Dyslipidemias and Related Factors in Brazilian Adolescents from Rural and Urban Areas

This study aimed to evaluate the prevalence of dyslipidemias and related factors, in Brazilian adolescents from rural and urban areas. This is a cross-sectional study with 182 adolescents aged 10 to 13 years, students, residing in the rural and urban area of Brazil;grouped according to age, gender and socioeconomic class. Sexual maturation, physical activity, blood pressure, nutritional status and body composition were evaluated. Total cholesterol, LDL, HDL and serum triglycerides were dosed. The food frequency questionnaire was applied, quantifying energy, carbohydrates, proteins, lipids, full fat and fibers. Bivariate and multiple analyses were carried out, by logistic regression. It was verified that 84.6% (n = 154) adolescents presented some lipid profile alteration. There was no difference in the lipid profile between adolescents for residence place. However, as for gender, it was noticed that girls presented higher levels of total cholesterol and HDL (p < 0.05). In addition, adolescents with excess weight and body fat showed lower HDL and higher triglycerides values compared with eutrophic and with those with appropriate body fat percentage (p < 0.05). In the multiple analyses, it was observed that gender and signs of sexual maturation were associated with total cholesterol;fiber intake remained associated with HDL and signs of sexual maturation with LDL (p < 0.05). For triglycerides the related factors were gender, nutritional status and protein intake (p < 0.05). The elevated prevalence of dyslipidemias found between adolescents from rural and urban areas reinforces the importance of monitoring these alterations and information as for the related risk factors, with programs for correction of changeable factors.

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.

Simple anthropometric measurements to predict dyslipidemias in Mexican school-age children: a cross-sectional study

Objective: The purpose of this study was to identify the best predictors of dyslipidemias in Mexican obese children using different anthropometric and body composition measurements. Methods: In an observational, cross-sectional study, 905 children from 5 schools were measured for weight, height, waist and hip circumference, and triceps and subscapular skinfolds. A fasting blood sample was taken from a random sub-sample of 306 children to determine lipid profile. Abnormal total cholesterol, LDL, HDL, triglycerides, total cholesterol to HDL ratio, and LDL to HDL ratio, were determined. Logistic regressions and ROC analysis were carried out to determine the best anthropometric predictors of these risk factors. Results: Prevalence of elevated total cholesterol, triglycerides and LDL cholesterol was 14%, 56% and 58%, respectively. In logistic regressions, BMI and triceps skinfold had the highest odds ratios to predict elevated total cholesterol (1.05, 95%CI: 0.97 - 1.14;1.07, 1.01 - 1.13, respectively), triglycerides (1.19, 1.11 - 1.27;1.12, 1.08 - 1.17, respectively), LDL cholesterol (1.11, 1.04 - 1.18;1.09, 1.05 - 1.14, respectively), total cholesterol to HDL ratio (1.06, 1.00-1.14;1.07,1.03-1.12, respectively) and LDL to HDL ratio risk (1.08,1.01-1.15;1.07, 1.03-1.12, respectively). After BMI and triceps skinfold, subscapular skinfold also predicted dyslipidemias, except for low HDL;both skinfolds had a narrower odds ratio confidence interval than BMI. In ROC analysis, subscapular skinfold was the best predictor of elevated triglycerides with an AUC ≥ 0.7. Conclusion: Anthropometric measurements are not strongly associated with dyslipidemias in Mexican children. However, since triceps and subscapular skinfolds were better predictors than other anthropometry measures, they may be a simple way to predict dyslipidemias in Mexican children.

Relationship between longitudinal changes in lipid composition and ischemic stroke among hypertensive patients

BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.

