Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

Prevalence of Dyslipidemia among Patients Received at the Biochemistry Unit of the Charles de Gaulle Pediatric University Hospital in Ouagadougou

Introduction: Cardiovascular disease represents a major public health burden worldwide. Research and management of risk factors contribute to the prevention of these diseases. The aim of this study was to assess the prevalence of dyslipidemia in the biochemistry unit of the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) in Ouagadougou. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection from January 1, 2020 to December 31, 2022. Patients of all ages who performed a lipid panel in the CHUP-CDG biochemistry unit during the study period have been included. Results: A total of 2872 patients have been included. The mean age of the study population was 27.72 ± 19.51 years and the M/F sex ratio was 0.81. Among the patients, 22.84% had at least one dyslipidemia. The prevalences of hypercholesterolemia, hypo-HDL cholesterolemia and hyper-LDL cholesterolemia were 11.57%, 49.19% and 57.50% respectively. Hypertriglyceridemia and mixed hyperlipidemia were present in 9.04% and 2.08% of patients. Hypercholesterolemia was significantly more frequent in the female sex (p = 0.0077);hyper-LDL cholesterolemia (p = 0.0255) and mixed hyperlipidemia (p Conclusion: The relatively high prevalence of dyslipidemia in the study indicates a worrying situation. It would therefore appear essential to extend the search for risk factors nationwide, particularly those that can be modified, in order to reduce morbidity and mortality linked to cardiovascular disease.

Glucokinase regulatory protein rs780094 polymorphism is associated with type 2 diabetes mellitus, dyslipidemia, non-alcoholic fatty liver disease, and nephropathy

In this editorial,we comment on the article by Liu et al published in the recent issue of the World Journal of Diabetes(Relationship between GCKR gene rs780094 polymorphism and type 2 diabetes with albuminuria).Type 2 diabetes mellitus(T2DM)is a chronic disorder characterized by dysregulated glucose homeostasis.The persistent elevated blood glucose level in T2DM significantly increases the risk of developing severe complications,including cardiovascular disease,re-tinopathy,neuropathy,and nephropathy.T2DM arises from a complex interplay between genetic,epigenetic,and environmental factors.Global genomic studies have identified numerous genetic variations associated with an increased risk of T2DM.Specifically,variations within the glucokinase regulatory protein(GCKR)gene have been linked to heightened susceptibility to T2DM and its associated complications.The clinical trial by Liu et al further elucidates the role of the GCKR rs780094 polymorphism in T2DM and nephropathy development.Their findings demonstrate that individuals carrying the CT or TT genotype at the GCKR rs780094 locus are at a higher risk of developing T2DM with albuminuria compared to those with the CC genotype.These findings highlight the importance of genetic testing and risk assessment in T2DM to develop effective preventive strategies and personalized treatment plans.

Analysis of the Mechanism of Intervention of Fangxiangxiaozhi Prescription on Dyslipidemia Based on Network Pharmacology and Molecular Docking

Objective: To explore the mechanism of intervention of Fangxiangxiaozhi prescription on dyslipidemia by using network pharmacology and molecular docking. Methods: The traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Pubchem, Uniprot, and other databases were adopted to screen the active ingredients and the corresponding targets of Fangxiangxiaozhi prescription. Dyslipidemia-related targets were identified using the databases of Disgenet and GeneCards. Then, the intersection target of drugs and diseases was demonstrated via a Venn diagram. Cytoscape3.7.2 was used to construct a “drugs-active ingredients-intersection targets” network map and the key active ingredients with the top 7-degree values were determined. The protein interaction network and topology analysis of the intersection target genes were carried out by combining STRING11.0 and Cytoscape3.7.2. Moreover, the gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the intersection target genes were carried out using the Metascape database. Lastly, the key active ingredients and targets were molecular docked by AutoDockTools, Pymol, and other software. Results: There were 51 active components and 509 target genes of which 74 intersect with dyslipidemia. The key targets included tumor necrosis factor (TNF), interleukin-6 (IL-6), AKT1, PPAR gamma (PPARG), VEGFA, and PPARα. GO enrichment analysis obtained 1040 biological processes, 33 cell components, and 84 molecular functions;KEGG enrichment analysis obtained 148 pathways. The molecular docking results showed that the key targets and compounds exhibited good binding force. Conclusion: The active ingredients of Fangxiangxiaozhi prescription regulated several pathways through multiple targets to intervene in dyslipidemia. This study can serve as a foundation for further research.

