Association of the Apolipoprotein A-I Gene Polymorphisms with Cardiovascular Disease Risk Factors and Atherogenic Indices in Patients from Assam, Northeast India

Atherogenic Combined Index: Validation of a Coronary Artery Disease Predictive Biomarker

BACKGROUND/AIM

The balance between atherogenic and antiatherogenic lipid particles significantly influences coronary artery disease (CAD), as an imbalance may contribute to the development and progression of atherosclerosis, which affects the risk and severity of CAD. This study aims to introduce and validate the atherogenic combined index (ACI) as a novel lipid biomarker that, comprehensively assesses the balance between atherogenic and antiatherogenic particles in the blood to effectively reflect the cumulative atherogenic effect and its association with the presence and severity of CAD.

MATERIAL AND METHODS

In this cross-sectional study, 1,830 patients diagnosed with CAD and a total of 650 patients without CAD were included in the study cohort for comprehensive analysis and comparison. Based on the tertiles of the SYNTAX score (SS), three subgroups of patients with CAD were identified. ACI and other atherogenic indices were compared to predict the presence and severity of CAD.

RESULTS

The levels of ACI and other non-traditional lipid markers levels were higher in the CAD group compared to the non-CAD group (p <0.05, for all). ACI showed a good linear association with the SYNTAX score (r = 0.527; p <0.001). The multivariate logistic regression model showed that ACI was an independent predictor of the presence (OR: 1.602, 95% CI: 1.509-1.701, p <0.001) and severity (OR: 1.296, 95% CI: 1.243-1.351, p <0.001) of CAD after adjustment for various confounders.

CONCLUSION

The results suggest that ACI may serve as a promising and stronger tool for predicting the presence and severity of CAD.

Atherogenic index of plasma as a predictor of coronary artery disease: a cohort study in south of Iran

BACKGROUND

Coronary artery disease (CAD) is an atherosclerotic disease of an inflammatory nature. Previous studies examining the relationship between triglycerides and high-density lipoprotein cholesterol have highlighted the importance of plasma atherogenic index (AIP) as an important predictor of coronary heart disease. However, due to the lack of adequate information on this topic, this study aimed to investigate the relationship between AIP and coronary heart disease risk.

RESULTS

This study included 2,226 women and 1,690 men aged 35-70 years who participated in the Bandar Kong Cohort study and met the eligibility criteria. The data was collected using a checklist and questionnaires, which were designed by experienced individuals. After participants completed a registration form and gave informed consent, face-to-face interviews were conducted by trained experts. The validity and reliability of the questionnaire had been verified by the national cohort team prior to its use. The Ethics Committee of Hormozgan University of Medical Sciences (IR.HUMS.REC.1400.171) approved the study. Data from the initial cohort survey using SPSS software version 25, were analyzed to include several factors, including age, sex, smoking status, body mass index (BMI), physical activity level, socioeconomic status, AIP, systolic blood pressure, and diastolic blood pressure. The prevalence of coronary heart disease was found to be 7.5% higher in people with a BMI of 25 or higher. Also, Individuals with low physical activity had a higher prevalence. Individuals with CAD had significantly higher mean values for the AIP, age, systolic blood pressure, and diastolic blood pressure (0.46, 57.50, 128.43, and 81.10, respectively) compared to those without CAD. Furthermore, patients with CAD had lower years of education (2649.45 and 3.59) than individuals without CAD (P < 0.05). Importantly, our findings showed that AIP increased the odds ratio of coronary heart disease by 1.86 as an independent risk factor.

CONCLUSIONS

Based on our investigation, the AIP is a valuable and independent predictive risk factor for coronary artery disease. This index can be utilized effectively due to its accessibility and affordability, making it a promising tool for risk assessment in clinical settings.

Atherogenic Index as a Cardiovascular Biomarker in Mexican Workers from Marginalized Urban Areas Occupationally Exposed to Metals

BACKGROUND

Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants.

AIM

This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk.

METHODS

A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices.

RESULTS

The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367).

CONCLUSIONS

Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.

Nontraditional Lipid Parameters as a Predictor of Cardiovascular Disease Risk in Nepalese Women

Background

The use of nontraditional lipid parameters for assessing clinical conditions is emerging; however, no study has identified thresholds for those parameters for the identification of cardiovascular disease (CVD) risk. The present study aimed to establish the thresholds of nontraditional lipid parameters and test its ability to identify CVD risk factors.

Methodology

A cross-sectional study in women (n = 369, age: 46 ± 13 years, body mass index (BMI): 26.31 ± 2.54 kg/m2) was conducted. Blood samples were collected and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol (TC), and triglycerides (TGs) were estimated. Subsequently, nontraditional lipid parameters were calculated, namely non-HDL-C, Castelli's Risk Index II (CRI-II), CRI-I, lipoprotein combined index (LCI), atherogenic index (AI), and AI of plasma (AIP).

