The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study

Baseline lipid profile is associated with adverse outcomes in adults with coronary artery disease and obstructive sleep apnea despite lipid-lowering drugs and CPAP treatment: A secondary analysis of the RICCADSA cohort

BACKGROUND

Reducing lipid levels is essential for preventing major adverse cardiovascular and cerebrovascular events (MACCE) in management of coronary artery disease (CAD) patients with obstructive sleep apnea (OSA). The first line treatment of OSA is continuous positive airway pressure (CPAP), however, its impact on the association between lipid profile and MACCEs is uncertain.

METHODS

This was a secondary analysis of the RICCADSA cohort. In all, 224 revascularized CAD patients with OSA (apnea-hypopnea index [AHI] ≥15 events) were allocated to CPAP, 103 to no-CPAP, and 86 patients had no OSA (AHI<5/h). All patients were on lipid-lowering medication. Circulating triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels (all in mg/dL) were measured at baseline and after one year. The undesired TG levels were defined as circulating TG ≥ 150 mg/dL, and undesired LDL levels were defined as ≥70 mg/dL.

RESULTS

OSA patients had higher TG and lower HDL levels than no-OSA patients whereas LDL levels were similar at baseline. There were no significant within-group differences in the CPAP group, no-CPAP group and no-OSA group regarding the lipid levels after one year. Undesired LDL levels at baseline predicted MACCEs med Hazard Ratio 2.18 (%95 CI 1.03-4.60; p = 0.04.) CONCLUSIONS: Most of the RICCADSA cohort had undesired LDL levels at baseline despite statin treatment, and CPAP had no additional lipid lowering effect after one year, suggesting that a more aggressive lipid lowering therapy as well as a more effective OSA treatment in addition to lifestyle changes should be targeted in the management of CAD patients with concomitant OSA.

Association between atherogenic index of plasma and all-cause mortality and cardiovascular disease among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common chronic liver diseases worldwide, both of which are closely associated with an increased risk of cardiovascular disease (CVD). Atherogenic index of plasma (AIP), as a biomarker of dyslipidemia, may predict CVD risk and mortality in these patients, but its specific role in patients with NAFLD and MASLD has not been studied in detail. This study adopted a cohort design, using data from the National Health and Nutrition Examination Survey (NHANES, 1988-1994) database, which was conducted by the Centers for Disease Control and Prevention. A total of 12,929 adult participants were analyzed. After participants were grouped according to AIP quartiles, the relationship between AIP levels and CVD risk was explored using multivariate logistic regression models and restricted cubic splines. The relationship between AIP levels and all-cause and CVD mortality was analyzed using multivariate Cox regression models.

RESULTS

Participants with the higher AIP quartiles showed high rates of CVD among participants with NAFLD (Quartile 1: 7.57%; Quartile 2: 10.00%; Quartile 3: 11.63%; Quartile 4: 15.08%). Participants with the higher AIP quartiles showed high rates of CVD among participants with MASLD (Quartile 1: 9.71%; Quartile 2: 11.30%; Quartile 3: 11.14%; Quartile 4: 15.00%). The findings suggested a linear association between the AIP index and the risk of CVD in participants with NAFLD or MASLD. AIP was significantly associated with CVD in the highest quartile of NAFLD or MASLD patients, and the adjusted hazard ratio indicated that high AIP levels were associated with high risk of CVD among participants with NAFLD (HR: 1.77, 95% CI: 1.24, 2.52) and MASLD (HR 1.76, 95% CI: 1.04, 2.98). In addition, higher AIP levels were also associated with increased all-cause mortality and CVD mortality among participants with NAFLD or MASLD.

CONCLUSION

This study showed that AIP is an effective tool for predicting CVD risk and mortality in patients with NAFLD and MASLD. Regular monitoring of AIP levels can help identify high-risk patients early and provide clinical risk assessment before intervention, thereby improving patient management and prognosis. Future studies need to further explore the role of AIP in different ethnic and economic conditions to optimize cardiovascular disease prevention and treatment strategies.

Machine Learning Model for Predicting Coronary Heart Disease Risk: Development and Validation Using Insights From a Japanese Population-Based Study

Background

Coronary heart disease (CHD) is a major cause of morbidity and mortality worldwide. Identifying key risk factors is essential for effective risk assessment and prevention. A data-driven approach using machine learning (ML) offers advanced techniques to analyze complex, nonlinear, and high-dimensional datasets, uncovering novel predictors of CHD that go beyond the limitations of traditional models, which rely on predefined variables.

Objective

This study aims to evaluate the contribution of various risk factors to CHD, focusing on both established and novel markers using ML techniques.

Methods

The study recruited 7672 participants aged 30-84 years from Suita City, Japan, between 1989 and 1999. Over an average of 15 years, participants were monitored for cardiovascular events. A total of 7260 participants and 28 variables were included in the analysis after excluding individuals with missing outcome data and eliminating unnecessary variables. Five ML models-logistic regression, random forest (RF), support vector machine, Extreme Gradient Boosting, and Light Gradient-Boosting Machine-were applied for predicting CHD incidence. Model performance was evaluated using accuracy, sensitivity, specificity, precision, area under the curve, F1-score, calibration curves, observed-to-expected ratios, and decision curve analysis. Additionally, Shapley Additive Explanations (SHAPs) were used to interpret the prediction models and understand the contribution of various risk factors to CHD.

Results

Among 7260 participants, 305 (4.2%) were diagnosed with CHD. The RF model demonstrated the highest performance, with an accuracy of 0.73 (95% CI 0.64-0.80), sensitivity of 0.74 (95% CI 0.62-0.84), specificity of 0.72 (95% CI 0.61-0.83), and an area under the curve of 0.73 (95% CI 0.65-0.80). RF also showed excellent calibration, with predicted probabilities closely aligning with observed outcomes, and provided substantial net benefit across a range of risk thresholds, as demonstrated by decision curve analysis. SHAP analysis elucidated key predictors of CHD, including the intima-media thickness (IMT_cMax) of the common carotid artery, blood pressure, lipid profiles (non-high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), and estimated glomerular filtration rate. Novel risk factors identified as significant contributors to CHD risk included lower calcium levels, elevated white blood cell counts, and body fat percentage. Furthermore, a protective effect was observed in women, suggesting the potential necessity for gender-specific risk assessment strategies in future cardiovascular health evaluations.

Conclusions

We developed a model to predict CHD using ML and applied SHAP methods for interpretation. This approach highlights the multifactor nature of CHD risk evaluation, aiming to support health care professionals in identifying risk factors and formulating effective prevention strategies.

Differential lipid impact on mortality in patients undergoing CABG versus PCI

BACKGROUND AND AIMS

The impact of revascularization type, including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), on lipid control efficacy remains unclear. We aim to assess the associations of lipid levels with all-cause and cardiovascular mortality in patients undergoing PCI or CABG.

METHODS

We used data from the ChinaHEART cohort and enrolled patients with a self-reported history of PCI or CABG. We employed Cox proportional hazards regression models to evaluate the associations between lipid levels and mortality.

RESULTS

Our analysis included 29 003 participants, of whom 23 959 (82.6 %) undergoing PCI and 5044 (17.4 %) undergoing CABG. Over a median follow-up of 3.22 years, 1007 deaths were recorded, with 579 attributed to cardiovascular causes. Each 1 mmol/L increase in TC, LDL-C, and non-HDL-C was associated with multivariable-adjusted HRs of 1.16 (95 % CI 1.10,1.22), 1.23 (1.15,1.32) and 1.16 (1.10,1.23) for all-cause mortality, respectively. Similar results were observed in patients undergoing PCI, while no significant associations were found in patients undergoing CABG.

CONCLUSIONS

Elevated lipid levels are associated with all-cause and cardiovascular mortality in revascularization patients. Suboptimal lipid control appears to have a more pronounced effect on mortality in patients undergoing PCI. The effects of elevated lipid levels on mortality in CABG patients may need a longer follow-up to manifest due to the more complex nature of the grafts and the long-term adaptation process.

Lipid profiles, lipid ratios and 28-day mortality risk in non-surgical older patients with critical illnesses: a retrospective cohort study using hospitalization records

BACKGROUND AND AIMS

The relationship between dyslipidemia and mortality varies by age, with an inverse association observed in the oldest age groups. There is limited research examining lipid profiles' correlation with short-term mortality risk in older adults. This study aimed to investigate associations of lipid profiles and lipid ratios with 28-day mortality risk in non-surgical older patients with critical illnesses.

METHODS

A retrospective cohort study was conducted with non-surgical older patients with critical illness who were admitted to the ICU of Shanghai East Hospital between January 2022 and November 2024. All data were collected via the hospitalization information system. Elastic network models were used to select covariates and Cox proportional hazards models were constructed to examine the association of lipid profiles and lipid ratios with 28-day mortality risk. Restricted cubic splines were used to test for non-linear relationships. Subgroup analyses were performed based on median age and gender.

