[A study on the epidemic characteristics of dyslipidemia in adults of nine provinces of China]

Lipid-lowering, antihypertensive, and antithrombotic effects of nattokinase combined with red yeast rice in patients with stable coronary artery disease: a randomized, double-blinded, placebo-controlled trial

Nattokinase (NK) and red yeast rice (RYR) are both indicated for their potential in cardiovascular disease prevention and management, but their combined effects especially in coronary artery disease (CAD) are scarcely examined. This 90-day randomized, double-blind trial aims to investigate the effect of NK and RYR supplementations on cardiometabolic parameters in patients with stable CAD. 178 CAD patients were randomized to four groups: NK + RYR, NK, RYR, and placebo. No adverse effects due to the interventions were reported. In comparisons across groups, NK + RYR showed the maximum effect in reducing triglyceride (-0.39 mmol), total cholesterol (-0.66 mmol/L), diastolic blood pressure (-7.39 mmHg), and increase in high-density lipoprotein cholesterol (0.195 mmol/L) than other groups (all p for multiple groups comparison<0.01). Both NK + RYR and NK groups had significantly better-improved lactate dehydrogenase than the others (-29.1 U/L and - 26.4 U/L). NK + RYR group also showed more potent reductions in thromboxane B2 and increases in antithrombin III compared to placebo (both p < 0.01). These improved markers suggest that combined NK and RYR may preferably alter antithrombin and COX-1 pathways, potentially reducing thrombosis risks in CAD patients. Overall, the combined NK and RYR supplementation is safe and more effective than separately in improving cardiometabolic markers among CAD patients with multiple heart medications use.

Association of Egg Consumption Frequency and Quantity with Dyslipidemia in Chinese Rural Adults

OBJECTIVE

The aim was to estimate the association of egg consumption with dyslipidemia and its subtypes in Chinese adults.

METHODS

The cross-sectional health survey was conducted in Hanzhong city of Shaanxi province in 2010.Consumption of eggs (alone and mixed in foods) and nutrients were assessed using a semi-quantitative 81-item food frequency questionnaire (FFQ). Serum lipids and other physical measurements were measured by trained medical staff. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariable logistic regressions. Restricted cubic spline was used to visualize the possible non-linear association.

RESULTS

A total of 2241 participants (mean age, 48.0 years; 34.5% men) were included. The age- and gender- standardization dyslipidemia prevalence was 21.1% in men and 18.4% in women, respectively. Approximately 42.1% of individuals never or rarely consumed egg, while 9.4% consumed ≥2 times/week. The mean egg intake was 21.5 g/d in men and 17.4 in women. In women, after adjustment for demographics and lifestyle factors, the ORs (95%CI) for dyslipidemia and hypertriglyceridemia were 0.57(0.32-1.05) and 0.38 (0.17-0.85) for individuals consuming egg ≥2 times/week, compared with never or rarely consumers. When further adjustment of BMI and dietary factors, the inverse relation persisted for hypertriglyceridemia but attenuated to margin of significance for dyslipidemia (P-trend = 0.050). Increment of 25 g/d was associated with 15% (OR: 0.85, (0.71-1.00)) lower risk of dyslipidemia. Results from restricted cubic splines showed a substantial reduction of the risk within lower range of consumption, which reached the minimum risk around 20-50 g/d (P-nonlinearity = 0.069). No associations were observed in men.

CONCLUSION

Egg consumption was associated with decreased risk of dyslipidemia among Chinese women but not men. Additionally, the beneficial effect tended to be stronger at 20-50 g egg per day. Further study is warranted to validate these findings and clarify the causality.

Efficacy of oats for dyslipidaemia: protocol for a systematic review and meta-analysis

INTRODUCTION

Dyslipidaemia is a critical factor in the development of atherosclerotic cardiovascular disease. Concerning dyslipidaemia regulation, we advocate for lifestyle interventions such as diet to complement drug treatment. Numerous studies have confirmed that oat β-glucan, a critical component of oats, can help lower cholesterol. However, there is no conclusive evidence for the efficacy of oats and their products in the treatment of dyslipidaemia. As a result, we have developed this protocol to serve as a guide for future research on oat intervention for dyslipidaemias.