Results

Based on TC (≥200 mg/dL), the derived thresholds for non-HDL-C, CRI-II, CRI-I, LCI, AI, and AIP were 139 mg/dL, 2.29, 3.689, 58,066, 2.687, and 0.487, respectively. Similarly, based on the threshold of TG (≥150 mg/dL), the derived thresholds for non-HDL-C, CRI-II, CRI-I, LCI, AI, and AIP were 127 mg/dL, 2.3, 3.959, 58,251, 2.959, and 0.467, respectively. Out of considered five risk factors, non-HDL-C, CRI-II, CRI-I, LCI, and AI thresholds were capable in identifying four risk factors (physical activity, blood pressure, BMI, and age) and AIP was able to associate with two risk factors at most (blood pressure and BMI).

Conclusion

The derived thresholds of nontraditional lipid parameters were capable of differentiating between CVD risk and nonrisk groups suggesting the possible use of these thresholds for studying CVD risk.

Current Data and New Insights into the Genetic Factors of Atherogenic Dyslipidemia Associated with Metabolic Syndrome

Atherogenic dyslipidemia plays a critical role in the development of metabolic syndrome (MetS), being one of its major components, along with central obesity, insulin resistance, and hypertension. In recent years, the development of molecular genetics techniques and extended analysis at the genome or exome level has led to important progress in the identification of genetic factors (heritability) involved in lipid metabolism disorders associated with MetS. In this review, we have proposed to present the current knowledge related to the genetic etiology of atherogenic dyslipidemia, but also possible challenges for future studies. Data from the literature provided by candidate gene-based association studies or extended studies, such as genome-wide association studies (GWAS) and whole exome sequencing (WES,) have revealed that atherogenic dyslipidemia presents a marked genetic heterogeneity (monogenic or complex, multifactorial). Despite sustained efforts, many of the genetic factors still remain unidentified (missing heritability). In the future, the identification of new genes and the molecular mechanisms by which they intervene in lipid disorders will allow the development of innovative therapies that act on specific targets. In addition, the use of polygenic risk scores (PRS) or specific biomarkers to identify individuals at increased risk of atherogenic dyslipidemia and/or other components of MetS will allow effective preventive measures and personalized therapy.

Association between atherogenic index of plasma and periodontitis among U.S. adults

BACKGROUND

Serum lipids have been proven to influence periodontitis. The atherogenic index of plasma (AIP) is an important marker of lipid levels. The purpose of this study was to investigate the association between periodontitis and AIP in adults.

METHODS

The study included participants from the 2009-2014 National Health and Nutrition Examination Survey who received a complete periodontal exam and a complete record of AIP. AIP was calculated as log₁₀ (triglycerides/high-density lipoprotein cholesterol). Periodontitis can be classified into four categories based on attachment loss and probing depth (no periodontitis, moderate periodontitis, mild periodontitis, and severe periodontitis). Multivariable logistic regression after adjusting and hierarchical analysis were conducted to investigate the relationship between periodontitis and AIP in adults.

RESULTS

The final sample included 4,371 participants, representing approximately 60 million people in the United States. Periodontitis among the AIP groups (quartile, Q1-Q4) was statistically significant (P < 0.05). Univariate analysis showed that AIP was associated with the incidence of periodontitis (P < 0.05), but not with the severity of periodontitis (P > 0.05) in participants. Multifactorial logistic regression analysis showed no correlation between the incidence of periodontitis and AIP among all participants (the trend P-value = 0.341), but a significant association with AIP in the non-smoking participants (the trend P-value = 0.031).

CONCLUSION

There was a significant correlation between periodontitis and AIP in the non-smoking population.

Effects of plasma atherogenic index and plasma osmolality on arteriovenous fistula patency in hemodialysis patients

BACKGROUND

The purpose of the present study was to investigate the effects of Plasma atherogenic index (AIP) and plasma osmolality (PO) values on arteriovenous fistula (AVF) patency in patients with chronic renal failure.

METHODS

The patients with primary AVF between December 2012 and March 2020 with the diagnosis of end-stage renal disease in our clinic were included in the study. The patient data were collected retrospectively in digital medium. Diabetic patients were not included in the study. The Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), sodium (Na), fasting blood glucose, and blood urea nitrogen (BUN) values were found and recorded from the files. AIP and PO were calculated with special formulas. Fistula patency rate in 6th, 12th, and 24th months were evaluated in 2-year follow-ups.