RESULTS

The median age of study's participants was 75 years, 35.91% of whom were female. Those who died within 28 days were more likely to receive dopamine, norepinephrine and mechanical ventilation than survivors. Adjusted models indicated that LDLC (HR = 0.82, 95% CI: 0.69 to 0.97), lbLDLC (HR = 0.79, 95% CI: 0.63 to 0.98), sdLDLC (HR = 0.44, 95% CI: 0.24 to 0.83), LDLC/HDLC (HR = 0.85, 95% CI: 0.73 to 1.00), and sdLDLC/HDLC (HR = 0.63, 95% CI: 0.40 to 1.00) were associated with decreased 28-day mortality risk. However, no non-linear associations were detected. In younger older adults (age < 75 years), TC, non HDLC, remanent C, TC/HDLC and remanent C/HDLC were related to increased short-term mortality risk. In very old adults, TC, LDLC, lbLDLC, sdLDLC, non HDLC, TC/ HDLC, LDLC/HDLC, lbLDLC/HDLC, and sdLDLC/HDLC were associated with lower 28-day mortality risk. In women, only lower sdLDLC was associated with increased short-term mortality risk.

CONCLUSION

Lower levels of LDLC and its subtypes (lbLDLC, sdLDLC) were associated with increased 28-day mortality risk, particularly in patients aged ≥ 75 years and women. Conversely, elevated residual cholesterol levels correlated with higher mortality in younger older adults (< 75 years). These findings underscore the need for age- and sex-specific lipid management strategies in older patients with critical illnesses.

Dyslipidaemia among children and adolescents in Pakistan: a five-year retrospective cohort study based on laboratory data

BACKGROUND

Dyslipidaemia is a significant risk factor for cardiovascular diseases, which can manifest early in life. Despite its importance, the prevalence of dyslipidaemia in the paediatric population of Pakistan remains poorly understood. This study uses laboratory data to determine the prevalence of dyslipidaemia and lipid testing practices among Pakistani children and adolescents.

METHODS

This retrospective cohort study analysed the laboratory data from children and adolescents, aged up to 19 years, who underwent lipid testing. The data was obtained from two centres with collection points all over Pakistan for five years (March 2019-March 2024). Logistic regression models were used to assess relationships between demographic factors (age, sex and regions/provinces) and lipid profile parameters.

RESULTS

Over five years, 9,787 children and adolescents with a mean age of 13.8 ± 5.1 years underwent lipid testing. Boys accounted for 59.7% of those tested compared to 40.3% of girls (p = 0.09). Most tests were conducted in Punjab (81.2%), with minimal representation from Balochistan (0.5%) and Gilgit Baltistan (0.3%). Among tested children and adolescents, 33.3% had elevated total cholesterol, 25.4% high low-density lipoprotein cholesterol, 46.6% low high-density lipoprotein cholesterol, 48.0% abnormal non- high-density lipoprotein cholesterol and 41.7% hypertriglyceridemia. Compared to boys, girls had significantly lower odds of abnormal high-density lipoprotein cholesterol (Odds Ratio 0.556, 95% CI 0.511-0.607, p < 0.001) and triglyceride levels (Odds Ratio 0.702, 95% CI 0.642-0.767, p < 0.001).

CONCLUSION

This study highlights a high prevalence of dyslipidaemia among Pakistani children, with boys more affected than girls. The study also highlights a gender-based inequality in lipid testing where girls appear to be less frequently tested compared to boys.

Serum Zinc and Copper Concentrations and Dyslipidemia as Risk Factors of Cardiovascular Disease in Adults: Data Mining Techniques

This study aimed to examine the relationship between serum cholesterol levels and the ratio of zinc (Zn) and copper (Cu) in the blood serum and the incidence of cardiovascular disease (CVD). In Phase I of the study, 9704 individuals between the age of 35 and 65 years were recruited. Phase II of the cohort study comprised 7561 participants who completed the 10-year follow-up. The variables which were measured at the baseline of the study included gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP); biochemical parameters including serum Cu, Zn, copper-zinc ratio (Cu/Zn), zinc-copper ratio (Zn/Cu); fasted lipid profile consisting of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) as well as fasting serum glucose, and triglycerides-glucose (TyG) index. Decision tree (DT) and logical regression (LR) models were applied to examine the relationship between the aforementioned factors and CVD. CVD was diagnosed in 837 individuals (378 males and 459 females) out of 7561 participants. According to the LR models, SBP, TC, HDL, age, Zn/Cu, and TyG index for males and SBP, age, TyG index, HDL, TC, Cu/Zn, and Cu for females had the highest correlation with CVD (p-value ≤ 0.033). Based on the DT algorithm, 88% of males with SPB < 129.66 mmHg, younger age (age < 53 years), TyG index < 9.53, 173 ≤ TC < 187 mg/dL, and HDL ≥ 32 mg/dL had the lowest risk of CVD. Also, 98% of females with SBP < 128 mmHg, TyG index < 9.68, age < 44, TC < 222 mg/dL, and HDL ≥ 63.7 mg/dL had the lowest risk of CVD. It can be concluded that the Zn/Cu for men and Cu/Zn for women, along with dyslipidemia and SBP, could significantly predict the risk of CVD in this cohort from northeastern Iran.

Plasma Lipid Profile Among Perimenopausal Latvian Women in Relation to Dietary Habits

Background/Objectives: Hormonal changes throughout a woman's life cycle significantly affect serum lipid levels. Alterations in the serum lipid profile can increase the risk of cardiovascular diseases (CVDs). Additionally, nutrition and dietary habits are crucial for managing dyslipidemia. The current study evaluated the association between dietary habits and plasma lipid profiles among perimenopausal women in Latvia. Methods: The randomized clinical trial involved perimenopausal women (n = 61) aged 49 ± 3 years with moderately high low-density lipoprotein cholesterol (LDL-C) levels of 3.61 ± 0.30 mmol L-1. A series of questionnaires were completed, including a questionnaire on the subject's demographic, anthropometric, lifestyle, health, physical activity, and dietary factors, a 24 h food diary, a 72 h food diary, and a food-frequency questionnaire (FFQ). Blood testing was conducted for all participants, which included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), alanine aminotransferase (ALAT), and glucose level analyses. Results: The consumption of refined sugar, honey, syrup, and jam demonstrated a strong positive association with higher levels of remnant cholesterol (β = 0.462, p ≤ 0.05) and non-high-density lipoprotein cholesterol (non-HDL-C) (β = 0.395, p ≤ 0.05). Similarly, the consumption of fruit juices is associated with increased LDL-C (β = 0.303, p ≤ 0.05) and non-HDL-C (β = 0.285, p ≤ 0.05). Conversely, higher meat and poultry consumption negatively correlates with TC levels (β = -0.290, p ≤ 0.05). Conclusions: This underscores the need for further examination to understand the impact of dietary habits on lipid profile.

The Association Between Periodontitis, Gingivitis, Tooth Loss and Stroke: An Umbrella Study with Meta-Analysis

BACKGROUND

Cerebrovascular diseases (CVAs) have several risk factors that are categorized as modifiable and nonmodifiable. Periodontal diseases (PD) have a modifiable role in causing CVA, where several studies suggested direct or indirect correlations with systemic diseases. This study aims to summarize, evaluate and analyze all the evidence available in literature, to reach a better understanding of the relation between periodontitis, gingivitis, tooth loss and CVA.

METHODS

PubMed, Cochrane, Scopus and Web of Science databases were searched for all meta-analyses assessing the effect of PD on CVA in accordance with Joanna Briggs Institute guidance for umbrella reviews in March 2024. Assessment of Multiple Systematic Reviews (AMSTAR) was used for quality assessment. Pooled analysis was performed to assess the effect of periodontitis, gingivitis and tooth loss on CVA, depending on the availability of data using Review Manager Version 5.2.11.

RESULTS

Seven of the identified meta-analyses were of high quality, and they were distributed in different countries. Periodontitis was generally associated with a significant increase in CVA risk (OR = 2.32, 95% CI: 1.70, 3.17, p < 0.00001 and RR = 1.22, 95% CI: 1.15-1.29, p < 0.00001), same as tooth loss, but to a lower degree (0.78). However, the effect of gingivitis was insignificant in terms of CVA (RR = 1.32, 95% CI: 1.12-1.56, p = 0.0008).

CONCLUSIONS

This study confirms the effect of periodontitis and tooth loss on CVA, disregarding any significant role for gingivitis. The relation reached favors the suggested role of some inflammatory changes in the pathogenic pathway leading to atherosclerotic changes.

Sustained-Release Solid Dispersions of Fenofibrate for Simultaneous Enhancement of the Extent and Duration of Drug Exposure

BACKGROUND/OBJECTIVES

A sustained-release formulation of fenofibrate while enhancing drug dissolution with minimal food effect is critical for maximizing the therapeutic benefits of fenofibrate. Therefore, this study aimed to develop an effective solid dispersion formulation of fenofibrate for simultaneous enhancement in the extent and duration of drug exposure.

METHODS

Fenofibrate-loaded solid dispersions (FNSDs) were prepared using poloxamer 407 and Eudragit® RSPO at varied ratios via solvent evaporation. In vitro/in vivo characteristics of FNSDs were examined in comparison with untreated drugs.

