISSEMINATION

As the proposed study will use secondary published data, approval will not be sought from the ethics committee.

PROSPERO REGISTRATION NUMBER

CRD42023451731.

Monocyte to high-density lipoprotein ratio is associated with mortality in patients with coronary artery diseases

BACKGROUND

Whether the monocyte to high-density lipoprotein ratio (MHR) is associated with the prognosis of coronary artery disease (CAD) is inconclusive.

METHODS

Patients with CAD were enrolled and their data were collected. Blood was sampled within 24 h after admission. Multivariate Cox regression analysis was performed to determine the relationship between the MHR and all-cause mortality as well as complications during hospitalization.

RESULTS

We included 5371 patients in our cohort study. Among them, 114 (2.12%) patients died in hospital. MHR was independently associated with all-cause mortality (hazard ratio [HR], 1.81; 95% confidence interval [CI] 1.35, 2.42), cardiovascular mortality (1.69; 1.17, 2.45) and non-cardiovascular mortality (2.04; 1.27, 3.28). This association was only observed in patients with hypertension (P for interaction = 0.003). Patients with higher MHR levels also have a higher risk of complications, including infection, pneumonia, electrolyte disturbance, gastrointestinal bleeding, multiple organ dysfunction syndrome, and disturbance of consciousness. The receiver operating characteristic (ROC) analysis showed that the MHR had higher prognostic values than monocytes and high-density lipoprotein.

CONCLUSION

MHR was an independent predictor of all-cause mortality and in-hospital complications in patients with CAD, especially in patients with hypertension.