Correlation between Body Mass Index and Lipid Profile in patients with Type 2 Diabetes attending a tertiary care hospital in Peshawar

Dietary and plasma atherogenic and thrombogenic indices and cardiometabolic risk factors among overweight and individuals with obesity

BACKGROUND

Obesity and hyperlipidemia are the two central metabolic disorders linked to non-communicable diseases (NCDs) that increase the risk of cardiovascular disease (CVD). Apart from dyslipidemia, the Atherogenic Index of Plasma (AIP), which is associated with dietary consumption, is another marker for predicting the risk of CVD. Healthy fat quality indicators may impact AIP. The purpose of this study is to ascertain whether there is any connection between Iranian obese people's plasma and dietary indices and cardiometabolic risk factors.

METHODS

This cross-sectional study, consisted of 645 overweight and obese participants. The study included assessments of body composition and anthropometric measurements. Dietary fatty acid consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) containing 168 items. Additionally, biochemical parameters, including serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were measured using enzymatic methods. The lipid profile was quantified.

RESULTS

For participants in higher tertiles of the AIP, the percentage of men was significantly higher than women (men: 48.1%, women: 51.7%, p < 0.001). Additionally, individuals in higher tertiles of AIP had a higher waist-to-hip ratio (WHR) (mean WHR: 0.92 ± 0.05 vs. 0.86 ± 0.04 in lower tertile, p < 0.001). Participants in the highest tertile of AIP had higher systolic blood pressure (SBP: 132 ± 8 mmHg vs. 118 ± 6 mmHg in lower tertile, p < 0.001), total cholesterol (TC: 210 ± 15 mg/dL vs. 185 ± 12 mg/dL, p < 0.001), triglycerides (TG: 180 ± 20 mg/dL vs. 120 ± 15 mg/dL, p < 0.001), and glucose concentrations (fasting glucose: 105 ± 10 mg/dL vs. 90 ± 8 mg/dL, p < 0.001). Participants in the lower tertile of AIP had higher HDL cholesterol levels (HDL: 60 ± 5 mg/dL vs. 45 ± 4 mg/dL in higher tertile, p < 0.001). In the model for Thrombogenicity Index (TI), participants in the higher tertile had higher glucose concentrations (glucose: 110 ± 12 mg/dL vs. 95 ± 9 mg/dL in lower tertile, p = 0.04).

CONCLUSION

This research introduces a novel field of investigation and emphasizes the possible importance of TI, AI, and AIP indices in regulating cardiometabolic risk factors.

The impact of overweight on lipid phenotype in different forms of dyslipidemia: a retrospective cohort study

PURPOSE

Dyslipidemia plays a pivotal role in increasing cardiovascular risk. In clinical practice the misleading association between altered lipid profile and obesity is common, therefore genetically inherited dyslipidemias may not completely be addressed among patients with overweight. Thus, we aim to investigate the influence of overweight and obesity on the lipid phenotype in a cohort of patients with different forms of dyslipidemia.

METHODS

A retrospective analysis was conducted on patients with dyslipidemia from 2015 to 2022. Patients were stratified in familial hypercholesterolemia (FH), familial combined hyperlipidemia (FCHL), non-familial hyperlipidemia or polygenic hypercholesterolemia (PH). Clinical characteristics and lipid profile were evaluated.

RESULTS

Of the total of 798 patients, 361 were affected by non-familial hyperlipidemia (45.2%), while FCHL, FH and PH was described in 19.9%, 14.0% and 20.9% of patients, respectively. Overweight prevalence was higher in FCHL and non-familial hyperlipidemia patients than FH and PH patients. Subjects with overweight and obesity were independently associated with lower levels of high-density lipoprotein cholesterol (HDL-C) compared to patients with normal weight (52.4 and 46.0 vs 58.1, respectively; p < 0.0001); levels of triglycerides (TG) and non-HDL-C were higher in patients with overweight and obesity than patients with normal weight (257.3 and 290.9 vs 194.8, and 221.5 and 219.6 vs 210.1, p < 0.0001 and p = 0.01, respectively), while no differences were observed between patients with overweight and obesity.

CONCLUSION

While dyslipidemias can be influenced by various factors, an important determinant may lie in genetics, frequently acting as an underlying cause of altered lipid profiles, even in cases of overweight conditions.

Reference intervals for 23 common biochemical parameters during pregnancy and the first six postpartum months

The concentration of many biochemical parameters changes significantly during pregnancy and the postpartum period, causing a need for specific reference values for biochemical parameters in these life periods. We have collected blood samples in pregnancy week 18, 28 and 36 and six weeks, four months and six months postpartum from 139 healthy women. Blood samples from 59 healthy never-pregnant women were included as controls. Serum samples were analyzed for 23 common biochemical parameters and reference intervals for pregnancy and postpartum periods were computed with the non-parametric method in accordance with recommendations from IFCC and CLSI. The dynamics of different biochemical parameters during and after pregnancy vary considerably between parameters. Some analytes like serum amylase and HDL cholesterol do not differ from never-pregnant values. Of the 23 parameters, serum alkaline phosphatase, chloride, gamma-glutamyl transferase and sodium and urea which were still significantly changed at six months postpartum compared to never-pregnant women. The physiological changes related to pregnancy and lactation have profound effects on biochemical parameters, denoting the use of specific reference intervals for both pregnancy and the postpartum period.