RESULTS

Based on dissolution profiles of FNSDs in aqueous media, the weight ratio of fenofibrate: poloxamer 407: Eudragit® RSPO at 1:1:4 (FNSD2) was selected as the optimal composition for achieving sustained drug release while maximizing the drug dissolution. The enhanced and sustained drug release of FNSD2 was also confirmed in a buffer transition system mimicking the pH change in the gastrointestinal tract. FNSD2 achieved approximately 66% drug release over 12 h, while pure drug exhibited only 12%. Furthermore, FNSD2 maintained similar release rates under fed and fasted conditions, while the entire drug dissolution slightly increased in the fed state. Structural analysis by x-ray diffraction showed that fenofibrate remained crystalline in FNSD2. Pharmacokinetic studies in rats revealed that orally administered FNSD2 significantly improved the extent and duration of systemic drug exposure. Compared to pure drugs, the FNSD2 formulation increased the oral bioavailability of fenofibrate by 22 folds with the delayed Tmax of 4 h in rats.

CONCLUSION

FNSD2 formulation is effective in improving the extent and duration of drug exposure simultaneously.

Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia

BACKGROUND

Sedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear.

METHODS AND RESULTS

We analyzed data from 113 918 newly diagnosed patients with dyslipidemia (2009-2012) without prior CVD, sourced from the Korea National Health Insurance Service. Ambient particulate matter (PM) 2.5 and PM10 levels were collected from the National Ambient Air Monitoring System in South Korea. Changes in PA, measured in metabolic equivalents of task-min/wk before and after dyslipidemia diagnosis, were evaluated for associations with air pollution levels and CVD risk using Cox proportional hazards regression. Patients were followed from January 1, 2013, until CVD onset, death, or December 31, 2021. Among patients exposed to low to moderate PM2.5 levels (≤25 μg/m3), increasing PA from inactive to ≥1000 metabolic equivalents of tasks-min/wk was associated with a lower risk of CVD (adjusted hazard ratio, 0.82 [95% CI, 0.70-0.97]; P for trend=0.022). In high PM2.5 (>25 μg/m3) conditions, increasing PA from inactive and decreasing PA from ≥1000 metabolic equivalents of task-min/wk was associated with reduced (P for trend=0.010) and elevated (P for trend=0.028) CVD risks, respectively. For PM10, increased PA was linked to reduced CVD risk (P for trend=0.002) and decreased PA to elevated risk (P for trend=0.042) in low to moderate PM10 (≤50 μg/m3) conditions, though benefits diminished at high PM10 (>50 μg/m3) exposures.

CONCLUSIONS

Promoting PA, while considering the high potential cardiovascular risk associated with air pollution, may be an effective intervention against CVD in patients with dyslipidemia.

Associations of genetic variation and mRNA expression of PDGF/PDGFRB pathway genes with coronary artery disease in the Chinese population

Platelet-derived growth factors (PDGFs) and receptors (PDGFR) play a key role in the process of coronary atherosclerosis. We aimed to investigate the association of genetic variations and mRNA expressions of PDGF/PDGFRB pathway genes with coronary artery disease (CAD). In this case-control study (3139 CAD vs. 3270 controls), 13 single nucleotide polymorphisms (SNPs) at five pathway genes were genotyped and combined to construct a weighted genetic risk score (wGRS). Three hundred and six pairs of cases and controls were selected for mRNA quantification. Restricted cubic spline (RCS) analyses were conducted for the dose-response relationship between wGRS, mRNAs and CAD. Area under the curve (AUC) was estimated to evaluate the discrimination of wGRS, mRNAs, and traditional risk factors (TRF) for CAD. The wGRS exhibited a positive linear relationship with CAD (p for linearity <0.001), and the medium and high wGRS had 37% and 50% increased risk of CAD compared to the low wGRS group (p = 1.5 × 10-4; p = 5.7 × 10-5). mRNA expression levels of five genes in peripheral blood leukocytes were all lower among patients at admission than controls (p < 0.001). The PDGF/PDGFRB mRNA expressions had significant non-linear correlations with AMI, with "U"-shaped trend for PDGFA, PDGFB and "L"-shaped trend for PDGFC, PDGFD and PDGFRB. Adding wGRS and mRNAs to the TRF model significantly improved the discrimination for CAD with an AUC of 0.921 (95% CI, 0.898-0.943). Genetic variations in the PDGF/PDGFRB pathway contribute to CAD susceptibility with a significantly joint effect. The down-regulated PDGF/PDGFRB mRNAs in peripheral leukocytes have the potential as blood-based biomarkers for CAD with high discriminative value.

Examination of Lipoprotein and Lipid Levels of Adult Patients With Atherosclerosis, Myocardial Infarction, and Stroke: A Narrative Review

The literature revealed correlations between high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) and vaso-occlusive disease. Specifically, positive linear relationships exist between LDL and VLDL and the development of vaso-occlusive disease. Alternatively, a U-shaped relationship between HDL and vaso-occlusive disease exists where both low and high levels of HDL increase the risk of developing conditions such as myocardial infarction and atherosclerosis. These results align with the National Institute of Health's lipoprotein targets. Recent literature postulates that the adverse effects associated with lipoproteins may be attributable to commonalities between the structures of HDL, LDL, and VLDL, such as apolipoprotein subunits and molecular sizes that are not commonly analyzed in clinical lab tests. Nonetheless, additional research remains ongoing to further understand the role of lipoproteins in atherogenesis and vaso-occlusive disease.

Serum zinc levels and body composition variability as trajectory for hyperlipidemic and dyslipidemic effect among welders exposed to welding fumes and smoking: A biomarker for cardiovascular health

Welding is a common method for joining metals by heating them to the welding temperature. Exposure to welding fumes has a serious effect on the health of welders. This study examined serum zinc variability and body composition as route for hyperlipidemia and dyslipidemia in welders exposed to welding fumes and smoking, exploring the possibilities for the risk of possible cardiovascular disease. The experimental case control design was adopted in the study. Forty apparently healthy adult males were randomly selected comprising of twenty control group (non-smokers and smokers without welding experience) and twenty experimental group (non-smokers and smokers with welding experience) welders. Data obtained were represented as Mean ± SEM while comparison of means across group was done by one-way ANOVA followed by Tukey's multiple comparison for post hoc test at p-value < 0.05 level of significance using Graph Pad prism version 8. The data obtained showed that the body mass index (BMI) of smokers (non-welders and welders) were slightly reduced while that of non-smoking welders was increased compared to the control. The serum zinc level increased among the smoking welders, while the smoking non-welders and non-smoking welders decreased when compared to the control group (p < 0.05). Exposure to welding fumes has been shown to increase total cholesterol levels compared to the control. Weld fumes significantly (p < 0.05) increased high-density lipoproteins (HDL) levels among smoking non-welders compared to the control group, while, HDL was reduced in non-smoking welders and smoking welders, respectively (p < 0.05). Triglyceride levels significantly (p < 0.05) increased in all experimental groups compared to control levels (p < 0.05). Exposure to welding fumes and smoking caused significant changes in serum zinc, HDL and triglycerides levels with implications for the formation of plaques around the arteries interfering with the effective flow of blood through the vascular system, with implications of hyperlipidemia and dyslipidemia. This study recommends that further studies should be done using biomarkers from urine or toe nails.

Effect of hesperidin on blood pressure and lipid profile: A systematic review and meta-analysis of randomized controlled trials

The cardioprotective activity of hesperidin has been well demonstrated in several clinical studies. Also, there is a meta-analysis published on this topic in 2019. However, considering the recently published clinical studies, there is a scope for performing a systematic review and meta-analysis of hesperidin to determine its beneficial effect in alleviating alterations in cardiovascular parameters. In this study, the literature search was performed using online databases such as PubMed and Google Scholar till April 2023 involving randomized controlled studies conducted on hesperidin against various cardiovascular disorders including metabolic disorders in healthy/diseased individuals compared to the placebo/control. Based on the inclusion and exclusion criteria, nine clinical studies involving 2414 subjects were included. The meta-analysis revealed that hesperidin has significantly reduced the low-density lipoprotein (LDL) (IV: -0.55 (-0.94 to -0.16) at 95% CI, p = 0.005, I2 = 70%), total cholesterol (TC) (IV: -61 (-0.82 to -0.41) at 95% CI, p < 0.00001, I2 = 69%), and triglycerides (TG) (IV: -0.21 (-0.40 to -0.02) at 95% CI, p = 0.03, I2 = 12%). However, there were no statistically significant changes in the systolic blood pressure (IV: -0.29 (-2.21 to 1.63) at 95% CI, p = 0.77, I2 = 60%), diastolic blood pressure (IV: 0.79 (-0.74 to 2.31) at 95% CI, p = 0.31, I2 = 49%), and high-density lipoprotein (IV: 0.04 (-0.25 to 0.34) at 95% CI, p = 0.78, I2 = 56%) in the hesperidin treatment compared to the placebo/control. In conclusion, the outcomes of this meta-analysis suggest that hesperidin administration could benefit patients with CVD by reducing LDL, TC, and TG. Further high-quality studies are needed to firmly establish the clinical efficacy of hesperidin for its benefits in treating cardiovascular conditions.