METHODS AND ANALYSIS

We will conduct a search of eight databases or websites (PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, SinoMed, VIP and Wanfang) to identify studies on oats' ability to regulate blood lipid levels. Two authors will screen articles independently, extract data based on inclusion and exclusion criteria, and assess the quality and bias of included studies. To assess and quantify heterogeneity, Q and I² statistics will be used. If there is significant heterogeneity between studies, the source of the heterogeneity will be investigated using subgroup analysis and sensitivity analysis. We will analyse potential publication bias using the Begg funnel plot and Egger's weighted regression statistics. To assess the quality of evidence for the primary outcomes, the Grades of Recommendations, Assessment, Development and Evaluation method will be used.

ETHICS AND DISSEMINATION

This study is based on the existing literature and data in the databases. It is not subject to ethical review. The findings, on the other hand, will be published in a peer-reviewed journal. These findings may aid in the management of dyslipidaemia on a daily basis.

PROSPERO REGISTRATION NUMBER

CRD42021226751.

Analysis of Influencing Factors for Chronic Diseases: A Large Sample Epidemiological Survey from Liaoyang

Purpose. Northeast China is a region with a serious aging population. There are fewer articles on epidemiological surveys on the prevalence of chronic diseases in aging areas of China. The study is aimed at understanding the prevalence of chronic noncommunicable diseases such as hypertension and diabetes mellitus (DM) in Liaoning Province, northeast China, and analyzing the risk factors for these chronic diseases. Methods. A questionnaire survey and physical examination were conducted in 5008 permanent residents in 2 streets (Henan Street and Hebei Street) covered by Liuerbao Central Health Center in Liaoyang and 4 villages (Miaogou Village, Wangjia Village, Heyan Village, and Shuiquan Village) covered by Shuiquan Health Center in Tianshui Town of Liaoyang from January 2020 to December 2020. Results. A total of 4990 patients were included. The prevalence rates of hypertension, DM, dyslipidemia, and obesity in residents in Liaoyang were 54.13%, 12.30%, 43.31%, and 20.52%, respectively. The prevalence of hypertension and DM was highest in both male and female patients aged 40-60 years, which was higher than that in the other age groups ( $P<0.05$ ). The prevalence of dyslipidemia was highest in men over 60 years old and women $18-<40$ years old. Obesity was most common in men aged over 60 and in women $40-<60$ years old. The proportion of male smokers in all age groups was significantly higher than that of female smokers. Smoking, dyslipidemia, and significant overweight or obesity are common risk factors for hypertension and DM. Conclusion. In Liaoyang, northeast China, the prevalence of noninfectious chronic diseases was high, and the prevalence rate in people over 40 years old was significantly higher than that in people under 40 years old. The prevalence and progression of chronic diseases were obviously related to local living and eating habits; thus, health education needs to be improved.

Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends

BACKGROUND

Previous epidemiological studies have indicated the seasonal variability of serum lipid levels. However, little research has explicitly examined the separate secular and seasonal trends of dyslipidemia. The present study aimed to identify secular and seasonal trends for the prevalence of dyslipidemia and the 4 clinical classifications among the urban Chinese population by time series decomposition.

METHODS

A total of 306,335 participants with metabolic-related indicators from January 2011 to December 2017 were recruited based on routine health check-up systems. Multivariate direct standardization was used to eliminate uneven distributions of the age, sex, and BMI of participants over time. Seasonal and trend decomposition using LOESS (STL decomposition) was performed to break dyslipidemia prevalence down into trend component, seasonal component and remainder component.

RESULTS

A total of 21.52 % of participants were diagnosed with dyslipidemia, and significant differences in dyslipidemia and the 4 clinical classifications were observed by sex (P <0.001). The secular trends of dyslipidemia prevalence fluctuated in 2011-2017 with the lowest point in September 2016. The dyslipidemia prevalence from January to March and May to July was higher than the annual average (λ = 1.00, 1.16, 1.06, 1.01, 1.02, 1.03), with the highest point in February. Different seasonal trends were observed among the 4 clinical classifications. Compared to females, a higher point was observed among males in February, which was similar to participants aged < 55 years (vs. ≥ 55 years) and participants with a BMI ≤ 23.9 (vs. BMI > 23.9).