A low-carbohydrate, high-fat diet leads to unfavorable changes in blood lipid profiles compared to carbohydrate-rich diets with different glycemic indices in recreationally active men

Objective

In addition to recent discussions of low-carbohydrate, high-fat diets (LCHF) from a performance perspective, there is a paucity of knowledge regarding influence of the combined effect of an exercise and nutritional intervention, which varies in carbohydrate (CHO) intake and glycemic indices, on blood lipid levels in recreationally active men.

Methods

A total of 65 male runners (VO2 peak = 55 ± 8 mL·min-1·kg-1) completed a 10-week ad libitum nutritional regimen (LOW-GI: ≥ 65% low GI CHO per day, n = 24; HIGH-GI: ≥ 65% high GI CHO per day, n = 20; LCHF: ≤ 50 g CHO daily, n = 21) with a concurrent prescribed endurance training intervention. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined before and after the intervention. Additionally, 24-h dietary recalls were completed twice weekly.

Results

Following the intervention, TC was significantly higher in LCHF (196 ± 37 mg·dL-1) compared to both LOW-GI (171 ± 41 mg·dL-1) and HIGH-GI (152 ± 28 mg·dL-1, p < 0.001). Additionally, LDL-C levels increased in LCHF (+17 ± 21 mg·dL-1, p = 0.001), while they decreased in both CHO groups (p < 0.05, respectively). Only the HIGH-GI group demonstrated a significant reduction in HDL-C (-3 ± 9 mg·dL-1, p = 0.006), while a decrease in TG was only significant in LOW-GI (-18 ± 36 mg·dL-1, p = 0.008).

Conclusion

Although mean blood lipid levels remained within the normal range, the data indicate that a low-carbohydrate, high-fat (LCHF) diet leads to unfavorable changes in individual blood lipid profiles compared to carbohydrate-rich diets. Therefore, it is recommended that the impact of a low-carbohydrate diet on blood lipids be considered when counseling active and healthy individuals.

Lipid Metabolism Disorders as Diagnostic Biosignatures in Sepsis

Critical illness causes disturbances in lipid metabolism. Here, we investigated the levels of apolipoprotein A-IV (apoA-IV), a regulator of triglyceride and cholesterol metabolism, in human sepsis. ApoA-IV (analyzed in 156 patients with systemic inflammatory response syndrome (SIRS)/sepsis) and cholesteryl ester (CE) (analyzed in 121 of these patients) were lower in patients compared to 43 healthy controls. In contrast, triglyceride (TG) levels were elevated in patients. ApoA-IV levels in plasma of the patients did not correlate with these lipids. Patients with SIRS, sepsis or septic shock had comparable apoA-IV, TG, CE and free cholesterol (FC) levels. Patients on dialysis had significantly lower CE levels, whereas apoA-IV levels did not change much. CE levels were elevated in patients with viral sepsis due to SARS-CoV-2 infection in comparison to SIRS/sepsis patients not infected by this virus. CE levels correlated negatively with procalcitonin, interleukin-6 and bilirubin, while TGs were positively associated with bilirubin and C-reactive protein. ApoA-IV, TG, CE and FC levels were not associated with bacterial infection or survival. In conclusion, this analysis suggests that CE levels decline in sepsis-related renal failure and also shows that plasma apoA-IV and CE levels are early biomarkers of sepsis.

Unmasking the Risk Factors Associated with Undiagnosed Diabetes and Prediabetes in Ghana: Insights from Cardiometabolic Risk (CarMeR) Study-APTI Project

INTRODUCTION

Undiagnosed diabetes poses significant public health challenges in Ghana. Numerous factors may influence the prevalence of undiagnosed diabetes among adults, and therefore, using a model that takes into account the intricate network of these relationships should be considered. Our goal was to evaluate fasting plasma levels, a critical indicator of diabetes, and the associated direct and indirect associated or protective factors.

METHODS

This research employed a cross-sectional survey to sample 1200 adults aged 25-70 years who perceived themselves as healthy and had not been previously diagnosed with diabetes from 13 indigenous communities within the Cape Coast Metropolis, Ghana. Diabetes was diagnosed based on the American Diabetes Association (ADA) criteria for fasting plasma glucose, and lipid profiles were determined using Mindray equipment (August 2022, China). A stepwise WHO questionnaire was used to collect data on sociodemographic and lifestyle variables. We analyzed the associations among the exogenous, mediating, and endogenous variables using a generalized structural equation model (GSEM).

RESULTS

Overall, the prevalence of prediabetes and diabetes in the Cape Coast Metropolis was found to be 14.2% and 3.84%, respectively. In the sex domain, females had a higher prevalence of prediabetes (15.33%) and diabetes (5.15%) than males (12.62% and 1.24%, respectively). Rural areas had the highest prevalence, followed by peri-urban areas, whereas urban areas had the lowest prevalence. In the GSEM results, we found that body mass index (BMI), triglycerides (TG), systolic blood pressure (SBP), gamma-glutamyl transferase (GGT), and female sex were direct predictive factors for prediabetes and diabetes, based on fasting plasma glucose (FPG) levels. Indirect factors influencing diabetes and prediabetes through waist circumference (WC) included childhood overweight status, family history, age 35-55 and 56-70, and moderate and high socioeconomic status. High density lipoprotein (HDL) cholesterol, childhood overweight, low physical activity, female sex, moderate and high socioeconomic status, and market trading were also associated with high BMI, indirectly influencing prediabetes and diabetes. Total cholesterol, increased TG levels, WC, age, low physical activity, and rural dwellers were identified as indirectly associated factors with prediabetes and diabetes through SBP. Religion, male sex, and alcohol consumption were identified as predictive factors for GGT, indirectly influencing prediabetes and diabetes.