Assessment of post-myocardial infarction lipid levels and management:Results from a tertiary care hospital of Pakistan

BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction(MI)patients at a tertiary care hospital in Pakistan.METHODS In this cross-sectional study,we analyzed patients who had experienced their first AMI event in the past 3 years.We assessed fasting and non-fasting lipid profiles,reviewed statin therapy prescriptions,and examined patient compliance.The recommended dose was defined as rosuvastatin≥20 mg or atorvastatin≥40 mg,with target total cholesterol levels set at<160 mg/dL and target low-density lipoprotein cholesterol(LDL-C)at<55 mg/dL.RESULTS Among 195 patients,71.3%were male,and the mean age was 57.1±10.2 years.The median duration since AMI was 36(interquartile range:10-48)months and 60% were diagnosed with ST-segment elevation MI.Only 13.8% of patients were advised to undergo lipid profile testing after AMI,88.7% of patients were on the recommended statin therapy,and 91.8% of patients were compliant with statin therapy.Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range.Hospital admission in the past 12 months was reported by 14.4%,and the readmission rate was significantly higher among non-compliant patients(37.5%vs 5.6%).Subsequent AMI event rate was also significantly higher among non-compliant patients(43.8%vs 11.7%).CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose,the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.

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.

Metabolic puzzle: Exploring liver fibrosis differences in Asian metabolic-associated fatty liver disease subtypes

BACKGROUND Metabolic-associated fatty liver disease(MAFLD)is a liver condition marked by excessive fat buildup in the absence of heavy alcohol use.It is primarily linked with metabolic issues like insulin resistance,obesity,and abnormal lipid levels,and is often observed with other conditions such as type 2 diabetes and cardiovascular disease.However,whether the subtypes of MAFLD based on the metabolic disorder differentially impact liver fibrosis is not well explicated,especially in the Asian population.AIM To compare the severity of liver fibrosis among different MAFLD subtypes.METHODS A total of 322 adult patients of either gender with fatty liver on ultrasound were enrolled between January to December 2021.MAFLD was defined as per the Asian Pacific Association for the Study of the Liver guidelines.Fibrosis-4 index(Fib-4)and nonalcoholic fatty liver disease fibrosis score(NFS)were employed to evaluate liver fibrosis.RESULTS The mean age was 44.84±11 years.Seventy-two percent of the patients were female.Two hundred and seventy-three patients were classified as having MAFLD,of which 110(40.3%)carried a single,129(47.3%)had two,and 34(12.5%)had all three metabolic conditions.The cumulative number of metabolic conditions was related to elevated body mass index,triglyceride(TG)levels,and glycated hemoglobin,lower high-density lipoprotein(HDL)levels,higher liver inflammation(by aspartate aminotransferase andγ-glutamyl transferase),and higher likelihood of fibrosis(by NFS and Fib-4 scores)(P<0.05 for all).The proportion of advanced fibrosis also increased with an increase in the number of metabolic conditions(4.1%,25.5%,35.6%,and 44.1%by NFS and 6.1%,10.9%,17%,and 26.5%by Fib-4 for no MAFLD and MAFLD with 1,2,and 3 conditions,respectively).Among MAFLD patients,those with diabetes alone were the eldest and had the highest mean value of NFS score and Fib-4 score(P<0.05),while MAFLD patients diagnosed with lean metabolic dysfunction exhibited the highest levels of TG and alanine aminotransferase but the lowest HDL levels(P<0.05).CONCLUSION The study suggests that the severity of liver fibrosis in MAFLD patients is influenced by the number and type of metabolic conditions present.Early identification and management of MAFLD,particularly in patients with multiple metabolic conditions,are crucial to prevent liver-related complications.

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.

Five Year Follow up after Surgical Treatment of Type 2 Diabetes with Laparoscopic Sleeve Gastrectomy Associated with a Duodenal Ileal Interposition

Introduction: Type 2 diabetes mellitus (T2D) is a chronic disease, primarily caused by a combination of defective insulin secretion and the inability of insulin-sensitive tissues to respond to insulin. Laparoscopic sleeve gastrectomy associated with duodenal ileal interposition (SGDII) has been shown to be a feasible treatment option for patients with T2D, as it provides improvement and control of glycemia, dyslipidemia and arterial hypertension. The aim of this study was to evaluate the mid and long-term results of SGDII for the treatment of diabetic patients, considering diabetic remission, weight loss and postoperative complications. Materials and Methods: Retrospective study with 96 patients with T2D submitted to SGDII, between 2010 and 2016. The glycated hemoglobin (HbA1c) value Results: Sixty-one patients (62.8%) were male, and 36 patients (37.2%) were female. The average age was 50.9 years. Median BMI was 33.43 kg/m2. The incidence of major postoperative complications in the first 30 days was 2.1%, with no mortality. Dyslipidemia control was sustained, after five years, in 62% of the patients. The five years follow-up demonstrated that 80% of patients had T2D remission at one year, 74.5% at three years and 61.8% at five years. Univariate analysis demonstrated that preoperative values of HbA1c and BMI, preoperative use of insulin, gender, and 30-day complication were not predictors of remission at all study intervals. The average duration of the disease was nine years and the mean glycated hemoglobin before surgery was 8.95%. Conclusion: SGDII resulted in good glycemic control at 5-years follow-up and represents a valid alternative for the treatment of T2D.