Oxidative stress,insulin resistance,dyslipidemia and type 2 diabetes mellitus

Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus(T2DM) and this appears to underlie the development of cardiovascular disease,T2 DM and diabetic complications.Increased oxidative stress appears to be a deleterious factor leading toinsulin resistance,dyslipidemia,β-cell dysfunction,impaired glucose tolerance and ultimately leading to T2 DM.Chronic oxidative stress,hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant,have high oxidative energy requirements,decrease the gene expression of key β-cell genes and induce cell death.If β-cell functioning is impaired,it results in an under production of insulin,impairs glucose stimulated insulin secretion,fasting hyperglycemia and eventually the development of T2 DM.

Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015

Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015.Methods Data were collected from three nationally representative cross-sectional surveys.Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination.Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender.Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively;by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period.Similar trends in mean non-HDL-c and lipid-related ratios were observed.The weighted dyslipidemia prevalence linearly increased;in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2%(P for trend <0.001).Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015.Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

Blood Lipid Profile and Prevalence of Dyslipidemia in Chinese Adults

To investigate the plasma lipid levels in a national representative sample of subjects and to determine the prevalence of dyslipidemia in the Chinese population. Methods Plasma lipid profile was analyzed using the data obtained during the Chinese national nutrition and health survey （CNHS） in 2002 which involved 14 252 participants at the age of 18 years or older. Results The mean levels of total cholesterol （TC）, triglyceride （TG） and high density lipoprotein cholesterol （HDL-C） in the participants were 3.81 retool/L, 1.10 mmol/L, and 1.30 mmol/L, respectively. In the groups of participants at the age of 18-44 years, 45-59 years, and over 60 years the mean TC level was 3.70 mmol/L, 4.09 mmol/L and 4.21 mmol/L, respectively, and the mean TG level was 07 mmol/L, 1.21 mmol/L, 1.20 mmol/L, 1.29 mmol/L, 1.33 mmol/L, and 1.33 mmol/L, respectively. The prevalence of dyslipidemia in Chinese adults was 18.6% and 22.2% in males and 15.9% in females. Dyslipidemia prevalence was higher in urban districts than in rural areas （21.0% vs. 17.7%）. The prevalence of hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol was 2.9%, 11.9%, and 7.4% respectively among the participants. Conclusion Dyslipidemia has become one of the important health risk factors in the Chinese population. There is no significantly difference in the prevalence of dyslipidemia between the groups of participants at the age of 45-59 years and over 60 years. This study provides important lipid profile data for policy making and guideline development for the prevention of dyslipidemia in the Chinese population.

Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?