Correlations Between Acute Coronary Syndrome and Novel Inflammatory Markers (Systemic Immune-Inflammation Index, Systemic Inflammation Response Index, and Aggregate Index of Systemic Inflammation) in Patients with and without Diabetes or Prediabetes

Purpose

Type 2 diabetes mellitus (DM) is a recognized independent risk factor for both chronic coronary syndrome (CCS) and its complication, acute coronary syndrome (ACS). Patients with DM and prediabetes (preDM) face an increased ACS risk. Inflammation plays a significant role in the pathogenesis of both CCS and ACS. This study delves into novel inflammatory markers, such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI, also known as SIIRI or PIV), to explore their relationship with ACS and CCS in patients that have been or have not been diagnosed with DM or preDM.

Patients and Methods

This study included data of 493 patients with chest pain undergoing coronary angiography. They were categorized into four groups: 1) without DM/preDM and with CCS; 2) with both DM/preDM and CCS; 3) without DM/preDM and with ACS, 4) with both DM/preDM and ACS. Standard methods of statistical analysis were used to reveal possible differences between groups and to find the most influential ACS risk factors in groups with DM/preDM and without DM/preDM.

Results

The analysis showed no significant differences in SII, SIRI, or AISI between the respective patient groups. A logistic regression analysis generated a model incorporating SII, high-density lipoprotein, and low-density lipoprotein levels as the influential ACS risk factors for patients with DM/preDM. The model demonstrated 71.0% accuracy, 37.0% sensitivity, and 89.4% specificity.

Conclusion

The findings suggest that the aforementioned inflammatory markers may have potential for distinguishing DM/preDM patients at higher risk of ACS at a low financial cost. However, further comprehensive and well-designed research is required to validate their clinical utility.

Causal association of blood lipids with all-cause and cause-specific mortality risk: a Mendelian randomization study

Dyslipidemia has long been implicated in elevating mortality risk; yet, the precise associations between lipid traits and mortality remained undisclosed. Our study aimed to explore the causal effects of lipid traits on both all-cause and cause-specific mortality. One-sample Mendelian randomization (MR) with linear and nonlinear assumptions was conducted in a cohort of 407,951 European participants from the UK Biobank. Six lipid traits, consisting of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and lipoprotein(a), were included to investigate the causal associations with mortality. Two-sample MR was performed to replicate the association between each lipid trait and all-cause mortality. Univariable MR results showed that genetically predicted higher ApoA1 was significantly associated with a decreased all-cause mortality risk (HR[95% CI]:0.93 [0.89-0.97], P value = 0.001), which was validated by the two-sample MR analysis. Higher lipoprotein(a) was associated with an increased risk of all-cause mortality (1.03 [1.01-1.04], P value = 0.002). Multivariable MR confirmed the direct causal effects of ApoA1 and lipoprotein(a) on all-cause mortality. Meanwhile, nonlinear MR found no evidence for nonlinearity between lipids and all-cause mortality. Our examination into cause-specific mortality revealed a suggestive inverse association between ApoA1 and cancer mortality, a significant positive association between lipoprotein(a) and cardiovascular disease mortality, and a suggestive positive association between lipoprotein(a) and digestive disease mortality. High LDL-C was associated with an increased risk of cardiovascular disease mortality but a decreased risk of neurodegenerative disease mortality. The findings suggest that implementing interventions to raise ApoA1 and decrease lipoprotein(a) levels may improve overall health outcomes and mitigate cancer and digestive disease mortality.

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.

Modifiable and Non-Modifiable Risk Factors for Premature Coronary Heart Disease (PCHD): Systematic Review and Meta-Analysis

AIM

We aimed to compare the prevalence of modifiable and non-modifiable coronary heart disease (CHD) risk factors among those with premature CHD and healthy individuals.

METHODS

PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol is registered in PROSPERO CRD42020173216). The quality of studies was assessed using the National Heart, Lung and Blood Institute tool for cross-sectional, cohort and case-control studies. Meta-analyses were performed using Review Manager 5.3. Effect sizes for categorical and continuous variables, odds ratio (OR) and mean differences (MD)/standardised mean differences (SMD) with 95% confidence intervals (CI) were reported.

RESULTS

A total of n=208 primary studies were included in this review. Individuals presenting with premature CHD (PCHD, age ≤65 years) had higher mean body mass index (MD 0.54 kg/m2, 95% CI 0.24, 0.83), total cholesterol (SMD 0.27, 95% CI 0.17, 0.38), triglycerides (SMD 0.50, 95% CI 0.41, 0.60) and lower high-density lipoprotein cholesterol (SMD 0.79, 95% CI: -0.91, -0.68) compared with healthy individuals. Individuals presenting with PCHD were more likely to be smokers (OR 2.88, 95% CI 2.51, 3.31), consumed excessive alcohol (OR 1.40, 95% CI 1.05, 1.86), had higher mean lipoprotein (a) levels (SMD 0.41, 95% CI 0.28, 0.54), and had a positive family history of CHD (OR 3.65, 95% CI 2.87, 4.66) compared with healthy individuals. Also, they were more likely to be obese (OR 1.59, 95% CI 1.32, 1.91), and to have had dyslipidaemia (OR 2.74, 95% CI 2.18, 3.45), hypertension (OR 2.80, 95% CI 2.28, 3.45), and type 2 diabetes mellitus (OR 2.93, 95% CI 2.50, 3.45) compared with healthy individuals.

CONCLUSION

This meta-analysis confirms current knowledge of risk factors for PCHD, and identifying these early may reduce CHD in young adults.

The impact of medroxyprogesterone acetate on lipid profiles in Women: A time and dose-response meta-analysis of randomized controlled trials

BACKGROUND

The effect of MPA on the lipid profile and CVD risk is still controversial; hence, this comprehensive dose-response meta-analysis of randomized controlled trials was conducted to assess the effect of MPA on lipid profiles in women.

METHODS

A comprehensive search was conducted in the following databases: Web of Science, Scopus, PubMed/Medline, and Embase, up to October 20, 2023. A random-effects meta-analysis approach based on the DerSimonian and Laird method was used to compute the combined estimates of the intervention's impact on the lipid profile.

RESULTS

35 eligible studies with 58 arms were included in our meta-analyses analysis. Combined effect sizes suggested a significant effect of MPA on total cholesterol (TC) levels (WMD: -3.43 mg/dL, 95 % CI: -5.38 to -1.48, p < 0.001), HDL-C levels (WMD: -3.34 mg/dL, 95 % CI: -3.77 to -2.91, p < 0.001), and triglyceride (TG) levels (WMD: -9.13 mg/dL, 95 % CI: -10.92 to -7.33, p < 0.001). The subgroup meta-analysis revealed a more substantial reduction in TC in studies with dosages > 2.5 mg/day (WMD: -4.10 mg/dL), mean participant age lower than 60 years (WMD: -3.80 mg/dL), mean BMI lower than 25 kg/m2 (WMD: -5.61 mg/dL), duration of intervention of 12 months or more (WMD: -3.98 mg/dL), and when the baseline TC value was equal to or greater than 200 mg/dL (WMD: -4.13 mg/dL).

CONCLUSIONS

The current meta-analysis showed a statistically significant decrease in TC, TG, and HDL-C levels and a non-significant increase in LDL-C levels after MPA administration in women.

High-sensitivity C-reactive protein among people living with HIV on highly active antiretroviral therapy: a systemic review and meta-analysis

The pathological consequences of inflammation persist in people living with the human immunodeficiency virus (PLWH), regardless of the positive outcomes of highly active antiretroviral therapy (HAART). The current systematic review and meta-analysis aims to understand and explore the levels of high-sensitivity C-reactive protein (hs-CRP) and other cardiovascular disease (CVD)-risk factors including lipid profiles among PLWH on HAART. Major electronic databases including PubMed, Scopus, and Web of Science were searched to retrieve relevant global literature reporting on hs-CRP levels in PLWH on HAART. A total of twenty-two studies with an average participant age of 40 years were eligible for this systematic review and meta-analysis. Majority of the included studies were from Africa (n = 11), the United States (n = 6), and Europe (n = 5). Our systemic review showed that most studies reported increased levels of hs-CRP among PLWH on HAART when compared to controls (PLWH not on HAART or those without HIV), especially in studies from Africa. This was supported by a meta-analysis showing significantly elevated levels of hs-CRP in PLWH on HAART when compared to PLWH not on HAART (standardised mean difference [SMD] = 0.56; 95% CI = 0.10‑1.01, z = 2.41; p = 0.02) or those without HIV (SMD = 1.19; 95% CI = 0.76‑1.63, z = 5.35; p < 0.001). Where lipid profiles, as a major predictor for CVD risk, were also impaired in PLWH on HAART when compared to PLWH not on HAART and HIV-negative participants. In conclusion, elevated levels of hs-CRP and lipid levels are prevalent in PLWH on HAART, this may increase the risk of CVD complications, especially for those people living in Africa. However, more evidence in larger population studies is required to confirm these outcomes and unveil any possible clinical implications of HAART-induced modulation of hs-CRP levels in PLWH.

The effect of Sumac on cardiometabolic parameters in adults: a systematic review and meta-analysis of randomized controlled trials

Background

The current evidence on the effect of Sumac consumption on cardiovascular parameters has produced controversial findings.

Methods

We systematically searched several databases, including PubMed-Medline, SCOPUS, and ISI Web of Science, to find eligible studies until January 2023. Meta-analysis to calculated the weighted mean difference (WMD) and 95 %CI, Sub-group meta-analysis and meta-regression analysis were conducted throughout the study.