RESULTS

According to the results of two-year follow-ups of the 162 patients, who underwent primary AVF, 21 (13%) patients were found to have thrombosis in the 6th month, 33 (20.4%) patients in the 12th month; however,141 (87%) and 129 (79.6%) patients actively used AVF in the 6th and 12th months, respectively. The AIP and PO values that were calculated in the patient group with AVF thrombosis were significantly higher (p = 0.001, p < 0.001; respectively). In the multivariate logistic regression analysis, Na, BUN, and HDL-C variables were found to be independent predictive factors for AVF thrombosis (OR (Odds Ratio): 1.169, 95% CI (Confidence interval)): 1.056-1.294, p = 0.003; OR: 1.108, 95% CI: 1.043-1.176, p = 0.001; OR: 0.874, 95% CI: 0.820-0.932, p < 0.001; respectively). It was also found that the patency rate was 64.2% (104 patients) in the 24th month.

CONCLUSION

AIP, PO, Na, and BUN values are positively associated with AVF thrombosis. Checking AIP, Na, and BUN values will be useful in patients with end-term renal failure, who already have difficulties in renal replacement methods and vascular access.

Anti-atherogenic and cardio-protective properties of sweet melon (Cucumis melo. L. Inodorus) seed extract on high fat diet induced obesity in male wistar rats

BACKGROUND

Cucumis melon is a medicinal plant with multiple pharmacological properties such as anti-inflammatory, antioxidant, and diuretic effects. An increasing body of scientific evidence established the anti-diabetic/anti-obesity effects of Cucumis melo in humans, mice, and hamster models. However, there are no tangible reports on its ability to prevent cardiovascular complications following diet-induced obesity. The anti-atherogenic and cardioprotective effects of the Methanolic extract of Cucumis melo. L. Inodorus seeds on a high-fat diet (HFD)-induced obese rats was assessed in this study.  METHODS: Forty male Wistar rats were randomly divided into five groups, (n = 8/group); i.e., Normal (N), HFD, HFD + 50 mg/kg b.w. of MCMs (Methanolic extract of Cucumis melon seeds), HFD + 100 mg/Kg b.w. of MCMs and HFD + 200 mg/kg b.w. of MCMs. The experimental animals were anaesthetized and sacrificed after 10 weeks, and blood samples and heart tissue were collected for further analysis. Using the Graph Pad Prism version 5.0, the results expressed as Mean ± SD was tested using the one-way ANOVA to show intergroup differences, followed by Bonferonni 's post hoc test. The level of significance was determined at P ≤ 0.05.

RESULTS

MCMs significantly (P < 0.05) reduced body weight, adiposity index, total fat mass, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) compared with the HFD obese groups MCMs caused a significant reduction in the body weight, total fat mass, adiposity index, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) when compared to the animals in HFD obese groups. Also, the Atherogenic index of plasma (AIP), Castelli index and, malondialdehyde (MDA) significantly (P < 0.05) decreased in MCMs treated groups compared to the HFD obese group. The catalase, protein, and HDL levels were significantly increased in MCMs treated groups compared to HFD-obese animals. Expression of nitric oxide in the form of nitrite in the heart tissue significantly increased in the MCMs treated compared to the HFD-obese rats, with the majority of the positive results recorded at 100 mg/Kg b.w. of MCMs.

CONCLUSIONS

MCMs have anti-atherogenic and Cardio-protective properties on High Fat Diet-Induced Obesity in Male rats via an antioxidant and nitric oxide-dependent mechanism. Further study is recommended to evaluate the molecular mechanisms to which these anti-atherogenic and cardio-protective actions can be attributed and exploit the GCMS result in the development of drug candidates.

A Study of Biomarkers Associated with Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term that no longer excludes patients that consume alcohol or present other liver diseases, unlike nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the role of different biomarkers as predictors of MAFLD in patients with type 2 diabetes mellitus (T2DM). In this regard, a cross-sectional, non-interventional study was conducted over a period of 8 months in patients with T2DM. Liver steatosis displayed by abdominal ultrasound certified the MAFLD diagnosis. A percentage of 49.5% of the studied patients presented MAFLD. Through logistic regression adjusted for gender, age, T2DM duration, lipid-lowering therapy, smoking status, nutritional status, we demonstrated that elevated triglycerides (TG) levels, high non-high-density-lipoprotein (HDL)-cholesterol-to-HDL-cholesterol (non-HDL/HDL) ratio, high atherogenic index of plasma (AIP), and increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) had predictive value for MAFLD in patients with T2DM. Furthermore, we calculated the optimal cut-off values for these biomarkers (184 mg/dL for TG, 0.615 for AIP, 3.9 for the non-HDL/HDL ratio, and 2.01 for HOMA-IR) which can predict the presence of MAFLD in patients with T2DM. To our knowledge, this is the first study to assess the predictive value of the non-HDL/HDL ratio for MAFLD in patients with T2DM.

The correlation of plasma atherogenic index and obesity in patients with familial Mediterranean fever

BACKGROUND

The plasma atherogenic index (PAI) is associated with cardiovascular diseases. This study evaluated the relationship between PAI and obesity in patients with familial Mediterranean fever (FMF) and its advantage over conventional lipid components in predicting obesity.