CONCLUSIONS

Diabetes in indigenous communities is directly influenced by blood lipid, BMI, SBP, and alcohol levels. Childhood obesity, physical inactivity, sex, socioeconomic status, and family history could indirectly influence diabetes development. These findings offer valuable insights for policymakers and health-sector stakeholders, enabling them to understand the factors associated with diabetes development and implement necessary public health interventions and personalized care strategies for prevention and management in Ghana.

Correlates of normal and decreased HDL cholesterol levels in type 2 diabetes: a cohort-based cross-sectional study

BACKGROUND

The literature describes an inverse association between the values of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). This survey was designed to exhibit the features of people with type 2 diabetes (T2D) who display this inverse association and identify potential contributing factors to having normal HDL-C values.

METHODS

A total of 6127 persons with T2D were assigned to the present survey. Demographic features and clinical status data were compared between subjects with a substantial inverse association of TG and HDL-C and those without. Logistic regressions were performed to ascertain the role of different factors related to normal HDL-C. Moreover, the restricted cubic spline (RCS) functions were conducted to scrutinize the underlying relationships between the studied variables and low HDL-C levels.

RESULTS

Patients with high TG (150 ≤ TG < 400) compared to patients with normal TG (TG < 150) were less likely to have normal HDL-C. Younger age, narrow hip, lower levels of blood pressure, two-hour postprandial glucose (2hPP), fasting blood sugar (FBS), hemoglobinA1C (HbA1C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and non-HDL-C, higher atherogenic index of plasma (AIP), and TG/HDL-C ratio correlate with an inverse connection between the values of HDL-C and TG (all P < 0.05). Age greater than 65 years (odds ratio (OR) 1.260, 95% confidence intervals (CI) 1.124-1.413) had a positive association, whereas female sex (OR 0.467, CI 0.416-0.523) , 25 kg/m2 < body mass index (BMI) (OR 0.786, CI 0.691-0.894), and higher serum creatinine levels (OR 0.481, CI 0.372-0.621) had an inverse association with having normal HDL-C.

CONCLUSIONS

Patients with an inverse connection between TG and HDL-C values had considerably different anthropometric features, lipid profiles, and glucose indices compared to those without this relationship. Furthermore, patients who aged less than 65 years, had female gender, BMI more than 25 kg/m2, and higher serum creatinine levels were less likely to exhibit normal HDL-C levels.

Exploring the Effects of Short-Term Daily Intake of Nitraria retusa Tea on Lipid Profile: A Pre-Post, Uncontrolled Pilot Study in Both Healthy and Overweight/Obese Adults

In the present study, we aimed to explore the feasibility, compliance, and potential benefits of Nitraria retusa extract (NRE) intervention in both healthy (BMI ≤ 24.9 Kg/m2) and overweight/obese adults (BMI > 25 Kg/m2). A total of 98 participants, including 37 healthy individuals and 61 overweight/obese adults, were randomly assigned to either a low-dose (500 mg/day) or a high-dose (2000 mg/day) NRE intervention group. Plasma lipid biomarkers, liver and kidney functions, general hematology, and blood glucose levels were measured at the baseline and 10 days after intervention. While the lipid profile of the healthy participants did not show any statistically significant changes, the obese participants in the high-dose group experienced a significant decrease in triglyceride levels (within-group difference p value = 0.004) and an increase in HDL levels (within-group p value < 0.001). No significant differences were observed in other parameters, indicating that NRE at the given doses was safe. Furthermore, the study had impressive compliance and acceptability, with over 90% of participants completing the intervention and diligently following the study protocol. This pilot study represents the first investigation into the feasibility, acceptability, and potential benefits of NRE intervention on lipid profiles in human volunteers.

Loss of Anthropometry-Lipids Relationship in Obese Adults: A Cross-Sectional Study in Southern China

Background

Emerging data suggest that the interpretation of the association between obesity and lipids appears to be oversimplified. This study aimed to quantify the complex relationships between anthropometric indices and lipid profile.

Methods

This is a cross-sectional study including 9620 participants in Southern China. Anthropometric indices included the indices of general obesity (ie, body mass index (BMI)) and central obesity (ie, waist circumference (WC) and waist-to-hip ratio (WHR)). Lipids included low-density lipoprotein cholesterol (LDLc) and atherogenic lipids (ie, high-density lipoprotein cholesterol (HDLc), triglycerides (TG) and TG/HDLc ratio). LOESS regression and general linear model were the main statistical methods.