Objective To explore the impacts of types and degree of obesity on non‐alcoholic fatty liver disease （NAFLD） and related lipids disturbance in Chinese school‐age children. Methods A total of 1 452 school‐age Children of 7 to 17 years were recruited in Beijing with representative cluster sampling method. Data of anthropometric measurements including weight, height and waist circumference were collected from March to May of 2007. Body mass index（BMI）was calculated. Blood samples were obtained and lipid profiles including triglyceride （TG）, total cholesterol （TC）, high‐density lipoprotein cholesterol （HDL‐C） and low‐density lipoprotein cholesterol （LDL‐C） were measured, while glutamate‐pyruvate transaminase （ALT） and glutamic‐oxalacetic transaminase （AST） were determined to evaluate liver function. The liver was also scanned by sonography, and abnormal hepatic sonograms were documented. NAFLD was diagnosed according to the criteria recommended by the Fatty Liver and Alcoholic Liver Disease Study Group under the Chinese Liver Disease Association. Analysis of covariance （ANOVA）, Chi‐square test for trend and binary logistic regression analysis were performed. Results The dyslipidemia and ultrasonographic fatty liver deteriorated with the degree of obesity defined either by BMI or waist circumference. Compared with BMI, waist circumference contributed more to the development of dyslipidemia, fatty liver and NAFLD. The highest levels of TG, TC, LDL‐C, and lowest level of HDL‐C were seen in the mixed obese group followed by abdominal obese, peripheral obese and non‐obese ones. Adjusted for gender and age, the odds ratios （ORs） and their 95% confidence intervals of peripheral obesity, abdominal obesity and mixed obesity were 0, 10.93 （0.98‐121.96） and 79.16 （10.95‐572.44） for predicting NAFLD; 12.61 （1.24‐127.78）, 19.39 （5.23‐71.85）, and 93.21 （29.56‐293.90） for predicting ultrasonographic fatty liver; 1.78 （0.59‐5.44）, 3.01 （1.91‐4.77）, and 4.64 （3.52‐6.12） for predicting dyslipidemia, respectively compared with the non‐obese control group. The trend of hazards over groups was statistically significant （P0.01）. Conclusion The levels of lipid profile and the prevalence of NAFLD and dyslipidemia increased in parallel with the degree of obesity; As compared with the non‐obese control, the mixed obesity had the strongest association with NAFLD and dyslipidemia, followed by abdominal obesity and peripheral obesity in Chinese school‐age Children.

Dyslipidemia and Outcome in Patients with Acute Ischemic Stroke

Objective To study the relationship between dyslipidemia and outcome in patients with acute ischemic stroke. Methods Data about 2 568 patients with acute ischemic stroke were collected from 4 hospitals in Shandong Province from January 2006 to December 2008. National Institute of Health Stroke Scale （NIHSS） 〉10 at discharge or death was defined as the outcome. Effect of dyslipidemia on outcome in patients with acute ischemic stroke was analyzed by multivariate logistic regression analysis and propensity score-adjusted analysis, respectively. Results The serum levels of TC, LDL-C, and HDL-C were significantly associated with the outcome in patients with acute ischemic stroke. Multivariate logistic regression analysis and propensity score-adjusted analysis showed that the ORs and 95% CIs were 3.013 （1.259, 7.214）/2.655 （1.298, 5.43）, 3.157 （1.306, 7.631）/3.405 （1.621, 7.154）, and 0.482 （0.245, 0.946）/0.51 （0.282, O.921）, respectively, for patients with acute ischemic stroke. Hosmer-Lemeshow goodness-of-fit test showed no significant difference in observed and predicted risk in patients with acute ischemic stroke （chi-square=8.235, P=0.411）. Conclusion Serum levels of TC, LDL-C, and HDL-C are positively related with the outcome in patients with acute ischemic stroke.

Integrated metabolomic profiling for analysis of antilipidemic effects of Polygonatum kingianum extract on dyslipidemia in rats