METHODS

The cross-sectional study included 164 FMF patients in the attack-free period and a control group of 160 healthy individuals. Serum lipid components were measured, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). PAI was calculated as log 10 (TG/HDL-C). The relationship between PAI, four conventional lipid profiles, and obesity was evaluated.

RESULTS

The mean PAI values (p = 0.003), frequency of obesity (p = 0.005), TC (p = 0.008), TG (p = 0.000), and LDL-C (p = 0.005) values were determined to be statistically significantly higher in the FMF patients than in the control group. The FMF patients with a higher PAI value had a higher risk of obesity, systolic and diastolic blood pressure, TC, and LDL-C, and lower HDL-C (p < 0.001). The Pearson coefficient for PAI (r = 0.854; p < 0.001) was calculated as an explanatory percentage on the variable of obesity of r² = 0.730. There was a stronger relationship between obesity and PAI than conventional lipid components (p < 0.001).

CONCLUSION

We have found that the PAI, BMI, TC, TG, and LDL-C values of the FMF patients were determined to be higher. The higher PAI was strongly correlated to obesity in FMF patients. The first time in FMF patients, PAI showed increased sensitivity to predict obesity, higher than conventional lipid components. It can be a promising biomarker for obesity compared to other lipid components. A low-cost and readily available index derived from routine (TG and HDL-C) tests are advantages in identifying obesity in FMF patients. Key Points • The PAI is valuable for atherosclerotic CVD risk management in patients with rheumatismal diseases. • A correlation is found between PAI level and obesity, and it is used as a biomarker for obesity in the healthy population. • The PAI revealed increased sensitivity to predict obesity, higher than conventional lipid components in FMF patients.

Atherogenic Index of Plasma and Its Association with Risk Factors of Coronary Artery Disease and Nutrient Intake in Korean Adult Men: The 2013-2014 KNHANES

Coronary artery disease (CAD) has been linked to one of the highest death rates globally. The atherogenic index of plasma (AIP) may be an important predictor of atherosclerosis and cardiovascular disease, superior to the standard atherosclerotic lipid profile. This study investigated the relationship between AIP and obesity indices, blood glucose, lipid profile, and nutrient intake status in Korean adult men. The study included 1292 males aged ≥19 years old who participated in the Korea National Health and Nutrition Examination Survey, 2013-2014. Participants were divided into four groups according to AIP quartiles, calculated as log (triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)). Body mass index, waist circumference, fasting blood glucose, hemoglobin A1c, total cholesterol, TG, and low-density lipoprotein cholesterol levels increased as AIP levels increased, whereas HDL-C level declined. As the level of AIP increased, intake of saturated fatty acid, calcium, phosphorus, riboflavin, milk, and dairy product decreased significantly, and the contribution rate of milk and dairy products to fat intake decreased. AIP was linked to obesity indices, blood glucose, and blood lipid profile in Korean men, suggesting that it could predict CAD.

Interaction between dietary total antioxidant capacity and BDNF Val66Met polymorphism on lipid profiles and atherogenic indices among diabetic patients

Brain-derived neurotrophic factor (BDNF) belongs to the "neurotrophin" family of growth factors, and it has recently been associated to cardiovascular disease (CVD). We anticipated that BDNF Val66Met polymorphisms may alter CVD risk markers such as serum lipid profile differences, and interaction with total antioxidant capacity of diet (DTAC) could alter these clinical parameters. This cross-sectional study consisted of 667 diabetic patients (39.7% male and 60.3% female). DTAC was calculated by international databases. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α). interleukin 18 (IL18), leptin and ghrelin were measured by standard protocol. Atherogenic indices (AIP, AC, CR-I, CR-II) were calculated. Genotyping of the BDNF Val66Met polymorphisms was conducted by the real-time PCR-RFLP method. The gene-diet interactions were evaluated using a generalized linear mode (GLMs). Carriers of the Val/Met genotype who were in the higher median intake of FRAP had lower HDL (P:0.04) and higher TG (P:0.005), AIP (P:0.02) and AC (P:0.02) index compared to Val/Val genotypes with lower median intake. Moreover, diabetic patients with Val/Met genotype who consumed higher ORAC intake had increased odds for anthropometric indices (BMI (P:0.01) and WC (P:0.03)), lipid profiles (TG) (P:0.01), and atherogenic index (AIP) (P:0.02), also decreased odds for HDL (P:0.03) concentration compared to reference group whit lower ORAC intake. Individuals with Val/Met genotype who consumed higher TRAP intake had increased odds for WC (P:0.04), TC (P:0.001), TG (P < 0.001), AIP (P < 0.001) and AC (P < 0.001). Finally, Val/Met patients with a higher median intake of TEAC had higher TG (P:0.02), AIP (P:0.009) and AC (P:0.03) compared to the reference group whit lower TEAC intake. Our study showed that Val/Met genotype had also the highest lipid profile and atherogenic indices even in the highest adherence to DTAC. While it seems that the presence of the Val/Val wild-type and BDNF Met/Met homozygotes in diabetic patients with a high DTAC is a protective factor.