CONCLUSIONS

There were significant secular and seasonal features for dyslipidemia prevalence among the urban Chinese population. Different seasonal trends were found in the 4 clinical classifications of dyslipidemia. Precautionary measures should be implemented to control elevated dyslipidemia prevalence in specific seasons, especially in the winter and during traditional holidays.

Economic Burden of Myocardial Infarction Combined With Dyslipidemia

Background: Dyslipidemia is a common comorbidity and an important risk factor for myocardial infarction (MI). This study aimed to examine the economic burden of MI combined with dyslipidemia in China. Methods: Patients who were hospitalized due to MI combined with dyslipidemia in 2016 were enrolled. Costs were measured based on electronic medical records and questionnaires. The annual costs were analyzed by conducting descriptive statistics, univariable, and multivariable analyses. Results: Data of 900 patients were analyzed, and 144 patients were dead during the follow-up. The majority of patients were aged 51-70 years (n = 563, 62.55%) and males (n = 706, 78.44%). For all-cause costs, the median annual direct medical costs, direct non-medical costs, indirect costs, and total costs were RMB 13,168 (5,212-29,369), RMB 600 (0-1,750), RMB 676 (0-1,787), RMB 15,361 (6,440-33,943), respectively; while for cardiovascular-related costs, the corresponding costs were RMB 12,233 (3,795-23,746), RMB 515 (0-1,680), RMB 587 (0-1,655), and RMB 14,223 (4,914-28,975), respectively. Lifestyle and complications significantly affected both all-cause costs and cardiovascular-related costs. Conclusions: Increasing attention should be paid to encourage healthy lifestyle, and evidence-based medicine should focus on optimal precautions and treatments for complications, to reduce the economic burden among MI patients with a comorbid dyslipidemia.

Threshold-Effect Association of Dietary Cholesterol Intake with Dyslipidemia in Chinese Adults: Results from the China Health and Nutrition Survey in 2015

The association of dietary cholesterol intake with dyslipidemia and subtypes is controversial. This study aimed to examine the association of dietary cholesterol intake with dyslipidemia and subtypes in Chinese adults. Using data from the China Health and Nutrition Survey (CHNS) in 2015, the present study selected 4383 participants aged 18–59 years who were free of diabetes, apoplexy, and myocardial infarction disease. Information was obtained on dietary intake, anthropometric measurements, and blood laboratory measurements. Dietary cholesterol intake was calculated based on the data collected by consecutive 3 days 24 h recalls combined with the weighing of household seasonings and categorized by 11 levels: The first 10 levels in ranges of 50 mg/day and the 11th level at ≥500 mg/day. Dyslipidemia, hypercholesterolemia, hypertriglyceridemia, low-density lipoprotein (LDL)-hypercholesterolemia, and high-density lipoprotein (HDL)-hypocholesterolemia were defined based on the Chinese adult dyslipidemia prevention guide (2016 edition). Multivariable logistic regressions were performed to examine the association of dietary cholesterol intake levels with dyslipidemia and subtypes. The prevalence of dyslipidemia was 37.5% among Chinese adults in 2015 (hypercholesterolemia 9.6%, HDL-hypocholesterolemia 21.1%, LDL-hypercholesterolemia 12.7%, and hypertriglyceridemia 15.2%). The lowest prevalence of hypercholesterolemia and LDL-hypercholesterolemia was 6.7% and 9.4%, respectively, which was relative to a dietary cholesterol intake level of 100.0 to <150.0 mg/day. After adjusting for all potential confounders, adults with the highest dietary cholesterol intake level of ≥500 mg/day compared with the dietary cholesterol intake of 100.0 to <150.0 mg/day showed one-time higher odds of hypercholesterolemia (odds ratios (OR) 2.0, 95% confidence intervals (CI) 1.3–3.3), as well as LDL-hypercholesterolemia (OR 2.0, 95% CI 1.3–3.0), but a null association of dietary cholesterol intake with dyslipidemia, hypertriglyceridemia, and HDL-hypocholesterolemia. The study suggested that a dietary cholesterol intake level of 500 mg/day and above may be a threshold point for high odds of hypercholesterolemia and LDL-hypercholesterolemia.