Results

Almost all associations between anthropometric indices and lipids were lost in obese adults. The loss of association occurred quicker with LDLc than that with atherogenic lipids; the break point for the association loss was at BMI of 24 kg/m² with LDLc (Slope _{Below break-point} = 1.81, P<0.001; Slope _{Above break-point} = 0.29, P=0.121), while at 28 kg/m² with HDLC (Slope _{Below break-point} = -1.41, P<0.001; Slope _{Above break-point} = 0.07, P=0.666) or TG (Slope _{Below break-point} = 4.96, P<0.001; Slope _{Above break-point} = 2.93, P=0.01), and at 30 kg/m² with TG/HDLc ratio (Slope _{Below break-point} = 0.15, P<0.001; Slope _{Above break-point}= 0.01, P=0.936), respectively. Similar relationships were found for WC and WHR. Besides, the presence of other metabolic disorders contributed to the loss of anthropometry-lipids relationships, for example, the BMI-LDLc association attenuated to null in both obese adults and non-obese population but with more than one other metabolic disorders.

Conclusion

The relationships were lost between anthropometric indices and lipids in obese adults with different break points across different lipids, which appeared to be dependent on metabolic status.

Prevalence of dyslipidaemia in OSA patients at a tertiary care center

Background Obstructive sleep apnea (OSA) is associated with many diseases, but evidence indicating that OSA is a risk factor for dyslipidemia is lacking. Aim This cross-sectional study investigated the prevalence of lipid abnormalities in patients with OSA and its association with OSA severity.

MATERIAL AND METHODS

In this cross-sectional study, 102 patients with suspected OSA underwent standard polysomnography. All patients with an apnea-hypopnea index (AHI) of ≥5 with symptoms were diagnosed as having OSA. A fasting blood sample was collected from all patients. Blood levels of triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) were measured. The relationship between the AHI and lipid profiles was analyzed, and linear regression analysis was performed to evaluate the effect of dyslipidemia on OSA.

RESULTS

The patients with OSA had a significantly higher TG level and a significantly lower HDL level than did those without OSA. The lipid abnormalities increased with OSA severity. The mean serum TG level was higher in the severe OSA group (175±46.5 vs. 153±42.45, mg/dl P = 0.048), and the mean serum HDL level was lower in the severe OSA group (38.43 ± 5.19 vs. 45.73 ± 4.98, mg/dl P = 0.004). Serum TG, cholesterol, and LDL levels were correlated with a BMI of <30 and a BMI of >30 in the OSA group. Linear regression analysis indicated that only age (β = 0.301, P = 0.000), BMI (β = 0.455, P = 0.000), serum HDL level (β = -0.297, P = 0.012), and serum LDL level (β = 0.429, P = 0.001) were the independent predictors of OSA.

CONCLUSION

OSA and obesity are potential risk factors for dyslipidemia. The diagnosis of hyperlipidemia was linked to OSA, and the association was more significant with OSA severity. Hyperlipidemia was well recognized in patients with OSA. LDL and HDL are the independent predictors of OSA.

Patterns of change in obesity indices and other cardiometabolic risk factors before the diagnosis of type 2 diabetes: two decades follow-up of the Tehran lipid and glucose study

BACKGROUND

Identifying patterns of variation in obesity indices and other cardiometabolic risk factors before the diagnosis of type 2 diabetes could provide insight into the critical period when drastic changes occurred and facilitate targeted interventions for the prevention of diabetes. Therefore, this study sought to explore patterns of change in obesity indices and other cardiometabolic risk factors before diabetes diagnosis.

METHODS

We investigated 6305 participants (43.7% men) aged 20-65 from the Tehran Lipid and Glucose Study (TLGS) who were free of diabetes at baseline. First, we jointly estimated developmental multi-trajectories of obesity indices using multivariate latent class growth mixed model, and then patterns of cardiometabolic risk factors within the identified multi-trajectories were assessed using mixed-effects models.

RESULTS

Three patterns of change in obesity indices were identified. Most participants belonged to the "progressing" group (83.4%; n = 742), with a slight but steadily rising in obesity indices until diagnosis in both men and women. All multi-trajectory groups showed similar exponential increases in fasting and 2-h plasma glucose concentrations 6 years before diagnosis and linear increases in blood pressure and total and LDL cholesterol throughout follow-up. Patterns of triglyceride and HDL cholesterol accompanied each group's patterns of change in obesity indices.

CONCLUSION

Three patterns of the joint progression of obesity indices before diabetes diagnosis were accompanied by similar blood glucose patterns and other cardiometabolic risk factors. These findings suggest the impact of the increasing trend of obesity indices and other metabolic factors on the incidence of diabetes and emphasize the importance of assessing the metabolic risk factors at each visit.

The differences of serum lipid profiles between primary aldosteronism and essential hypertension: a meta-analysis and systematic review

BACKGROUND

The data on lipid profile differences between primary aldosteronism (PA) and essential hypertension (EH) patients are inconsistent and inconclusive. Most studies reported lower levels of lipid profiles in PA than in EH. This meta-analysis aimed to explore differences in serum lipid profiles including triglyceride (TG), total cholesterol (TC), LDL and HDL levels in PA patients and EH patients.