Atherogenic indices in clinical practice and biomedical research: A short review

Cardiovascular diseases (CVD) represent a major cause of mortality and morbidity worldwide. To date, many physicians still requesting traditional lipid profile tests (TG, TC, HDL-C, and LDL-C) to confirm the clinical diagnosis related to CVD. However, using these tests may be inadequate for the prediction of CVD risk, especially in intermediate risk. For better clinical practice, laboratory diagnostic alternatives should constantly be evaluated and developed by physicians and laboratory scientists. In this review, we sought to focus on the benefits of lipid ratios (CRI-, CRI-II, AIP, AC, and CHOLindex) in supporting clinical diagnosis and how they can be calculated. To attain this aim, a literature search in reputed databases (PubMed and Scopus) was performed and peer-reviewed research articles were included to conduct this review. Short theoretical and practical notes about each index were accordingly included along with calculation formulas. Thus, the current article can assist new researchers and young physicians to review what supports their knowledge in managing early CVDs.    

Association between apolipoprotein gene polymorphisms and hyperlipidemia: a meta-analysis

BACKGROUND

Hyperlipidemia plays an important role in the etiology of cardio-cerebrovascular disease. Over recent years, a number of studies have explored the impact of apolipoprotein genetic polymorphisms in hyperlipidemia, but considerable differences and uncertainty have been found in their association with different populations from different regions.

RESULTS

A total of 59 articles were included, containing in total 13,843 hyperlipidemia patients in the case group and 15,398 healthy controls in the control group. Meta-analysis of the data indicated that APOA5-1131 T > C, APOA1 -75 bp, APOB XbaI, and APOE gene polymorphisms were significantly associated with hyperlipidemia, with OR values of 1.996, 1.228, 1.444, and 1.710, respectively. All P-values were less than 0.05.

CONCLUSIONS

Meta-analysis of the data indicated that the C allele of APOA5 1131 T > C, the A allele at APOA1-75 bp, the APOB XbaI T allele, and the ε2 and ε4 allele of APOE were each a risk factor for susceptibility for hyperlipidemia.

Lipoprotein Ratios: A Potential Biomarker for Clinical Diagnosis of Atherosclerosis in Type 1 Diabetic Patients With Foot Ulceration

Background Lipoprotein ratios are indicators of atherosclerosis and related diseases such as cardiovascular diseases (CVDs). Early and accurate diagnosis of atherosclerotic disease in patients with diabetic foot ulceration (DFU) is required urgently and remains fundamental to assess the risk of CVDs. This study aimed to determine whether lipoprotein ratios can predict atherosclerosis in type 1 diabetic patients with DFU. Methodology This was a cross-sectional study including 255 patients with confirmed type 1 diabetes with a male-to-female ratio of 1.19. Patients admitted to the hospital due to diabetes-related complications were divided into the following groups: patients without DFU (n = 153) and patients with DFU (n = 102). Clinical, biological, and pathophysiological features of patients were compared. Results Our study reported a distinct predominance of males (54.50%), with a mean age of 28.64 ± 10.92 years and duration of diabetes of 10.40 ± 9.25 years. The prevalence of DFU was 40.0%. The receiver operator characteristic curve was applied to define the best cut-off lipid ratios to detect atherosclerosis. Total cholesterol (TC)/high-density lipoprotein (HDL) ratio was a valid marker for atherosclerosis with a sensitivity of 86.3%, specificity of 71.4%, and diagnostic accuracy of 0.836%. The findings showed that the fourth quartiles (odds ratio [OR] = 83.02 [22.18-310.75]; p = <10^-3) of TC/HDL ratio was significantly higher in patients with DFU. Similarly, the last quartiles (fourth) of low-density lipoprotein (LDL)/HDL and triglyceride (TG)/HDL ratio were higher in DFU group (OR = 33.71 [12.04-94.38], p = <10^-3; OR = 9.60 [4.27-21.58], p = <10^-3; respectively). In the DFU group, conventional lipid profiles and lipid ratios were markedly higher in males compared to females patients (TG = 1.31 ± 0.69 g/L vs. 1.04 ± 0.84 g/L, p = 0.04; respectively; TC/HDL = 4.79 ± 1.04 vs. 4.22 ± 0.98, p = 0.03; respectively; LDL/HDL = 2.91 ± 1.13 vs. 2.17 ± 1.28, p = 0.01; respectively; TG/HDL = 3.65 ± 2.53 vs. 2.67 ± 1.94, p = 0.008; respectively). Conclusions Elevated atherogenic indices were significantly associated with the atherosclerotic load in patients with DFU, supporting the use of lipid ratios as a biomarker for the diagnosis of atherosclerosis disease in clinical practice in the future.