AIM To identify the effects and mechanism of action of Polygonatum kingianum(P. kingianum) on dyslipidemia in rats using an integrated untargeted metabolomic method.METHODS A rat model of dyslipidemia was induced with a high-fat diet(HFD) and rats were given P. kingianum [4 g/(kg·d)] intragastrically for 14 wk. Changes in serum and hepatic lipid parameters were evaluated. Metabolites in serum, urine and liver samples were profiled using ultra-highperformance liquid chromatography/mass spectrometry followed by multivariate statistical analysis to identify potential biomarkers and metabolic pathways.RESULTS P. kingianum significantly inhibited the HFD-induced increase in total cholesterol and triglyceride in the liver and serum. P. kingianum also significantly regulated metabolites in the analyzed samples toward normal status. Nineteen, twenty-four and thirty-eight potential biomarkers were identified in serum, urine and liver samples, respectively. These biomarkers involved biosynthesis of phenylalanine, tyrosine, tryptophan, valine, leucine and isoleucine, along with metabolism of tryptophan, tyrosine, phenylalanine, starch, sucrose, glycerophospholipid, arachidonic acid, linoleic acid, nicotinate, nicotinamide and sphingolipid.CONCLUSION P. kingianum alleviates HFD-induced dyslipidemia by regulating many endogenous metabolites in serum, urine and liver samples. Collectively, our findings suggest that P. kingianum may be a promising lipid regulator to treat dyslipidemia and associated diseases.

2016 Chinese guidelines for the management of dyslipidemia in adults

Abbreviations ACS： acute coronary syndrome ALT： alanine aminotransferase Apo： apolipoprotein ASCVD： atherosclerotic cardiovascular disease AST： aspartate aminotransferase

Dyslipidemia and H pylori in gastric xanthomatosis

AIM： To investigate the relationship among gastric xanthomatosis （GX）, Hpylori, dyslipidemia, and gastritis in Korea, a well-known Hpylori endemic area.METHODS： A total of 771 patients who had undergone gastroduodenoscopy by one endoscopist were included in this study. Among them, 54 patients with GX were assessed for Hpylori infection and their endoscopic characteristics and serum lipid profiles. The findings were compared with 54 age- and sex-matched control subjects without GX.RESULTS： The prevalence of GX was 7% （54/771） with no sex difference. GX was mainly single （64.8%） and located in the antrum （53.7%）. The mean diameter was 7 ± 3 mm. Mean body mass index （BMI） of patients with GX was 23.1 ± 2.8 and no one was above 30. Compared with the controls, lipid profiles of GX group showed significantly lower HDL-cholesterol （48.8 ± 12.3 vs 62.9 ± 40.5, P = 0.028） and higher LDL-cholesterol （112.9 ± 29.9 vs 95.9 ± 22.4, P = 0.032）. The level of total serum cholesterol, triglyceride and the existence of dyslipoproteinemia were not related to the presence of GX. However, GX showed a close relationship with endoscopically determined atrophic gastritis and histologic severity （24/53, 44.4% vs 8/54, 14.8%, P = 0.0082）. H pylori infection and bile reflux gastritis were not significantly related with GX.CONCLUSION： The prevalence of GX is 7% and it may be an increasing entity in Korea. Moreover, dyslipidemia and atrophic gastritis are found to be related to GX, but lip, H pylori infection is not.

Management of diabetic dyslipidemia: An update

Diabetic dyslipidemia is a cluster of lipoprotein abnormalities characterized by increased triglyceride level, decreased high-density lipoprotein-cholesterol levels and increase in small dense low-density lipoprotein(LDL) particles. It is extremely common in type 2 diabetes(T2DM) affecting around 70 % of patients.Diabetic is a significant risk factor for atherosclerotic cardiovascular disease(ASCVD) which is the most common cause of death in the United States and LDL-cholesterol is the number 1 predictor of ASCVD events in T2DM. The purpose of this review is to discuss the pathophysiology and treatment of diabetic dyslipidemia. In this review, we have discussed both nonpharmacological and pharmacological treatment modalities including major treatment trials which have impacted the cardiovascular outcomes in patients with diabetes. Statin therapy is the mainstay of treatment to reduce ASCVD by decreasing LDL-C by 30%-49% or at least 50% depending on risk level. Attractive adjunctive therapies include Ezetimibe which is more cost effective and PCSK9 inhibitors which display potent LDL-cholesterol lowering and ASCVD event reduction. For severe hypertriglyceridemia, to avert the risk of pancreatitis, both fish oil and fenofibrate in concert with diet is the best strategy.