Lipid Profile of Patients Seen in Consultation at the Cardiology Department at the Ignace DEEN National Hospital (City of Conakry, Republic of Guinea)

The study addressed a crucial public health concern of dyslipidemia and its management, with a focus on the Ignace DEEN National Hospital patients, filling a research gap in the Republic of Guinea. It contributed valuable epidemiological data on dyslipidemia in the studied population, emphasizing gender, age, and socio-professional categories, which could inform tailored prevention and management strategies in improving the health care of dyslipidemia patients by proposing diets to help these patients better manage their disease and a food system for preventing dyslipidemia. The study focused on the lipid profile of patients seen at the cardiology department at the Ignace DEEN National Hospital Republic of Guinea (Conakry). This was a prospective, descriptive study lasting six (6) months from January 24 to July 23, 2021;aimed at determining the frequency of lipid abnormalities and pathologies related to the lipid profile. A total of 523 people were included in this study with a female predominance of 59.34% compared to 40.66% of males for a ratio of 1.5 in favor of women. The age groups of 45 - 54 and 55 - 65 were the most affected with respective frequencies of 45.42% and 30.03%. The most represented socio-professional category was that of housewives, i.e. 45.78%, followed by traders 18.68%. Our series was dominated by the married couple, i.e. 77.29%. Dyslipidemia constitutes a modifiable cardiovascular risk factor in patients seen in the cardiology department at the Ignace DEEN Hospital;its control must be strict through the use of hygienic and dietary rules and hypolipidemia medications.

Assessing the impact of concurrent high-fructose and highsaturated fat diets on pediatric metabolic syndrome:A review

High-saturated fat(HF)or high-fructose(HFr)consumption in children predispose them to metabolic syndrome(MetS).In rodent models of MetS,diets containing individually HF or HFr lead to a variable degree of MetS.Nevertheless,simultaneous intake of HF plus HFr have synergistic effects,worsening MetS outcomes.In children,the effects of HF or HFr intake usually have been addressed individually.Therefore,we have reviewed the outcomes of HF or HFr diets in children,and we compare them with the effects reported in rodents.In humans,HFr intake causes increased lipogenesis,hypertriglyceridemia,obesity and insulin resistance.On the other hand,HF diets promote low grade-inflammation,obesity,insulin resistance.Despite the deleterious effects of simultaneous HF plus HFr intake on MetS development in rodents,there is little information about the combined effects of HF plus HFr intake in children.The aim of this review is to warn about this issue,as individually addressing the effects produced by HF or HFr may underestimate the severity of the outcomes of Western diet intake in the pediatric population.We consider that this is an alarming issue that needs to be assessed,as the simultaneous intake of HF plus HFr is common on fast food menus.

Team players in the pathogenesis of metabolic dysfunctionsassociated steatotic liver disease:The basis of development of pharmacotherapy