Genetic markers for preeclampsia in Peruvian women

BACKGROUND

Preeclampsia is a multiorgan disorder associated with maternal and perinatal morbi-mortality. In Peru, incidence is 10% and accounts for 22% of maternal deaths. Genome and genetic epidemiological studies have found an association between preeclampsia and genetic polymorphisms.

OBJECTIVE

To determine the association of the vascular endothelial growth factor (VEGF) +936 C/T and +405 G/C, interleukine-6 (IL-6) -174 G/C, IL-1β-511 C/T, Apo A-1-75 G/A, Apo B-100 2488 C/T (Xbal) polymorphisms with preeclampsia in pregnant Peruvian women.

METHODS

Were included preeclamptic and healthy (control) pregnant women. Maternal blood samples were subjected to DNA extraction, and molecular genetic analysis was conducted using the PCR-RFLP technique and following a specific protocol for each gene. Allele and genotypic frequencies in the cases and controls were compared.

RESULTS

No association was found between the VEGF+936C/T and VEGF+405 polymorphisms and preeclampsia. The frequencies of the GG genotypes and the G allele of the -174 G/C polymorphism in the IL6 gene in preeclamptic and controls showed significant differences, with higher frequencies in cases. For the -511 C/T polymorphism of the IL-1β gene, no significant differences were found in the frequencies of TT genotypes compared with CT+CC. The genotypes and alleles of the Apo-A1-75 G/A and Apo-B100 Xbal variants showed no significant differences between cases and controls.

CONCLUSION

No association was found between the studied genetic markers and preeclampsia. However, in the -174G/C polymorphism of the IL-6 gene, significant differences were found mainly in the GG genotype and G allele.

Visceral Obesity-Related Indices in the Identification of Individuals with Metabolic Syndrome Among Different Ethnicities in Xinjiang, China

BACKGROUND

Few studies have focused on the predictive ability of visceral obesity-related indices for metabolic syndrome (MetS), especially in different ethnic groups. This study aimed to evaluate the applicability of visceral obesity-related indices for MetS screening among three major ethnic groups living in remote rural areas of Xinjiang.

METHODS

Based on multistage stratified cluster random sampling method, 3,192 Uyghurs, 3,054 Kazakhs, and 3,658 Hans were recruited from Xinjiang, China. The Joint Interim Statement (JIS) criteria were used to define MetS. The receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and predictive value of each visceral obesity-related index were used to evaluate the predictive ability of MetS.

RESULTS

After adjusting for potential confounding factors, the lipid accumulation product (LAP), Chinese visceral adiposity index (CVAI), waist-to-height ratio (WHtR), and atherogenic index of plasma (AIP) were significantly correlated with MetS for each ethnic group, and the odds ratios (ORs) for MetS increased across quartiles. LAP was best able to identify MetS status in Kazakhs (AUC=0.853) and Uyghurs (AUC=0.851), with optimal cut-offs being 36.3 and 28.2, respectively. Both LAP (AUC=0.798) and CVAI (AUC=0.791) most accurately identified MetS status in Hans, with the optimal cut-offs being 27.3 and 85.0, respectively. Moreover, the AUC of the combination of these visceral obesity-related indices is higher for each ethnic group. However, compared with LAP, the improved value of combined screening was not significant.

CONCLUSION

LAP had the best discriminative capability for the screening of MetS among Kazakhs, Uyghurs, and Hans. The screening ability of CVAI for MetS was similar to that of LAP in Hans. Thus, LAP may be a complementary indicator for assessing MetS in various ethnic groups.

Association Between ApoA1 Gene Polymorphisms and Antipsychotic Drug-Induced Dyslipidemia in Schizophrenia

PURPOSE

Dyslipidemia frequently occurs in schizophrenia patients treated with antipsychotic drugs (APDs), especially atypical APDs. Apolipoprotein A1 (ApoA1) plays a key role in lipid metabolism. The aim of this study was to investigate whether ApoA1 gene polymorphisms are associated with APD-induced dyslipidemia in schizophrenia patients.

PATIENTS AND METHODS

A total of 1987 patients with schizophrenia were enrolled in this study. Serum lipid profiles were determined with a biochemistry analyzer. Genotyping for the rs5072 polymorphism of ApoA1 was performed with TaqMan assay. Logistic regression analysis was carried out to evaluate the relationship between ApoA1 gene polymorphisms and APD-induced dyslipidemia. The effects of drug classification (typical vs atypical APD) and drug regimen (monotherapy vs combination therapy) on serum lipid levels were also analyzed.