Alcohol Drinking, Dyslipidemia, and Diabetes： A Population-based Prospective Cohort Study among Inner Mongolians in China

Objective No previous studies have evaluated the association between dyslipidemia, alcohol drinking, and diabetes in an Inner Mongolian population. We aimed to evaluate the co-effects of drinking and dyslipidemia on diabetes incidence in this population. Methods The present study was based on 1880 participants from a population-based prospective cohort study among Inner Mongolians living in China. Participants were classified into four subgroups according to their drinking status and dyslipidemia. Multivariate logistic regression analysis and receiver operating characteristic （ROC） curves were used to evaluate the association between alcohol drinking, dyslipidemia, and diabetes. Results During the follow-up period, 203 participants were found to have developed diabetes. The multiva riable-adjusted odds ratios （95% confidence interval） for the incidence of non-dyslipidemia/drinkers, dyslipidemia/non-drinkers, and dyslipidemia/drinkers in diabetic patients were 1.40 （0.82-2.37）, 1.73 （1.17-2.55）, and 2.31 （1.38-3.87）, respectively, when compared with non-dyslipidemia/non-drinkers. The area under the ROC curve for a model containing dyslipidemia and drinking status along with conventional factors （AUC=0.746） was significantly （P=O.003） larger than the one containing only conventional factors （AUC=0.711）. Conclusion The present study showed that dyslipidemia was an independent risk factor for diabetes, and that drinkers with dyslipidemia had the highest risk of diabetes in the Mongolian population. These findings suggest that dyslipidemia and drinkin8 status may be valuable in predicting diabetes incidence.

Elevated alanine aminotransferase activity is not associated with dyslipidemias,but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results.

Relationship between Dyslipidemia and Gene Polymorphism in Tibetan Population

Objective To investigate the relationship between SNPs reported in previous studies and the blood lipid level in the Tibetan population. Methods Random cluster sampling was employed in 5 areas （Lhasa, Shigatse, Shannan, Nagqu, and Nyingchi）. The levels of cholesterol （TC）, triglyceride {TG）, high-density lipoprotein cholesterol （HDL-C）, and low-density lipoprotein cholesterol （LDL-C） from blood samples were determined and DNA was extracted for genotyping and statistical analyses. Results Among 1 318 subjects aged 〉18 years enrolled in this study, 367 had dyslipidemia with a prevalence of 27.8%, of whom dyslipidemia males accounted for 33.1% and dyslipidemia females - 24.5%. Results of the correlation analysis between all SNPs and TG showed that the SNPs of rs714052 and rs964184 were related to the serum TG level. Subjects with rs714052 CC genotype had the lowest TG level, and the highest TG level was found in those with rs714052 TT genotype. The serum TG level in individuals with TC genotype lied in between the above two population groups. Subjects with rs964184 CC genotype had the lowest TG level, and the highest serum TG level was noted in those with rs964184 GG genotype. Conclusion Several SNPs were found to be related to the serum TG level in the Tibetan population. The APOA5 gene and MLXlPL gene may be closely associated with the serum TG level in this ethnic population group.

Elevated Resting Heart Rate is Associated with Dyslipidemia in Middle-aged and Elderly Chinese

Objective To study the relationship between resting heart rate and blood lipid level. Methods A total of 9 415 subjects aged≥40 years were included in the present study. Their resting heart rate was monitored and their serum levels of triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） and high density lipoprotein cholesterol （HDL-C） were measured to define dyslipidemia according to the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Results The subjects were divided into group A with their resting heart rate〈70 beats/min, group B with their resting heart rate=70-79 beats/min, group C with their resting heart rate=80-89 beats/min, and group D with their resting heart rate≥90 beats/min. High TG, TC, and LDL-C were presented across the resting heart rate （Ptrend〈0.01）. Multiple logistic regression analysis revealed that the risk of high TG and TC was higher in subjects with their resting heart rate≥90 beats/min than in those with their resting heart rate〈70 beats/min （OR=1.42;95%CI：1.16-1.74 and OR=1.33;95%CI：1.09-1.64, respectively）. Conclusion Elevated resting heart rate is associated with high TG and TC in middle-aged and elderly Chinese subjects.