METHODS

A search of published studies was performed using PubMed, Embase and Scopus databases from their inception through August 2022. Thirty studies involving 11,175 patients were identified. Inclusion criteria included 1) observational studies which contained data on any of the lipid profiles of interest (TG, TC, LDL and HDL) which could be acquired from baseline data or the outcomes, 2) data which should be compared between adult PA and EH patients and 3) the use of appropriate methods to diagnose PA. Standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated to assess effect size by using STATA program version 15.0. Risk of bias was assessed by Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional, cohort and case-control studies.

RESULTS

Levels of the lipid parameters TG (SMD - 0.16 mmol/L; 95%CI (- 0.25, - 0.07)), TC (SMD - 0.30 mmol/L; 95%CI (- 0.41, - 0.19)) and LDL (SMD - 0.17 mmol/L; 95%CI (- 0.27, - 0.08)) were significantly lower in PA than in EH patients. There was no statistically significant difference in HDL between PA and EH patients (SMD - 0.08 mmol/L; 96%CI (- 0.23,0.07)). High levels of heterogeneity for TG, TC, HDL and LDL were observed in all studies. Risk of bias among the studies was low to moderate.

CONCLUSION

Lower levels of TG, TC and LDL were observed in PA than in EH patients. Further study should be conducted to address the underlying mechanisms of lipid alteration in PA.

Prevalence and Regulation of Dyslipidemia Among Adults With Type 2 Diabetes From Three Primary Health Care Centers in Riyadh

Background

Dyslipidemia is an added risk factor in patients with type 2 diabetes who are more prone to develop cardiovascular diseases as it implies an alteration of the lipid level leading to serious health complications.

Objective

This study aimed at assessing the prevalence of dyslipidemia among patients with type 2 diabetes and comparing the lipid profile measurements between controlled and uncontrolled type 2 diabetic patients.

Method

A cross-sectional retrospective study was performed in three primary health care centers in Saudi Arabia. A sample of 418 patients with type 2 diabetes was enrolled in this study. To collect data, the researcher used a structured questionnaire and retrieved patients' data from the electronic medical records in the study setting.

Results

The findings of the study showed that 82.1% of type 2 diabetes mellitus (DM) patients recruited in this study were dyslipidemic. In addition, it was found that there was a significant difference in triglycerides, fasting blood sugar (FBS), and high-density lipoprotein (HDL) between controlled and uncontrolled diabetic patients (p≤0.05). Moreover, a significant interaction was found between gender, HbA1c control, educational level, and frequency of exercising on one hand and dyslipidemia on the other hand (p≤0.05).

Conclusion

The study concluded that there is a high prevalence of dyslipidemia among type 2 diabetic patients in Saudi Arabia and a significant interaction between dyslipidemia and diabetic patients' gender, HbA1c control, educational level, and frequency of exercising. The study recommends increasing type 2 diabetic patients' awareness regarding the management of diabetes and dyslipidemia and the importance of providing educational intervention regarding diabetes self-care activities.

Effect of Dysglycemia on Urinary Lipid Mediator Profiles in Persons With Pulmonary Tuberculosis

Background

Oxidized lipid mediators such as eicosanoids play a central role in the inflammatory response associated with tuberculosis (TB) pathogenesis. Diabetes mellitus (DM) leads to marked changes in lipid mediators in persons with TB. However, the associations between diabetes-related changes in lipid mediators and clearance of M. tuberculosis (Mtb) among persons on anti-TB treatment (ATT) are unknown. Quantification of urinary eicosanoid metabolites can provide insights into the circulating lipid mediators involved in Mtb immune responses.

Methods

We conducted a multi-site prospective observational study among adults with drug-sensitive pulmonary TB and controls without active TB; both groups had sub-groups with or without dysglycemia at baseline. Participants were enrolled from RePORT-Brazil (Salvador site) and RePORT-South Africa (Durban site) and stratified according to TB status and baseline glycated hemoglobin levels: a) TB-dysglycemia (n=69); b) TB-normoglycemia (n=64); c) non-TB/dysglycemia (n=31); d) non-TB/non-dysglycemia (n=29). We evaluated the following urinary eicosanoid metabolites: 11α-hydroxy-9,15-dioxo-2,3,4,5-tetranor-prostane-1,20-dioic acid (major urinary metabolite of prostaglandin E2, PGE-M), tetranor-PGE₁ (metabolite of PGE2, TN-E), 9α-hydroxy-11,15-dioxo-2,3,4,5-tetranor-prostane-1,20-dioic acid (metabolite of PGD2, PGD-M), 11-dehydro-thromboxane B2 (11dTxB2), 2,3-dinor-6-keto-PGF₁α (prostaglandin I metabolite, PGI-M), and leukotriene E4 (LTE₄). Comparisons between the study groups were performed at three time points: before ATT and 2 and 6 months after initiating therapy.

Results

PGE-M and LTE₄ values were consistently higher at all three time-points in the TB-dysglycemia group compared to the other groups (p<0.001). In addition, there was a significant decrease in PGI-M and LTE₄ levels from baseline to month 6 in the TB-dysglycemia and TB-normoglycemia groups. Finally, TB-dysglycemia was independently associated with increased concentrations of PGD-M, PGI-M, and LTE₄ at baseline in a multivariable model adjusting for age, sex, BMI, and study site. These associations were not affected by HIV status.