RESULTS

A significant association was found between rs5072 and triglyceride (TG) levels in the recessive model of the logistic regression analysis (adjusted odds ratio [OR]=1.50, 95% confidence interval [CI]: 1.03, 2.17; P<0.05). TG level was significantly higher in patients treated with combination therapy (1.03 (0.71, 1.51) mmol/l) compared to monotherapy (0.93 (0.67, 1.43) mmol/l) and was also associated with sex. There were significant differences in TG levels among the three genotypes of ApoA1 rs5072 (GG, GA, and AA) in the whole study population and in patients treated with atypical APDs.

CONCLUSION

The ApoA1 rs5072 variant is associated with dysregulated TG metabolism in schizophrenia patients treated with APDs, which may increase susceptibility to dyslipidemia.

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.

Metabolic Syndrome and Atherogenic Indices in Rheumatoid Arthritis and their Relationship with Disease Activity: A Hospital-based Study from Northeast India

Background and Objective

Metabolic syndrome (MetS), a constellation of metabolic abnormalities including hypertension, obesity, glucose intolerance, and dyslipidemia, is highly prevalent in patients with rheumatoid arthritis (RA). Our aim was to assess the magnitude of MetS and its determinants in RA patients and to evaluate different atherogenic indices that are reflective of the risk for future cardiovascular disease.

Patients and Methods

The study was conducted on 104 RA patients and 103 age- and sex-matched healthy controls. The frequency of MetS was assessed using the guidelines recommended for Asian Indians.

Results

A total of 104 RA patients participated with majority being females (85.6%), with a mean age of 43.82 ± 13.32 years. The frequency of MetS in patients with RA (36.5%) was significantly higher than in controls (15.5%). The atherogenic indices were found to be significantly higher in RA patients than controls (P < 0.01). On logistic regression, disease activity score (DAS28) scale for 28 joints and disease duration remained significant independent predictors of the presence of MetS in RA patients (P < 0.01 and 0.05, respectively).

Conclusions

RA is a kind of chronic disease of long course, and MetS and atherogenic indices are often concomitant in these patients. The study showed that the frequency of MetS was higher in patients with RA than in controls, and that DAS28 and disease duration remained significant independent predictors of the presence of MetS in RA patients.

The value of the atherogenic index of plasma in non-obese people with non-alcoholic fatty liver disease: a secondary analysis based on a cross-sectional study

BACKGROUND AND OBJECTIVES

The atherogenic index of plasma (AIP) is elevated in fatty liver disease, but its value in non-obese people with non-alcoholic fatty liver disease (NAFLD) is unclear. This study aimed to investigate the relationship between AIP and NAFLD as well as to determine whether AIP might be used as an indicator of NAFLD in non-obese individuals.

METHODS

The present study involved non-obese Chinese and Japanese participants. Risk factors are evaluated using univariate and multivariate analysis. The performance of risk factors was compared according to the area under the receiver operating characteristic curve.

RESULTS

In the unadjusted model, the odds ratio (OR) for every 1 standard deviation (SD) increase in AIP was 52.30. In adjusted models I and II, the OR for every 1 SD increase in AIP was 36.57 and 50.84, respectively. The area under the receiver operating characteristic curve for AIP was 0.803 and 0.802 in the development and validation groups, respectively. The best cut-off value of AIP for discrimination between NAFLD and non-NAFLD was 0.005 in the Chinese group and - 0.220 in the Japanese group.

CONCLUSIONS

AIP and NAFLD are positively correlated in Chinese and Japanese populations. Therefore, AIP can be used as a new screening indicator for non-obese people with NAFLD in different nations.

Atherogenic Index of Plasma: A Potential Biomarker for Clinical Diagnosis of Diabetic Foot Osteomyelitis

Background: Osteomyelitis of the diabetic foot is a costly health problem worldwide. Early and accurate diagnosis of the disease in patients with diabetic foot infections is needed urgently and will have an important role in diabetic foot management. Methods: This was a case-control study of subjects with diabetic foot ulcers admitted to Beijing Shijitan Hospital from September 2015 to April 2018. We compared differences in the atherogenic index of plasma (AIP) in patients with or without osteomyelitis. Results: The mean AIP of 165 patients with osteomyelitis was 0.23 ± 0.24, which was significantly higher than the mean AIP of patients without osteomyelitis. Higher AIP values were associated with a considerably higher risk of osteomyelitis with an odds ratio of 1.81 (95% confidence interval [CI] 0.71-4.61), 4.70 (1.88-11.75), 5.03 (2.06-12.25) and 1.74 (1.33-2.28). Moreover, at a cut-off of 0.184, the AIP value showed a sensitivity of 84.3% and a specificity of 83.1% in the discriminatory identification of diabetic foot osteomyelitis. Conclusions: Elevated AIP was significantly associated with diabetic foot osteomyelitis, supporting the use of this index as a biomarker for the diagnosis in clinical practice.