Results

16 randomized controlled trials comprising a total number of 1,225 participants were included. The results of meta-analysis revealed that Sumac significantly affected low-density lipoprotein (WMD: -8.66 mg/dL; 95% CI: -14.2, -3.12), high-density lipoprotein (WMD: 3.15 mg/dL; 1.99,4.31), triglycerides (WMD: -11.96 mg/dL; -19.44, -4.48), fasting blood glucose (WMD: -4.15 mg/dL; -7.31, -0.98), insulin (WMD: -1.72; -3.18, -0.25), homeostasis model assessment of insulin resistance (HOMA-IR; WMD: -0.61; -1.22, -0.01), and anthropometric indices (p < 0.05). Moreover, the results significantly reduced total cholesterol when the intervention duration was ≥12 weeks (WMD: -8.58 mg/dL; -16.8, -0.37).

Conclusion

These findings suggest that Sumac is potentially an effective complementary intervention to improve cardiometabolic parameters. Thus, patients could utilize Sumac as part of their diet to improve their overall cardiometabolic status.

Exploratory analysis of the associations between neonicotinoids insecticides and serum lipid profiles among US adults: A cross-sectional, population-based study

Neonicotinoid insecticides (NNIs) are widely used in agriculture, horticulture, forestry, and household environment, but their potential impact on human health remains a subject of concern. This study aimed to investigate the relationship between NNIs and their metabolites in urine with serum lipid profiles in adults using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. The study included 1192 participants aged over 20 years with urinary NNIs levels, serum lipid parameter levels and potential confounders. Urinary concentrations of NNIs, including imidacloprid, acetamiprid, clothianidin, thiacloprid, N-desmethyl-acetamiprid, and 5-hydroxy-imidacloprid, were quantified. Serum lipids profiles, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (Apo-B), were assessed. Considering the effects of lipid-lowering medications, the censored normal regression model was used to explore the associations between urinary NNIs and TC, TG, HDL-C, LDL-C and Apo-B levels. The results revealed a significant increase of 9.0 mg/dL (95%CI: 2.0, 16.1) in TC levels among participants with detectable N-desmethyl-acetamiprid compared to those with undetectable levels. Stratified analysis indicated that the association between N-desmethyl-acetamiprid and HDL-C levels was more pronounced among participants aged ≥ 46 years compared to those aged between 20 and 45 years with undetectable N-desmethyl-acetamiprid (pinteraction=0.044). Additionally, there were marginal effect modification of BMI on the association between N-desmethyl-acetamiprid and LDL-C (pinteraction=0.097) and Apo-B (pinteraction=0.052) levels. Specifically, participants with BMI ≥ 25 kg/m² and detectable N-desmethyl-acetamiprid tended to have higher LDL-C and Apo-B levels compared to those with BMI < 25 kg/m² and undetectable N-desmethyl-acetamiprid. However, no significant associations were observed between other NNIs and lipid profiles in the present study. To validate these findings, further longitudinal studies with larger sample sizes should be conducted, particularly within populations characterized by a high detection rate of NNIs.

A realistic approach to evaluating the effect of baseline lipid profile in postcoronary artery bypass grafting surgery

BACKGROUND

There are still many uncertainties in the association between lipid profile and postcoronary artery bypass grafting (CABG) outcomes. Although simplifying the association to linear equations makes it understandable but cannot explain many findings.

HYPOTHESIS

There is a nonlinear associatin between lipid profile indices and adverse outcomes after CABG.

METHODS

A total of 17 555 patients who underwent isolated CABG between 2005 and 2016 were evaluated. During the median follow-up of 75.24 months, the Restricted Cubic Splines (RCS) estimated from the Cox regression model adjusted for all possible confounders was applied to show a nonlinear relationship of lipid profile contents with the "ln hazard ratio" of mortality and major cerebro-cardiac events (MACCE).

RESULTS

The relationship between LDL-C and HDL-C with all-cause mortality was nonlinear (nonlinear p were .004 and <.001, respectively). The relationship between remnant cholesterol and all-cause mortality was linear (linearity p = .023). Among men, those in the highest LDL-C level (Q4, LDL-C > 114) and those in the lowest HDL-C level (Q1, HDL-C < 30) showed a significantly higher risk of all-cause mortality compared to other groups (compared with Q3, LDL-C Q4, HR = 1.16, 95% confidence interval [CI]:1.02-1.26, p = .014; HDL-C Q1, HR = 1.14, 95% CI: 1.01-1.31, p = .041). Female patients in the lowest HDL-C level (Q1, HDL-C < 30) showed a significantly higher (compared with Q3, HR = 1.14, 95% CI:1.01-1.31, p = .028) and those in the highest HDL-C level (Q4, HDL-C > 43) showed a significantly lower (compared with Q3, HR = 0.74, 95% CI:0.58-0.98, p = .019) risk of all-cause mortality.

CONCLUSION

Determining a universal cut off for components of lipid profile may be misleading and should better be revised. Extreme values (very low or very high) for HDL-C and LDL-C have different effects on cardiovascular outcomes.

Association of nut consumption with insulin resistance and blood lipid profile in Spanish university students

AIMS

To examine whether nut consumption was associated with insulin resistance and blood lipid parameters in a sample of young healthy adults.

MATERIAL AND METHODS

A cross-sectional study was conducted involving 306 first-year students (aged 18-30 years) from the University of Castilla-La Mancha, Spain. Biochemical variables related to insulin resistance and blood lipid profile (glucose, insulin, HbA1c, total cholesterol (total-c), LDL-c, HDL-c, and triglycerides) were determined from morning fasting blood samples. Nut consumption was estimated using a 137-item Food-Frequency Questionnaire. The associations of walnuts, other nuts and total nut intakes with insulin resistance and lipid profile variables and surrogates were assessed by linear regression analysis. Differences in insulin resistance and lipid profiles between participants meeting or not meeting the nut consumption recommendations were examined by analysis of covariance (ANCOVA). Logistic regressions were used to analyze the likelihood of having higher levels of blood lipids or insulin resistance in participants who met or did not meet the recommended intake of nuts.

RESULTS

There was no association found between nut consumption, whether walnuts or other nut varieties, and insulin resistance and lipid profile variables. Additionally, there were no significant differences in insulin resistance or blood lipid profile variables between university students meeting or not meeting nut consumption recommendations. Finally, stratified analyses based on sex were consistent and did not substantially modify our estimates in the fully adjusted models.

CONCLUSIONS

In conclusion, our results suggest that walnuts, other types of nuts, and total nut consumption did not adversely influence metabolic or lipid profile variables among healthy young adults. Although nuts are recommended among healthy dietary patterns, our findings showed that nut consumption has a null effect on the cardiometabolic risk parameters explored in young healthy adults.

The effects of purslane consumption on lipid profile and C-reactive protein: A systematic review and dose-response meta-analysis

Earlier investigations into the impact of purslane, Portulaca oleracea, on lipid profile and C-reactive protein (CRP) produced contradictory findings. The effect of purslane consumption on lipid profiles and CRP was assessed in this comprehensive review and meta-analysis. We conducted a thorough literature search in online databases, including PubMed, Scopus, the Cochrane library, and ISI Web of Science to find relevant randomized controlled trials up to June 2023. By incorporating 14 effect sizes from 13 RCTs, we were able to show that purslane consumption significantly decreases serum triglyceride (TG) (WMD: -16.72, 95% CI: -22.49, -10.96 mg/dL, p < .001), total cholesterol (TC) (WMD: -9.97, 95% CI: -19.86, -0.07 mg/dL, p = .048), and CRP (WMD: -1.22, 95% CI: -1.63, -0.80 mg/L, p < .001) levels in patients compared to the control group. In addition, purslane consumption significantly increases high-density lipoprotein (HDL-C) (WMD: 4.09, 95% CI: 1.77, 6.41 mg/dL, p = .001) levels. However, purslane consumption did not affect low-density lipoprotein (LDL-C) levels. According to a suggested optimal dosage, purslane consumption is considered to be safe up to 30 g/day. Purslane consumption can significantly improve cardiovascular health by improving lipid profile and inflammation status.

The association between atherogenic index of plasma and all-cause mortality and cardiovascular disease-specific mortality in hypertension patients: a retrospective cohort study of NHANES

BACKGROUND

Atherogenic index of plasma (AIP), a marker of atherosclerosis and cardiovascular disease (CVD), was related to the all-cause mortality and CVD-specific mortality in a U-shape in general population respectively. However, no studies have investigated these associations in hypertensive populations. Herein, this study aims to explore the relationship of AIP and all-cause mortality and CVD-specific mortality in patients with hypertension in order to provide some reference for the risk hierarchical management of hypertension.

METHODS

Demographic and clinical data of 17,382 adult patients with hypertension were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2005-2018 in this retrospective cohort study. We used weighted univariate COX regression analysis to screen the covariates, and that weighted univariate and multivariate COX regression analyses to explore the association between AIP and all-cause mortality and CVD-specific mortality with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, gender, body mass index (BMI), CVD, diabetes mellitus (DM), antihyperlipidemic agents use, and hypotensive drugs use were also performed for further exploration of these relationships.