Conclusion

The urinary eicosanoid metabolite profile was associated with TB-dysglycemia before and during ATT. These observations can help identify the mechanisms involved in the pathogenesis of TB-dysglycemia, and potential biomarkers of TB treatment outcomes, including among persons with dysglycemia.

Activation of circulating monocytes by low-density lipoprotein-a risk factor for osteoarthritis?

Synovial macrophages are key mediators of OA pathology, and skewing of macrophage phenotype in favour of an M1-like phenotype is thought to underlie the chronicity of synovial inflammation in OA. Components of the metabolic syndrome (MetS), such as dyslipidaemia, can affect macrophage phenotype and function, which could explain the link between MetS and OA development. Recently published studies have provided novel insights into the different origins and heterogeneity of synovial macrophages. Considering these findings, we propose an important role for monocyte-derived macrophages in particular, as opposed to yolk-sac derived residential macrophages, in causing a pro-inflammatory phenotype shift. We will further explain how this can start even prior to synovial infiltration; in the circulation, monocytes can be trained by metabolic factors such as low-density lipoprotein to become extra responsive to chemokines and damage-associated molecular patterns. The concept of innate immune training has been widely studied and implicated in atherosclerosis pathology, but its involvement in OA remains uncharted territory. Finally, we evaluate the implications of these insights for targeted therapy directed to macrophages and metabolic factors.

The relationship between body mass index, blood pressure, and atherosclerosis risk factors in type 1 and 2 diabetic patients from northwestern Algeria

Objective. The present work was framed to study the relationship between body mass index (BMI), blood pressure, and atherosclerosis risk factors on the basis of three lipid ratios in type 1 (T1D) and type 2 diabetic (T2D) patients.

Methods. A prospective, comparative, and cross-sectional study was performed at the level of three health facilities in Sidi-Bel-Abbes city (north-western Algeria). Anthropometric parameters, systolic and diastolic blood pressures, and lipid profiles were assessed in adults T1D and T2D patients over a period of eleven months. Individual atherogenic risk factors were estimated based on lipid ratios in relation to corpulence and hypertension.

Results. From the total 237 adult diabetic patients, 90 T1D and 147 T2D ones were involved in the study. Total cholesterol (TC)/high-density lipoprotein (HDL) and triglycerides (TG)/HDL ratios were significantly higher in normal weight T2D comparing to T1D. The TC/HDL ratio was significantly higher (p=0.046) in obese men. Nevertheless, no significant differences were revealed in low-density lipoprotein (LDL)/HDL ratio between T1D and T2D patients. Higher TC/HDL ratios were observed in T2D patients (males and females) with normal blood pressure (systolic blood pressure, SBP ≤13.5 mmHg and diastolic blood pressure, DBP ≤8 mmHg) comparing to T1D patients. Likewise, the LDL/HDL ratio was significantly higher in T2D men with normal DBP (p=0.044).

Conclusion. The lipid ratios constitute good indices while managing diabetes. It is also recommended to screen T1D and T2D patients for hypertension, dyslipidemia, and obesity and initiate the management at early stages to prevent the related complications, such as atherosclerosis, as a priority.

Hydroalcoholic extract of dill and aerobic training prevents high-fat diet-induced metabolic risk factors by improving miR-33 and miR-223 expression in rat liver

Exercise training and medicinal herb supplementation may improve microRNAs (miRNAs) expression associated with obesity. This study aimed to assess the effects of 10 weeks of aerobic training (AT) and dill extract (DE) on miR-33 and miR-223 expression of liver in high-fat diet (HFD)-induced obese rats. Forty male Wistar rats were fed a defined high-fat (n = 32) and standard (n = 8, nonobese control [NC]) diet. After obesity induction, obese rats were randomly allocated to four groups: AT, DE, AT + DE, and obese control (OC). Rats were euthanized and plasma and liver tissue samples were collected after the intervention. The liver expression of miR-33 was lower in the AT, DE, AT + DE, and NC groups compared with the OC group. Also, the liver miR-223 expression was higher in the AT, DE, AT + DE, and NC groups compared with the OC group. Moreover, the liver expression of miR-223 in the AT + DE group was higher compared with the AT and DE groups. The AT, DE, AT + DE, and NC groups had lower liver TC compared with the OC group. Also, the plasma level of apolipoprotein B (Apo B) was significantly lower, and liver HDL-C was significantly higher in the AT + DE and NC groups compared with the OC group. These findings show that long-term AT combined with the intake of DE may improve the plasma levels of Apo B, and TC and HDL-C levels in the liver, which is probably due to AT and DE positive effects on miR-33 and miR-223 in the liver of obese rats. PRACTICAL APPLICATIONS: Aerobic training reduces overweight and obesity health problems, however, the duration and intensity of the exercise training distinguish between individuals. We used an integrated approach combining pharmacological and non-pharmacological as a medical strategy to prevent HFD-induced metabolic injury in obese rats. The present results discovered that a combination of AT + DE intervention improves the miR-33 and miR-223 in the liver of obese rats.