Dyslipidemia management in primary prevention of cardiovascular disease:Current guidelines and strategies

Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making costeffective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

Prevention of Osteopenia and Dyslipidemia in Rats after Ovariectomy with Combined Aspirin and Low-dose Diethylstilbestrol

Objective To study whether effect of aspirin plus low-dose diethylstilbestrol is more effective and safer than high diethylstilbestrol dose alone on prevention of ovariectomy-induced osteopenia and dyslipidemia. Methods Thirty-eight 4-month-old female SD rats were divided into baseline （BAS） group （n=6）, sham operation group （n=8） and ovariectomy （OVX） group （n=24）. The OVX group was further divided into vehicle treatment group （n=8）, diethylstilbestrol （30 ug/kg.d） treatment group （OVX＋D30 group, n=8）, and aspirin （9 mg/kg.d） plus diethylstilbestrol （10 ug/kg.d） treatment group （OVX＋A-D10 group, n=8）. Their left tibiae were collected for the bone histomorphometric analysis in undecalcified sections. Left femurs were collected for the bone mineral density measurement. Results The body weight and serum cholesterol were increased, while uterine weight and cancellous bone mass were decreased in OVX rats compared with the SHAM group. Cancellous bone mass was significantly increased, while body weight and bone resorption parameters were decreased in both A-D10 and D30 treatment group compared with OVX group. The rats treated with A-D10 showed significantly increased in bone formation parameters and decreased in serum triglyceride compared with the D30-treated rats. Conclusion Aspirin plus low-dose diethylstilbestrol can effectively prevent osteopenia by reducing bone resorption, and is thus a better treatment modality for preventing dyslipidemia than high-dose diethylstilbestrol alone.

Erosive esophagitis associated with metabolic syndrome,impaired liver function, and dyslipidemia

AIM:To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components,abnormal liver function,and lipoprotein profiles.METHODS:We conducted a cross-sectional,case control study of subjects who underwent upper endoscopy during a health examination at the Health Management and Evaluation Center of a tertiary medical care facility located in Southern Taiwan.Metabolic syndrome components,body mass index(BMI),liver function,dyslipidemia,and cardiovascular risk factors,as defined by the ratio of total cholesterol to high-density lipoprotein cholesterol(HDL-C),and the ratio of low-density lipoprotein cholesterol to HDL-C were compared betweenindividuals with and without erosive esophagitis.Risk factors for erosive esophagitis were evaluated by multivariate logistic regression.RESULTS:Erosive esophagitis was diagnosed in 507of 5015 subjects who were individually age and sex matched to 507 esophagitis-free control subjects.In patients with erosive esophagitis,BMI,waist circumference,blood pressure,fasting plasma glucose,triglyceride levels,aspartate aminotransferase,alanine aminotransferase,the ratio of total cholesterol to HDL-C,and the ratio of low-density lipoprotein cholesterol to HDL-C were significantly higher and HDL-C was significantly lower compared to patients without erosive esophagitis(all P<0.05).In a multivariate analysis,central obesity(OR=1.38;95%CI:1.0-1.86),hypertension(OR=1.35;95%CI:1.04-1.76),hypertriglyceridemia(OR=1.34;95%CI:1.02-1.76),cardiovascular risk factors as defined by a ratio of total cholesterol to HDL-C>5(OR=1.45;95%CI:1.06-1.97),and aspartate aminotransferase(OR=1.59;95%CI:1.08-2.34)were significantly associated with erosive esophagitis.CONCLUSION:Metabolic syndrome,impaired liver function,and a higher ratio of total cholesterol to HDL-C were associated with erosive esophagitis.