RESULTS

The average follow-up time was 97.10 months. A total of 2,844 patients died, and 971 of them died due to CVD. After adjusting for age, race, education level, marital status, poverty-income ratio (PIR), smoking, BMI, physical activity, antihyperlipidemic agents, DM, CVD, hypotensive drugs, estimated glomerular filtration rate (eGFR), and total energy intake, we found that both low [HR = 1.18, 95%CI: (1.07-1.32)] and high [HR = 1.17, 95%CI: (1.03-1.33)] levels of AIP were linked to an increased risk of all-cause mortality, and the U-shape association between AIP and CVD-specific mortality was also found [low AIP level: HR = 1.26, 95%CI: (1.05-1.51); high AIP level: HR = 1.26, 95%CI: (1.06-1.49)]. Furthermore, these relationships were existed in patients whose BMI > 25, were non-Hispanic White, with non-CVD, non-DM, non-antihyperlipidemic agents, and used hypertension drug (all P < 0.05).

CONCLUSION

AIP was associated with both all-cause mortality and CVD-specific mortality in patients with hypertension, but the specific role of AIP in prognosis in hypertensive populations is needed further exploration.

The Ketogenic Diet and Cardiovascular Diseases

The most common and increasing causes of death worldwide are cardiovascular diseases (CVD). Taking into account the fact that diet is a key factor, it is worth exploring this aspect of CVD prevention and therapy. The aim of this article is to assess the potential of the ketogenic diet in the prevention and treatment of CVD. The article is a comprehensive, meticulous analysis of the literature in this area, taking into account the most recent studies currently available. The ketogenic diet has been shown to have a multifaceted effect on the prevention and treatment of CVD. Among other aspects, it has a beneficial effect on the blood lipid profile, even compared to other diets. It shows strong anti-inflammatory and cardioprotective potential, which is due, among other factors, to the anti-inflammatory properties of the state of ketosis, the elimination of simple sugars, the restriction of total carbohydrates and the supply of omega-3 fatty acids. In addition, ketone bodies provide "rescue fuel" for the diseased heart by affecting its metabolism. They also have a beneficial effect on the function of the vascular endothelium, including improving its function and inhibiting premature ageing. The ketogenic diet has a beneficial effect on blood pressure and other CVD risk factors through, among other aspects, weight loss. The evidence cited is often superior to that for standard diets, making it likely that the ketogenic diet shows advantages over other dietary models in the prevention and treatment of cardiovascular diseases. There is a legitimate need for further research in this area.

Interactive effect of increased high sensitive C-reactive protein and dyslipidemia on cardiovascular diseases: a 12-year prospective cohort study

BACKGROUND

Dyslipidemia and inflammation are significant factors for the onset of cardiovascular diseases (CVD); however, studies regarding their interactions on the risk of CVD are scarce. This study aimed to assess the interaction of dyslipidemia and high-sensitivity C-reactive protein (hs-CRP) on CVD.

METHODS

This prospective cohort enrolled 4,128 adults at baseline in 2009 and followed them up until May 2022 for collecting CVD events. Cox-proportional hazard regression analysis estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of increased hs-CRP (≥ 1 mg/L) and dyslipidemia with CVD. The additive interactions were explored using the relative excess risk of interaction (RERI) and the multiplicative interactions were assessed with HRs (95% CI) while the multiplicative interactions were assessed by the HRs (95% CI) of interaction terms.

RESULTS

The HRs of the association between increased hs-CRP and CVD were 1.42 (95% CI: 1.14-1.79) and 1.17 (95% CI: 0.89-1.53) among subjects with normal lipid levels and subjects with dyslipidemia, respectively. Stratified analyses by hs-CRP levels showed that among participants with normal hs-CRP (< 1 mg/L), TC ≥ 240 mg/dL, LDL-C ≥ 160 mg/dL, non-HDL-C ≥ 190 mg/dL, ApoB < 0.7 g/L, and LDL/HDL-C ≥ 2.02 were associated with CVD [HRs (95%CIs): 1.75 (1.21-2.54), 2.16 (1.37-3.41), 1.95 (1.29-2.97), 1.37 (1.01-1.67), and 1.30 (1.00-1.69), all P < 0.05, respectively]. While in the population with increased hs-CRP, only ApoAI > 2.10 g/L had a significant association with CVD [HR (95% CI): 1.69 (1.14-2.51)]. Interaction analyses showed that increased hs-CRP had multiplicative and additive interactions with LDL-C ≥ 160 mg/dL and non-HDL-C ≥ 190 mg/dL on the risk of CVD [HRs (95%CIs): 0.309 (0.153-0.621), and 0.505 (0.295-0.866); RERIs (95%CIs): -1.704 (-3.430-0.021 and - 0.694 (-1.476-0.089), respectively, all P < 0.05].

CONCLUSION

Overall our findings indicate negative interactions between abnormal blood lipid levels and hs-CRP on the risk of CVD. Further large-scale cohort studies with trajectories measurement of lipids and hs-CRP might verify our results as well explore the biological mechanism behind that interaction.

Late Effects of Chronic Low Dose Rate Total Body Irradiation on the Heart Proteome of ApoE-/- Mice Resemble Premature Cardiac Ageing

Recent epidemiologic studies support an association between chronic low-dose radiation exposure and the development of cardiovascular disease (CVD). The molecular mechanisms underlying the adverse effect of chronic low dose exposure are not fully understood. To address this issue, we have investigated changes in the heart proteome of ApoE deficient (ApoE^-/-) C57Bl/6 female mice chronically irradiated for 300 days at a very low dose rate (1 mGy/day) or at a low dose rate (20 mGy/day), resulting in cumulative whole-body doses of 0.3 Gy or 6.0 Gy, respectively. The heart proteomes were compared to those of age-matched sham-irradiated ApoE^-/- mice using label-free quantitative proteomics. Radiation-induced proteome changes were further validated using immunoblotting, enzyme activity assays, immunohistochemistry or targeted transcriptomics. The analyses showed persistent alterations in the cardiac proteome at both dose rates; however, the effect was more pronounced following higher dose rates. The altered proteins were involved in cardiac energy metabolism, ECM remodelling, oxidative stress, and ageing signalling pathways. The changes in PPARα, SIRT, AMPK, and mTOR signalling pathways were found at both dose rates and in a dose-dependent manner, whereas more changes in glycolysis and ECM remodelling were detected at the lower dose rate. These data provide strong evidence for the possible risk of cardiac injury following chronic low dose irradiation and show that several affected pathways following chronic irradiation overlap with those of ageing-associated heart pathology.

The cause-effect relation of tuberculosis on incidence of diabetes mellitus

Tuberculosis (TB) is one of the oldest human diseases and is one of the major causes of mortality and morbidity across the Globe. Mycobacterium tuberculosis (Mtb), the causal agent of TB is one of the most successful pathogens known to mankind. Malnutrition, smoking, co-infection with other pathogens like human immunodeficiency virus (HIV), or conditions like diabetes further aggravate the tuberculosis pathogenesis. The association between type 2 diabetes mellitus (DM) and tuberculosis is well known and the immune-metabolic changes during diabetes are known to cause increased susceptibility to tuberculosis. Many epidemiological studies suggest the occurrence of hyperglycemia during active TB leading to impaired glucose tolerance and insulin resistance. However, the mechanisms underlying these effects is not well understood. In this review, we have described possible causal factors like inflammation, host metabolic changes triggered by tuberculosis that could contribute to the development of insulin resistance and type 2 diabetes. We have also discussed therapeutic management of type 2 diabetes during TB, which may help in designing future strategies to cope with TB-DM cases.

Can the Substitution of Milk with Plant-Based Drinks Affect Health-Related Markers? A Systematic Review of Human Intervention Studies in Adults

The consumption of plant-based drinks (PBDs) in substitution for cow's milk (CM) is increasing due to concerns for human and planet health and animal welfare. The present review aims to analyze the main findings from intervention trials investigating the effect of PBDs in comparison with CM on markers of human health. Suitable articles published up to July 2022 were sourced from PubMed and Scopus databases. A total of 29 papers were collected, with 27 focusing on soy drinks (1 of which also evaluated the effects of an almond drink), while only 2 focused on rice drinks. Among studies focused on soy drinks, the most investigated factors were anthropometric parameters (n = 13), the lipid profile (n = 8), markers of inflammation and/or oxidative stress (n = 7), glucose and insulin responses (n = 6) and blood pressure (n = 4). Despite some evidence of a beneficial effect of PBDs, especially for the lipid profile, it was not possible to draw any overall conclusions due to some conflicting results. As well as the low number of studies, a wide heterogeneity was found in terms of the characteristics of subjects, duration and markers, which reduces the strength of the available results. In conclusion, further studies are needed to better elucidate the effects of substituting CM with PBDs, especially in the long term.

Associations between Per- and Polyfluoroalkyl Substances Exposures and Blood Lipid Levels among Adults-A Meta-Analysis

BACKGROUND

Associations between per- and polyfluoroalkyl substances (PFAS) and blood lipid levels in humans were mixed.

OBJECTIVES

The objective of this meta-analysis was to summarize associations between PFAS and blood lipids in adults.