Atherogenic Index of Plasma: Novel Predictive Biomarker for Cardiovascular Illnesses

BACKGROUND/AIM

Cardiovascular diseases (CVD) are the most important cause of mortality globally. Nevertheless, the World Health Organization have declared that a precise and quick recognition of susceptible individuals to develop CVD is imperative to combat those illnesses. Additionally, developing countries need affordable alternatives to effectively prognosticate cardiovascular events. Therefore, the objective of this study was to assess well-established clinical prognostic markers in Mexican women to identify affordable, specific, and useful tools to predict cardiovascular events.

MATERIAL AND METHODS

A cross-sectional study was performed including 340 healthy women. Anthropometric and clinical measurements were acquired from all enrolled individuals. Also, a blood sample of each participant women was obtained to complete biochemical analyses (triglycerides, glucose, total cholesterol, LDL cholesterol, and HDL cholesterol), and serum asymmetric dimethylarginine (ADMA), and adipocyte-fatty acid binding protein (FABP4) determinations. Finally, with anthropometric, clinical and biochemical determinations, atherogenic indices (Framingham risk score, Castelli's risk index, and atherogenic index of plasma) were estimated.

RESULTS

A mean value of 6.5 ± 7.2 was detected for the Framingham risk score, 3.7 ± 1.3 for Castelli's risk index, and 0.12 ± 0.22 for the atherogenic index of plasma (AIP). Circulating mean ADMA and FABP4 levels found in assessed women were 0.68 ± 0.34 mmol/L and 20.3 ± 16.6 ng/mL, respectively. Furthermore, strong positive relationships (p <0.05) between AIP and serum FABP4 and ADMA concentrations were detected after adjustment by traditional CVD risk factors.

CONCLUSION

In conclusion, AIP could be recommended as a potential biomarker in the early diagnosis of CVD events in developing countries.

Atherogenic index of plasma is a novel and strong predictor associated with fatty liver: a cross-sectional study in the Chinese Han population

Background

Atherogenic index of plasma (AIP) has been reported to be an important predictor for coronary artery disease and obesity. However, few studies has yet systematically evaluated the association between AIP and Fatty Liver (FL) and its advantage in FL prediction compared with BMI, waist, SBP, DBP, BG, ALT and AST.

Methods

A total of 7838 participants aged from 19 to 93 years were included in this study. Height, weight, waist, SBP, DBP, BG, ALT and AST were measured. Difference analyses, odds ratio calculation, logistic and predictive analyses were used to evaluate the association and discrimination ability between AIP, BMI, waist, SBP, DBP, BG, ALT, AST and FL.

Results

Compared with non-FL, AIP in FL people showed a significant increase. Subjects in the higher quartiles of AIP had a significantly increased risk of fatty liver compared with those in the lowest quartile (P < 0.01) after adjustment of gender and age. ORs were grown faster in female and youth group. AIP contributed most in the logistic eq. (B = 2.64, P < 0.01) and showed high ability in risk prediction for FL (AUC = 0.810, P < 0.01).

Conclusions

AIP might be a novel and strong predictor associated with FL in Chinese Han population. Higher AIP level was positively and strongly associated with FL.

Electronic supplementary material

The online version of this article (10.1186/s12944-019-1112-6) contains supplementary material, which is available to authorized users.

Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China

Background

Atherogenic index of plasma (AIP) has been reported to be associated with cardiovascular diseases. However no study has yet systematically evaluated the association between AIP and obesity and its advantage in obesity prediction compared with conventional lipid components.

Methods

A total of 6465 participants aged over 30 years were included in this study. Blood lipid components including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured, and AIP was calculated as log₁₀(TG/HDL-C). Pearson correlation analyses, multivariable logistic analyses and predictive analyses were used to evaluate the association and discrimination ability between AIP, four conventional lipid profiles and obesity.

Results

Subjects in the higher quartiles of AIP all had a significantly increased risk of obesity compared with those in the lowest quartile (P for trend< 0.01). AIP showed a stronger association with obesity than the conventional lipid components as the pearson coefficient reached up to 0.372 and the adjusted odds ratio was 5.55. Using AIP rather than HDL-C and TG significantly improved risk prediction for obesity (AUC improvement = 0.011, P = 0.011; Continuous net reclassification index = 29.55%, P < 0.01; Category net reclassification index = 6.06%; Integrated discrimination improvement = 0.68%, P < 0.01).

Conclusions

Higher AIP level was positively and strongly associated with obesity. AIP is a novel and better biomarker associated with obesity. Controlling the AIP level would be more helpful for the prevention of obesity.