A review on interplay between obesity, lipoprotein profile and nutrigenetics with selected candidate marker genes of type 2 diabetes mellitus

BACKGROUND

Type 2 diabetes mellitus, a rapidly growing epidemic, and its frequently related complications demand global attention. The two factors commonly attributed to the epidemic are genetic factors and environmental factors. Studies indicate that the genetic makeup at an individual level and the environmental aspects influence the occurrence of the disease. However, there is insufficiency in understanding the mechanisms through which the gene mutations and environmental components individually lead to T2DM. Also, discrepancies have often been noted in the association of gene variants and type 2 diabetes when the gene factor is examined as a sole attribute to the disease.

STUDY

In this review initially, we have focused on the proposed ways through which CAPN10, FABP2, GLUT2, TCF7L2, and ENPP1 variants lead to T2DM along with the inconsistencies observed in the gene-disease association. The article also emphasizes on obesity, lipoprotein profile, and nutrition as environmental factors and how they lead to T2DM. Finally, the main objective is explored, the environment-gene-disease association i.e. the influence of each environmental factor on the aforementioned specific gene-T2DM relationship to understand if the disease-causing capability of the gene variants is exacerbated by environmental influences.

CONCLUSION

We found that environmental factors may influence the gene-disease relationship. Reciprocally, the genetic factors may alter the environment-disease relationship. To precisely conclude that the two factors act synergistically to lead to T2DM, more attention has to be paid to the combined influence of the genetic variants and environmental factors on T2DM occurrence instead of studying the influence of the factors separately.

Determinants of glycaemic control among type 2 diabetes mellitus patients in Northern State of Kedah, Malaysia: a cross-sectional analysis of 5 years national diabetes registry 2014-2018

Introduction

type 2 diabetes mellitus has become a global public health crisis. The increment in the cases has contributed significantly to the parallel increase in the prevalence of overweight and obesity. This paper aimed to analyse the relationship between lipid profile, waist circumference and body mass index (BMI) with the glycaemic control of the diabetes patients in Kedah.

Methods

a cross-sectional study was conducted, using the Kedah audit samples data extracted from the National Diabetes Registry (NDR) from the year 2014 to 2018. A total of 25,062 registered type 2 diabetes mellitus patients were selected using the inclusion and exclusion criteria from the registry. Only patients with complete data on their HbA1C, lipid profile, waist circumference and BMI were analysed using SPSS version 21.

Results

the means for the age, BMI and waist circumference of the samples were 61.5 (±10.85) years, 27.3 (±5.05) kg/m² and 89.46 (±13.58) cm, respectively. Poor glycaemic control (HbA1c>6.5%) was observed in 72.7% of the patients, with females having poorer glycaemic control. The BMI and waist circumference were found to be significantly associated with glycaemic control (P<0.001). The total cholesterol, triglycerides and low-density lipoproteins values showed positive correlation with glycaemic control (r = 0.178, 0.157, 0.145, p<0.001), while high-density lipoproteins values are negatively correlated (r = -0.019, p<0.001).

Conclusion

implementing lifestyle changes such as physical activity and dietary modifications are important in the management of BMI, waist circumference and body lipids, which in turn results in improved glycaemic control.

Analysis of fitness among Korean adults by the cause-effect relation in lump mean scheme

BACKGROUND

The aim of this study was to examine whether the fitness of Korean adults can be analyzed by the cause-effect relation using the linearity or Gaussianity in the lump mean scheme (LMS).

METHODS

This study analyzed previous results for the sit-up test obtained in the LMS by regression analysis in Sigmaplot 14. The effects of the body mass index (BMI) and new waist-to-height ratio (WHT2R) introduced by the present author on fitness were investigated.

RESULTS

The distribution of the sit-up test score with respect to the BMI and WHT2R were interpreted by their Gaussianity and linearity, respectively. This means that the muscular endurance of males is determined by two causes (fat and muscle) when the BMI is a variable and one cause (abdominal fat) when the WHT2R is a variable.

CONCLUSIONS

Personal exercise aims were simpler to establish using WHT2R than using BMI. On the other hand, it was recommended for people with a low BMI to increase their fitness using exercises that increase their muscle mass.

Undiagnosed Diabetes and Prediabetes in Patients with Chronic Coronary Syndromes-An Alarming Public Health Issue

Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male (n = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.

Prevalence and associated factors of uncontrolled hyperlipidemia among Thai patients with diabetes and clinical atherosclerotic cardiovascular diseases: a cross-sectional study

Objectives

The research aimed to determine the prevalence and associated factors of uncontrolled hyperlipidemia among Thai patients with the disease and Clinical ASCVD.

Results

A total of 1,527 Thai diabetic patients with a history of ASCVD were included in the study. Uncontrolled hyperlipidemia was detected among 1,216 patients (79.6%; 95% CI 77.6–81.7). The independent factors associated with uncontrolled hyperlipidemia included being female (adjusted odds ratio (AORs); 1.5, 95% CI 1.2–2.0), using thiazolidinedione (AORs; 1.7, 95% CI 1.1–2.7), community hospital (AORs; 4.3, 95% CI 1.0–18.0) and BMI level at 18.5–22.9 kg/m² (AORs; 2.2, 95% CI 1.2–4.0), 23.0–24.9 kg/m² (AORs; 1.8 95% CI 0.9–3.3), 25.0–29.9 kg/m² (AORs; 2.3 95% CI 1.3–4.3) and ≥ 30 kg/m² (AORs; 2.5 95% CI 1.3–4.9).