METHODS

A literature search was conducted on PubMed and Web of Science for articles published through 13 May 2022 that examined associations between PFAS and blood lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triacylglycerols (TGs). Inclusion criteria included the presence of associations between five PFAS (PFOA, PFOS, PFHxS, PFDA, and PFNA) and four blood lipid measures (TC, HDL-C, LDL-C, and TGs) in adults. Data on study characteristics and PFAS-lipid associations were extracted. Assessments of individual study quality were performed. Associations of changes of blood lipid levels corresponding to 1 interquartile range (IQR)-unit increase of blood PFAS levels were pooled using random effects models. Dose-response relationships were examined.

RESULTS

Twenty-nine publications were included in the present analyses. Every IQR increase of PFOA was significantly associated with a 2.1 -mg / dL increase in TC (95% CI: 1.2, 3.0), a 1.3 -mg / dL increase in TGs (95% CI: 0.1, 2.4), and a 1.4 -mg / dL increase in LDL-C (95% CI: 0.6, 2.2). PFOS was also significantly associated with TC and LDL-C levels, and the corresponding values were 2.6 (95% CI: 1.5, 3.6) and 1.9 (95% CI: 0.9, 3.0), respectively. Associations of PFOS and PFOA with HDL-C levels were largely null. For minor PFAS species, PFHxS was significantly associated with higher levels of HDL-C [0.8 (95% CI: 0.5, 1.2)]. Inverse associations were observed between PFDA and TGs [- 5.0 (95% CI: - 8.1 , - 1.9 )] and between PFNA and TGs [- 1.7 (95% CI: - 3.5 , - 0.02 )], whereas a positive association was observed between PFDA and HDL-C [1.4 (95% CI: 0.1, 2.7)]. Nonsignificant nonlinear dose-response relationships were identified for associations of PFOA and PFOS with certain blood lipids.

DISCUSSION

PFOA and PFOS were significantly associated with TC and LDL-C levels in adults. Whether these findings may translate into an elevated cardiovascular disease risk associated with PFAS exposure warrants further investigation. https://doi.org/10.1289/EHP11840.

Joint Effect of Multiple Metals on Hyperuricemia and Their Interaction with Obesity: A Community-Based Cross-Sectional Study in China

Metal exposures have been inconsistently related to the risk of hyperuricemia, and limited research has investigated the interaction between obesity and metals in hyperuricemia. To explore their associations and interaction effects, 3300 participants were enrolled from 11 districts within 1 province in China, and the blood concentrations of 13 metals were measured to assess internal exposure. Multivariable logistic regression, restricted cubic spline (RCS), Bayesian kernel machine regression (BKMR), and interaction analysis were applied in the single- and multi-metal models. In single-metal models, five metals (V, Cr, Mn, Co, and Zn) were positively associated with hyperuricemia in males, but V was negatively associated with hyperuricemia in females. Following the multi-metal logistic regression, the multivariate-adjusted odds ratios (95% confidence intervals) of hyperuricemia were 1.7 (1.18, 2.45) for Cr and 1.76 (1.26, 2.46) for Co in males, and 0.68 (0.47, 0.99) for V in females. For V and Co, RCS models revealed wavy and inverted V-shaped negative associations with female hyperuricemia risk. The BKMR models showed a significant joint effect of multiple metals on hyperuricemia when the concentrations of five metals were at or above their 55th percentile compared to their median values, and V, Cr, Mn, and Co were major contributors to the combined effect. A potential interaction between Cr and obesity and Zn and obesity in increasing the risk of hyperuricemia was observed. Our results suggest that higher levels of Cr and Co may increase male hyperuricemia risk, while higher levels of V may decrease female hyperuricemia risk. Therefore, the management of metal exposure in the environment and diet should be improved to prevent hyperuricemia.

Characterisation of the Paternal Influence on Intergenerational Offspring Cardiac and Brain Lipid Homeostasis in Mice

There is growing evidence that poor paternal diet at the time of conception increase the risk of offspring developing a range of non-communicable metabolic diseases, such as obesity, diabetes and cardiovascular disease, in adulthood. We hypothesise that a paternal low protein-high carbohydrate diet perturbs offspring tissue lipid abundance through both sperm and seminal plasma-mediated mechanisms. To test our hypothesis, we fed male C57BL/6 mice either a control normal protein diet (NPD; 18% protein) or an isocaloric low protein diet (LPD; 9% protein) for a minimum of 8 weeks. We generated offspring through artificial insemination, in combination with vasectomised male mating. Using this approach, we derived offspring from either NPD or LPD sperm but in the presence of NPD or LPD seminal plasma. Using high resolution mass-spectrometry, we found that offspring derived from either LPD sperm or seminal fluid displayed perturbed cardiac and brain lipid abundance from just three weeks of age, typically associated with the altered abundance of tissue triglycerides. We also observed the differential sex-specific patterns of lipids between the control and experimental offspring's hearts and brains. These observations indicate that poor paternal diet at the time of conception affects offspring cardiac and brain lipid profiles in an age-, sex- and generation-specific manner.

SNP rs3803264 polymorphisms in THSD1 and abnormally expressed mRNA are associated with hemorrhagic stroke

Background

Thrombospondin Type 1 Domain Containing Protein 1 (THSD1) has been suggested to be a new regulator of endothelial barrier function in the angiogenesis process, preserving vascular integrity. We sought to characterize the association of THSD1 genetic variants and mRNA expression with the risk of hemorrhagic stroke (HS) with population-based evidence.

Methods

A case-control study was conducted with 843 HS cases and 1,400 healthy controls. A cohort study enrolled 4,080 participants free of stroke at baseline in 2009 and followed up to 2022. A synonymous variant, the main tag SNP rs3803264 of the THSD1 gene, was genotyped in all subjects, and peripheral leukocyte THSD1 mRNA expression was detected using RT-qPCR in 57 HS cases and 119 controls.

Results

In the case-control study, rs3803264 AG/GG variations are associated with a decreased risk of HS with odd ratio (OR) and 95% confidence interval (CI) of the dominant model of 0.788 (0.648-0.958), p = 0.017. In addition, rs3803264 and dyslipidemia had a multiplicative interaction [OR (95% CI) = 1.389 (1.032, 1.869), p = 0.030]. In the cohort study, a similar association strength of rs3803264 dominant model and the risk of HS was observed with the incidence rate ratio (IRR) of 0.734 and p-value of 0.383. Furthermore, the risk of HS showed a non-linear as THSD1 mRNA expression increased (p for non-linearity <0.001). For the subjects without hypertension, we observed THSD1 mRNA expression had a negative correlation with systolic blood pressure (SBP; ρ = -0.334, p = 0.022).

Conclusion

SNP rs3803264 polymorphisms in THSD1 are associated with the decreased risk of HS and interacted with dyslipidemia, and a non-linear association was observed between THSD1 mRNA expression and the risk of HS.

Age Stratification in Acute Ischemic Stroke Patients with Heart Failure

Background and Purpose. Heart failure (HF) is considered one of the major risk factors associated with the severity of acute ischemic stroke(AIS). The risk factors associated with stroke severity in AIS with a history of HF is not fully understood. Methods. A prospectively maintained database from comprehensive stroke centers in PRISMA Health Upstate Sc, was analyzed for patients with AIS and a history of HF from January 2010 to 30 June 2016. The primary outcome was risk factors associated with a National Institute of Health Stroke Scale score (NIHSS) < 7 indicating lower severity and a score ≥ 7 indicating high severity for 65−74 age category and ≥75 years age category for AIS-HF patients. Univariate analysis was used to determine risk factors based on age categories and stroke severities, while multivariable analysis was used to adjust for the effect of confounding variables. Results: A total 367 AIS-HF patients were identified in this study, 113 patients were between 65−74 years old, while 254 patients were in the ≥75 years old age category. In the adjusted analysis for 65−74 age category, history of smoking (OR = 0.105, 95% Confidence interval (CI): 0.018−0.614, p = 0.012), triglycerides (Odd ratio(OR) = 0.993, 95% (CI): 0.987−0.999, p = 0.019), and International Normalized Ratio (INR) (OR = 0.454, 95% CI: 0.196−1.050, p = 0.045), and direct admission treatment (OR = 0.355, 95% CI: 0.137−0.920, p = 0.033) were associated with a lower stroke severity, elevated heart rate (OR = 1.032, 95% CI: 1.009−1.057, p = 0.007) was associated with a higher stroke severity. For the ≥75 years old age category, previous stroke (OR = 2.297, 95% CI: 1.171−9.852, p = 0.024), peripheral vascular disease (OR = 6.784, 95% CI: 1.242−37.065, p = 0.027), heart rate (OR = 1.035, 95% CI: 1.008−1.063, p = 0.012), and systolic blood pressure (OR = 1.023, 95% CI: 1.005−1.041, p = 0.012) were associated with a higher severe stroke severity. Conclusions: After adjusting for the effect of potential confounders, more risk factors were associated with a high severity of stroke among ≥75 years old compared with 65−74 years old AIS-HF patients. Elevated heart rate was an independent risk factor associated with stroke severity in 65−74 and ≥75 years old AIS-HF patients. Elevated heart rate and other identified risk factors should be managed to reduce stroke severity among elderly AIS-HF patients.