Nutrient metabolism is regulated by several factors.Social determinants of health with or without genetics are the primary regulator of metabolism,and an unhealthy lifestyle affects all modulators and mediators,leading to the adaptation and finally to the exhaustion of cellular functions.Hepatic steatosis is defined by presence of fat in more than 5%of hepatocytes.In hepatocytes,fat is stored as triglycerides in lipid droplet.Hepatic steatosis results from a combination of multiple intracellular processes.In a healthy individual nutrient metabolism is regulated at several steps.It ranges from the selection of nutrients in a grocery store to the last step of consumption of ATP as an energy or as a building block of a cell as structural component.Several hormones,peptides,and genes have been described that participate in nutrient metabolism.Several enzymes participate in each nutrient metabolism as described above from ingestion to generation of ATP.As of now several publications have revealed very intricate regulation of nutrient metabolism,where most of the regulatory factors are tied to each other bidirectionally,making it difficult to comprehend chronological sequence of events.Insulin hormone is the primary regulator of all nutrients’metabolism both in prandial and fasting states.Insulin exerts its effects directly and indirectly on enzymes involved in the three main cellular function processes;metabolic,inflammation and repair,and cell growth and regeneration.Final regulators that control the enzymatic functions through stimulation or suppression of a cell are nuclear receptors in especially farnesoid X receptor and peroxisome proliferator-activated receptor/RXR ligands,adiponectin,leptin,and adiponutrin.Insulin hormone has direct effect on these final modulators.Whereas blood glucose level,serum lipids,incretin hormones,bile acids in conjunction with microbiota are intermediary modulators which are controlled by lifestyle.The purpose of this review is to overview the key players in the pathogenesis of metabolic dysfunction-associated steatotic liver disease(MASLD)that help us understand the disease natural course,risk stratification,role of lifestyle and pharmacotherapy in each individual patient with MASLD to achieve personalized care and target the practice of precision medicine.PubMed and Google Scholar databases were used to identify publication related to metabolism of carbohydrate and fat in states of health and disease states;MASLD,cardiovascular disease and cancer.More than 1000 publications including original research and review papers were reviewed.

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.

Multi-omics: Opportunities for research on mechanism of type 2 diabetes mellitus

Type 2 diabetes mellitus(T2DM)is a burdensome global disease.In-depth understanding of its mechanism will help to optimize diagnosis and treatment,which reduces the burden.Multi-omics research has unparalleled advantages in contributing to the overall understanding of the mechanism of this chronic metabolic disease.In the past two decades,the study of multi-omics on T2DMrelated intestinal flora perturbation and plasma dyslipidemia has shown tremendous potential and is expected to achieve major breakthroughs.The regulation of intestinal flora in diabetic patients has been confirmed by multiple studies.The use of metagenomics,16S RNA sequencing,and metabolomics has comprehensively identified the overall changes in the intestinal flora and the metabolic disturbances that could directly or indirectly participate in the intestinal flora-host interactions.Lipidomics combined with other“omics”has characterized lipid metabolism disorders in T2DM.The combined application and crossvalidation of multi-omics can screen for dysregulation in T2DM,which will provide immense opportunities to understand the mechanisms behind T2DM.

Metabolic syndrome after liver transplantation: Preventable illness or common consequence?

The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As the United States population ages and the rate of obesity increases, prevention of the metabolic syndrome in the post-transplant population deserves special consideration. Currently, the metabolic syndrome after transplant appears at least two times more common than observed rates in the general population. Specific guidelines for patients after transplant does not exist, therefore prevention rests upon knowledge of risk factors and the presence of modifiable elements. The current article will focus on risk factors for the development of the metabolic syndrome after transplant, will highlight potentially modifiable factors and propose potential areas for intervention. As in the non-transplant population, behavioral choices might have a major role. Opportunities exist in this regard for health prevention studies incorporating lifestyle changes. Other factors such as the need for immunosuppression, and the changing characteristics of wait listed patients are not modifiable, but are important to know in order to identify persons at higher risk. Although immunosuppression after transplant is unavoidable, the contribution of different agents to the development of components of the metabolic syndrome is also discussed. Ultimately, an increased risk of the metabolic syndrome after transplant is likely unavoidable, however, there are many opportunities to reduce the prevalence.