Mendelian randomisation study of the effects of known and putative risk factors on pancreatic cancer

BACKGROUND

Observational studies have reported multiple risk factors for pancreatic ductal adenocarcinoma (PDAC). Some are well established, like tobacco smoking, alcohol drinking, obesity and type 2 diabetes, whereas some others are putative, such as allergy and dietary factors. Identifying causal risk factors can help establishing those that can be targeted to contribute to prevent PDAC.

OBJECTIVE

We sought to investigate the possible causal effects of established and putative factors on PDAC risk.

METHODS

We conducted a two-sample Mendelian randomisation (MR) study using publicly available data for genetic variants associated with the factors of interest, and summary genetic data from genome-wide association studies of the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4), including in total 8769 cases and 7055 controls. Causality was assessed using inverse-variance weighted, MR-Egger regression and weighted median methods, complemented with sensitivity and radial MR analyses.

RESULTS

We found evidence for a causal effect of body mass index (BMI) on PDAC risk (OR 1.43, 95% CI 1.20 to 1.71, p=8.43×10-5). Fasting insulin (OR 2.84, 95% CI 1.23 to 6.56, p=0.01), low-density lipoprotein cholesterol (OR 1.16, 95% CI 1.02 to 1.32, p=0.03) and type 2 diabetes (OR 1.09, 95% CI 1.01 to 1.17, p=0.02) were also causally associated with PDAC risk. BMI showed both direct and fasting insulin-mediated causal effects.

CONCLUSION

We found strong evidence that BMI is causally associated with PDAC risk, providing support that obesity management may be a potential prevention strategy for reducing pancreatic cancer risk while fasting insulin and type 2 diabetes showed a suggestive association that should be further investigated.

The correlation between dietary fat quality indices and lipid profile with Atherogenic index of plasma in obese and non-obese volunteers: a cross-sectional descriptive-analytic case-control study

BACKGROUND AND AIM

Abnormalities in lipid metabolism are commonly observed in patients who were obese. Alongside dyslipidemia, one of the markers in predicting the risk of cardiovascular disease is the Atherogenic Index of Plasma (AIP), which is related to dietary intake. Healthy fat quality indices might affect on AIP. The purpose of this study is to find the possible relationship between dietary fat quality, and AIP and comparison of these indices among obese and non-obese volunteers.

METHODS

This study was a cross-sectional descriptive-analytic case-control study with 157 normal and overweight and obese volunteers (n = 71 normal, Age: 38.90 ± 10.976 vs n = 86 overweight/obese, Age: 38.60 ± 9.394) in the age range of 18-65 years. Food intake was measured using FFQ, anthropometric indices (weight, height, body mass index and waist to hip ratio), body composition (visceral fat level, total body water, body fat mass), and lipid profile were measured.

RESULTS

Based on the present results, comparable biochemical parameters including TC (P = 0.580), TG (P = 0.362), LDL (P = 0.687) and HDL (P = 0.151) among overweight/obese volunteers as compared to normal ones were noticed. Effects of dietary fat quality, including Atherogenicity (AI) and Thrombogenicity (TI) hypo/hypercholesterolemic ratio (h/H), the Cholesterol-Saturated Fat Index (CSI) showed significantly higher AI (P = 0.012) in the overweight/obese group as compared to the normal group. Whereas, h/H (P = 0.034) and ω-6/ω-3 ratio (P = 0.004) were significantly higher in normal-weight volunteers. There was a positive correlation between AI, TI, CSI, SFA, MUFA, PUFA and ω-6/ω-3 ratio with AIP and negative correlation between h/H with AIP in both groups. Despite the significances of these correlations no strong relation was observed by doing multiple regression among normal and overweight/obese groups (R2 = 0.210, R2 = 0.387).

CONCLUSIONS

In summary, the present work proposes a direct relationship between dietary fat quality, increased BMI, and lipid abnormalities with AIP. Nevertheless, further large-scale studies are required to sustain a clear conclusion in this wish.

Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

Glycosylated hemoglobin (HbA1c) was the best indicator of glycemic control, which did not show the dynamic relationship between glycemic control and lipid profiles. In order to guide the health management of Type 2 diabetes (T2D), we assessed the levels of lipid profiles and fasting plasma glucose (FPG) and displayed the relationship between FPG control and lipid profiles. We conducted a cross-sectional study that included 5822 participants. Descriptive statistics were conducted according to gender and glycemic status respectively. Comparisons for the control of lipid profiles were conducted according to glycemic control. Four logistic regression models were generated to analyze the relationship between lipid profiles and glycemic control according to different confounding factors. The metabolic control percentage of FPG, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) was 27.50%, 73.10%, 28.10%, 64.20% and 44.80% respectively. In the fourth model with the most confounding factors, the odds ratios (ORs) and 95% confidence intervals (CIs) of TG, TC, LDL-C and HDL-C were 0.989 (0.935, 1.046), 0.862 (0.823, 0.903), 0.987 (0.920, 1.060) and 2.173 (1.761, 2.683). TC and HDL-C were statistically significant, and TG and LDL-C were not statistically significant with adjustment for different confounding factors. In conclusion, FPG was significantly associated with HDL and TC and was not associated with LDL and TG. Our findings suggested that TC and HDL should be focused on in the process of T2D health management.