Risk of Cardiovascular Complication Among Type 2 Diabetes Mellitus Patients in Medan, Indonesia. A Cross-sectional Study

Background

Cardiovascular disease (CVD) is a disease associated with impaired heart and blood vessel function. The occurrence of Diabetes Mellitus (DM) is due to an imbalance in blood glucose that could cause damage to large and small blood vessels and increase platelet aggregation, contributing to atherosclerosis and cardiovascular disease. It could be attributed to high blood pressure, smoking, diabetes, lack of movement, obesity, high cholesterol, unbalanced diet. CVD can be prevented, especially in at-risk groups, with risk assessment utilizing the Framingham Risk Score (FRS).

Objective

The study aimed to to analyze the risk of CVD according to the Framingham Risk Score (FRS) in type 2 DM patients in Medan.

Methods

The data were collected with the Framingham Risk Score, which consisted of sub-variables of age, total cholesterol, HDL cholesterol, systolic blood pressure (SBM), history of DM, and history of smoking, which were assessed by gender. It was a cross-sectional analytic study with consecutive sampling on 252 respondents, namely DM patients who came for treatment or control to the health centers in Medan and fulfilled the inclusion and exclusion criteria. The data were then analyzed with SPSS.

Results

The respondents consisted of 197 women (78.2%) and 55 men (21.8%). The results were predominated with high risk patients (139, 55.2%), followed by those with medium risks (80, 31.7%), and low risks (33, 13.1%). Chi-square test yielded a significant association between each sub-variable of CVD risk factors and the risks based on FRS in type 2 DM patients.

Conclusion

Each sub-variable of CVD risk factors and the risks on FRS among type 2 DM patients. In future studies, it is recommended to include that a larger number of samples in the community with a balanced proportion of men and women.

Association of THBS1 genetic variants and mRNA expression with the risks of ischemic stroke and long-term death after stroke

Background

Thrombospondin-1 (THBS1) derived from platelets and acted as a critical mediator of hemostasis promoting platelet activation in thrombus formation. The biological connection of genetic variants and mRNA expression of THBS1 with ischemic stroke (IS) warrants further validation with population-based evidence.

Objective

To evaluate the association of single nucleotide polymorphisms (SNPs) and mRNA expression of THBS1 with the risks of IS and long-term death after stroke.

Methods

A case-control study consisted of 4,584 IS patients recruited from five hospitals in Jiangsu, China, and 4,663 age-gender-matched controls free of IS. A cohort study enrolled 4,098 participants free of stroke and lasted from 2009 to 2022. Early collected 3158 IS patients aged between 35 and 80 years were followed up an average of 5.86-year to follow up their long-term death outcomes. Two tagSNPs of the THBS1 gene, rs2236471 and rs3743125, were genotyped in all subjects and THBS1 mRNA expression of peripheral leukocyte was measured using RT-qPCR in 314 IS cases and 314 controls.

Results

There is no significant difference in genotype and haplotype frequencies of rs2236741 and rs3743125 between IS cases and controls (all P > 0.05). Furthermore, the cohort studies did not observe significant associations between THBS1 variants and the risk of IS incidence or long-term death after IS (all P > 0.05). The THBS1 mRNA expression level (2^–ΔΔCT) in IS cases was approximately equal to that in controls (1.01 vs. 0.99, P = 0.833). In addition, THBS1 mRNA expression had no significant association with all-cause death, stroke death, and IS death of IS patients (all P > 0.05).

Conclusion

Therefore, our study suggested that there is no significant association of THBS1 polymorphisms and mRNA expression level with the risk of IS and long-term death after IS.

Evaluation of Sampson equation for LDL-C in acute coronary syndrome patients: a Chinese population-based cohort study

OBJECTIVE

Low-density lipoprotein cholesterol (LDL-C) is an important cardiovascular disease marker that is used to estimate the risk of acute coronary syndrome in patients. The Sampson equation is an accurate LDL-C equation, but its application in Chinese patients is unclear.

METHODS

This study enrolled 12,989 consecutive Chinese patients with the acute coronary syndrome (ACS), LDL-C levels were determined by direct standard method and two indirect equations (Friedewald and Sampson). The detection accuracy and consistency of these two equations were compared in patients classified by triglyceride (TG). In addition, the efficiency of the Sampson equation was also evaluated in patients with different comorbidities.

RESULTS

Patients were divided into six groups according to TG level, and indicated that the Sampson formula was more accurate than the Friedewald formula in all TG spectrums (P < 0.001). The Friedewald formula may underestimate the risk in patients with TG > 400 mg/dL, especially in TG > 800 mg/dL group (r: 0.931 vs. 0.948, 0.666 vs. 0.898, respectively). Compared with the Friedewald equation, the Sampson equation showed more advantages in female, age ≥ 65, body index mass (BMI) < 25, non-smoker, and non-diabetes (0.954 vs. 0.937, 0.956 vs. 0.934, 0.951 vs. 0.939, 0.951 vs. 0.936, and 0.947 vs. 0.938, respectively) than those in male, age < 65, BMI ≥ 25, smoker, and diabetes.

CONCLUSIONS

Compared with the Friedewald equation, the Sampson equation is more accurate for LDL-C evaluation in Chinese patients diagnosed with ACS, especially in patients with hypertriglyceridemia even in those with TG > 800 mg/dL. Additionally, the Sampson equation demonstrates greater accuracy even in subgroups of various baseline characteristics and comorbidities.

Interaction Analysis of Abnormal Lipid Indices and Hypertension for Ischemic Stroke: A 10-Year Prospective Cohort Study

Background

Dyslipidemia and hypertension are two important independent risk factors for ischemic stroke (IS); however, their combined effect on IS remains uncertain.

Objectives

This present study aimed to evaluate the interaction effect of hypertension and abnormal lipid indices on IS in a 10-year prospective cohort in Chinese adults.

Methods

The cohort study of 4,128 participants was conducted in May 2009 and was followed up to July 2020. All qualified participants received a questionnaire survey, physical examination, and blood sample detection. Cox regression was used to evaluate the association of dyslipidemia and hypertension with IS, and calculate the hazard ratio (HR) and 95% confidence interval (CI). The relative excess risk of interaction (RERI) and the HR (95%CI) of interaction terms were used to examine additive and multiplicative interactions.

Results

In the hypertensive population, Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2 and HDL-C ≥60 mg/dl were statistically associated with IS, and after adjusting for covariates, HRs (95%CIs) were 1.565 (1.007–2.429), 1.414 (1.034–1.933) and 0.665 (0.450–0.983), respectively. While in the non-hypertension population, no significant association of Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2, and HDL-C ≥60 was detected with IS (P &gt; 0.05). There was a significant association between TC/HDL-C ≥ 3.6 and the decreased risk of IS in the non-hypertension population, and the HR (95%CI) was 0.479 (0.307–0.750). Whereas, a similar association was not observed in the hypertensive population. HDL-C ≥ 60 mg/dl, Non-HDL-C ≥ 190 mg/dl, TC/HDL-C ≥ 3.6, and TG/HDL-C ≥ 1 have additive and multiplicative interactions with hypertension (P &lt; 0.05). The RERIs (95% CIs) of the additive interaction are −0.93 (−1.882–0.044), 1.394 (0.38–2.407), 0.752 (0.354–1.151) and 0.575 (0.086–1.065), respectively. The HRs (95% CIs) of the multiplicative interaction terms were 0.498 (0.272–0.911), 4.218 (1.230–14.464), 2.423 (1.437–4.086) and 1.701 (1.016–2.848), respectively.

Conclusion

High concentration of HDL-C reduces the impact of hypertension on IS, while the high concentration of Non-HDL-C, TC/HDL-C, and TG/HDL-C positively interact with hypertension affecting the incidence of IS. This study provides useful evidence for the combined effects of dyslipidemia and hypertension in predicting IS.

The association of coffee consumption rate with serum 25-hydroxyvitamin D, non-HDL levels, and TC/HDL ratio in females with vitamin D deficiency

OBJECTIVES

The purpose of this study was to evaluate the association of coffee consumption rate with serum 25-hydroxyvitamin D, non-high-density lipoprotein cholesterol levels, and total cholesterol to high-density lipoprotein cholesterol ratio in females with vitamin D deficiency.

METHODS

This retrospective cross-sectional study was carried out by studying the records of 270 Jordanian females aged 18-65 years with varying degrees of vitamin D deficiency. Following completion of the questionnaire regarding their anthropometric characteristics and coffee consumption rate during the preceding 3 months, the participants were required to provide blood samples for analysis to measure 25-hydroxyvitamin D and lipid profile levels including non-high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol ratio.

RESULTS

The current study demonstrated that coffee consumption rate and vitamin D deficiency were significantly positively connected with the total cholesterol to high-density lipoprotein cholesterol ratio (p = .003) in women with vitamin D deficiency. In addition, vitamin D deficiency alone correlated positively with non-high-density lipoprotein cholesterol levels and the total cholesterol to high-density lipoprotein cholesterol ratio (p = .010) and (p = .002), respectively.

CONCLUSION

Higher coffee consumption rate among women with vitamin D deficiency significantly elevated total cholesterol to high-density lipoprotein cholesterol ratio that may increase woman's risk of hyperlipidemia.