Postprandial dyslipidemia in insulin resistant states in adolescent populations

Obesity and the metabolic syndrome are becoming increasingly prevalent not only in adults,but also in adolescents.The metabolic syndrome,a complex cluster of metabolic abnormalities,increases one’s risk of developing type 2 diabetes and cardiovascular disease(CVD).Dyslipidemia,a key component of the metabolic syndrome,is highly associated with insulin resistance and contributes to increased CVD risk.Dyslipidemia has traditionally been assessed using a fasting lipid profile [i.e.fasting triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)].However,the postprandial state predominates over the course of a day and non-fasting triglycerides independently predict CVD risk.In insulin resistant states,the intestine overproduces triglyceride-rich lipoprotein(TRL) particles,termed chylomicrons(CMs),following ingestion of a fat-containing meal,as well as in the fasting state.Along with elevated hepatic TRLs(i.e.very-low density lipoproteins),CMs contribute to remnant lipoprotein accumulation,small dense LDL particles,and reduced HDL-C,which collectively increase CVD risk.Given the early genesis of atherosclerosis and physiological metabolic changes during adolescence,studying postprandial dyslipidemia in the adolescent population is an important area of study.Postprandial dyslipidemia in the pediatric population poses a significant public health concern,warranting a better understanding of its pathogenesis and association with insulin resistance and CVD.This review discusses the metabolic syndrome,focusing on the link between insulin resistance,postprandial dyslipidemia,and CVD risk.Furthermore,the clinical significance and functional assessment of postprandial dyslipidemia,specifically in the adolescent population,is discussed in more detail.

Specific metabolic biomarkers as risk and prognostic factors in colorectal cancer

Advances in genomics,molecular pathology and metabolism have generated many candidate biomarkers of colorectal cancer with potential clinical value.Epidemiological and biological studies suggest a role for adiposity,dyslipidaemia,hyperinsulinemia,altered glucose homeostasis,and elevated expression of insulin-like growth factor(IGF)axis members in the risk and prognosis of cancer.This review discusses some recent past and current approaches being taken by researches in obesity and metabolic disorders.The authors describe three main systems as the most studied metabolic candidates of carcinogenesis:dyslipidemias,adipokines and insulin/IGF axis.However,each of these components is unsuccessful in defining the diseases risk and progression,while their co-occurrence increases cancer incidence and mortality in both men and women.

Avocado and Cardiovascular Health

Avocado is a fruit which had a caloric density of 1.7 kcal per gram and a half unit (~70 g) is composed by 114 kcal, 4.6 g of fibers, 345 mg of potassium, 19.5 mg of magnesium, 1.3 mg of vitamin E and 57 mg of phytosterols. Approximately 75% of fiber’s avocado contents are considered insoluble and 25% are soluble. The avocado contains lipids that consist of 71% from monounsaturated fatty acids (MUFA), 13% from polyunsaturated (PUFA) and 16% from saturated fatty acids (SFA). Recent researches have shown that avocado may improve hypercholesterolemia and may be useful in the treatment of hypertension and type 2 diabetes mellitus (T2DM). This way, avocado plays an important role in the cardiovascular health. This review summarizes the potential benefits of avocado consumption in the prevention of cardiovascular risk factors and metabolic diseases.

Factors Related to Adherence with Treatment of Dyslipidemic Patients on Continuous Use of Oral Lipid-Lowering Drugs

Several studies have shown that regular prescribed statins may reduce cardiovascular events and decrease the overall mortality. The aim of this study was to analyze factors related to medication and patients with dyslipidemia, statin users in the city of Ribeir&atilde;o Preto, S&atilde;o Paulo, Brazil. It was an observational, descriptive, traverse character, relating to the year 2007. We included 332 individuals, randomly selected, of both sexes, referred to public health system and private clinics. The selected individuals were submitted to an interview and their medical files analyzed. Simvastatin was the most frequently used oral lipid-lowering drugs. 60% of patients showed forgetfulness as the main cause for treatment interruption, followed by the difficulty of finding of drugs in public pharmacies. Adherence to diet was the main conduct adopted by patients to help control lipid levels. The prevalent adverse events were muscle cramps, paresthesias of the limbs and muscle pains. Among the key factors that would discourage the correct follow-up treatment for lipid control were: long wait for office visits and the difficulties of finding of drugs in pharmacies (Clinical Hospital of the Faculty of Medicine of Ribeir&atilde;o Preto-USP and public health posts). The study allowed a reflection regarding the functioning of the Public Health System. The study allows a reflection regarding the functioning of the Public Health System for which we must constantly search for strategies that enable the same functionality, which has factors that discourage patient adherence to treatment.