Differential impact of aging and gender on lipid and lipoprotein profiles in a cohort of healthy Chinese Singaporeans

Aim： To evaluate the impact of age and gender on lipid and lipoprotein profiles and the burden of dyslipidemia in a cohort of healthy Chinese Singaporean. Methods： A total of 1 775 healthy Chinese, 536 men and 1 239 women aged between 30 and 70 years old were involved in the present study. Results： Gender differences in all lipid and lipoprotein levels were clearly evident. Singaporean Chinese men have significantly higher levels of total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C） and total cholesterol/high density lipoprotein-cholesterol （TC/HDL-C）, and lower levels of HDL-C than women. Although lipid and lipoprotein levels in men did not change in the different age groups, those in women, especially TC, LDL-C and TC/HDL-C, were significantly higher in older women （〉 50 years old） than corresponding levels in younger women （30-46 years old）. Furthermore, TG was significantly correlated with lipids and lipoproteins differently in men and women. If 100 mg/dL of LDL-C were to be adopted as the therapeutic cut-off level, then the burden of care will be huge as approximately 90% of both Chinese men and women have LDL-C greater than 100 mg/dL. Condusion： In light of the findings of the present study, we suggest that preventive measures to promote the reduction in risk of coronary heart disease （CHD） must address the high proportion of men and women with high LDL-C, and that these measures should take into account both the gender and age factors. For men, reduction of high cholesterol must start early in life, whereas for women, steps must be taken earlier to mitigate the anticipated sharp increase in risk, especially after menopause.

Markers of inflammation and cardiovascular disease in recently diagnosed celiac disease patients

AIM To evaluate novel risk factors and biomarkers of car-diovascular disease in celiac disease(CD) patients compared with healthy controls. METHODS Twenty adult patients with recent diagnosis of CD and 20 sex, age and body mass index-matched healthy controls were recruited during a period of 12 mo. Indicators of carbohydrate metabolism, hematological parameters and high sensitive C reactive protein were determined. Moreover, lipoprotein metabolism was also explored through evaluation of the lipid profile andthe activity of cholesteryl ester transfer protein and lipoprotein associated phospholipase A2, which is also considered a specific marker of vascular inflammation. The protocol was approved by the Ethic Committee from School of Pharmacy and Biochemistry, University of Buenos Aires and from Buenos Aires Italian Hospital, Buenos Aires, Argentina.RESULTS Regarding the indicators of insulin resistance, CD patients showed higher plasma insulin levels [7.2(5.0-11.3) m U/L vs 4.6(2.6-6.7) m U/L, P < 0.05], increased Homeostasis Model Assessment-Insulin Resistance [1.45(1.04-2.24) vs 1.00(0.51-1.45), P < 0.05] and lower Quantitative Sensitive Check index [0.33(0.28-0.40) vs 0.42(0.34-0.65), P < 0.05] indexes. Folic acid concentration [5.4(4.4-7.9) ng/m L vs 12.2(8.0-14.2) ng/m L, P < 0.01] resulted to be lower and High-sensitivity C reactive protein levels higher(4.21 ± 6.47 mg/L vs 0.98 ± 1.13 mg/L, P < 0.01) in the patient group. With respect to the lipoprotein profile, CD patients showed lower high density lipoprotein-cholesterol(HDL-C)(45 ± 15 mg/d L vs 57 ± 17 mg/d L, P < 0.05) and apo A-I(130 ± 31 mg/d L vs 155 ± 29 mg/d L, P < 0.05) levels, as well as higher total cholesterol/HDL-C [4.19(3.11-5.00) vs 3.52(2.84-4.08), P < 0.05] and apo B/apo A-I(0.75 ± 0.25 vs 0.55 ± 0.16, P < 0.05) ratios in comparison with control subjects. No statistically significant differences were detected in lipoprotein-associated lipid transfer protein and enzymes.CONCLUSION The presence and interaction of the detected alterations in patients with CD, would constitute a risk factor for the development of atherosclerotic cardiovascular disease.

Vulnerability and Resilience to Stress and Immune and Neuroendocrine Function in Portuguese Subjects with Psychic Anomaly (Anxiety and Depression)

The present study aimed to investigate the impact of chronic psychosocial stress and resilience, including at a biological level (immune and neuroendocrine function) in Portuguese citizens with psychic anomaly/mental disorder. The sample aggregated 69 participants. It has been used the following psychometric instruments: 21-item depression, anxiety and stress scales (DASS-21), in the Portuguese validated version;measuring state resilience (MSR), in the Portuguese validated version;the Portuguese scale of 23 questions on vulnerability to stress. Serum levels of cortisol, dehydroepiandrosterone sulfate, antibodies anti-viral capsid antigen of Epstein-Barr virus, triglycerides, high density lipoprotein-cholesterol and body mass index have been measured. It has been concluded that factors of vulnerability to stress and chronic stress, of social nature (lack of social support, adverse living conditions), correlate positively with depression, anxiety and stress, and, through alostatic load, are involved in a greater propensity for immune and neuroendocrine dysfunction in this population.

Relation of combined non-high density lipoprotein cholesterol and apolipoprotein B with Gensini Score of coronary atherosclerosis in non-diabetic acute coronary syndrome

Background Non-high-density lipoprotein cholesterol （non-HDL-C） and Apolipoprotein B （apoB） increase car- diovascular disease （CVD） risk, but few studies have explored the correlations of non-HDL-C and apoB with cor- onary atherosclerosis in non-diabetes acute coronary syndrome （ACS）. Methods The study enrolled 443 sub- jects with non-diabetic ACS, and all subject check coronary angiography, and coronary atherosclerosis were eval- uated using Gensini Score （GS） scale including small （GS 1-15）, middle （GS16-43）, and severe （GS≥44）. All sub- jects were classified into 4 groups： High apoB （≥90 mg/dL） and High non-HDL-C （≥130 mg/dL）, High non-HDL -C alone, High apoB alone, and normal apoB and non-HDL-C. Results After adjusted for risk factors, non-HDL -C and apoB were positively correlated with GS （ r = 0.075, P = 0.002 and r = 0.092, P 〈 0.001）. In the GS 0-15, high non-HDL-C ＋ high apoB group 29.3% and high apoB alone group 28.2% were significantly lower than nor- mal non-HDL-C＋ normal apoB group 48% （p = 0.010）. In the GS 16-43, high non-HDL-C alone group 50.4% and high apoB alone group 47.6% were significantly more than high non-HDL-C＋ high apoB group 34.1% （P = 0.036）. In the GS ≥44, high non-HDL-C＋ high apoB group 36.6% was significantly higher than high non-HDL- C alone group 16% and normal non-HDL-C＋ normal apoB 14.2%（P 〈 0.001）. Conclusions The high non-HDL- C and apoB are the risk factors for coronary artery atherosclerosis in non-diabetic ACS.

Dyslipidaemia among diabetic patients with ischemic stroke in a Chinese hospital

Background Dyslipidaemia is a potential independent The aim of this study was to investigate dyslipidaemia, with ischemic stroke in a Chinese hospital. risk factor for cerebrovascular disease in patients with diabetes. treatment and control of dyslipidaemia among diabetic patients Methods A total of 1046 type 2 diabetic patients were assigned to diabetes with （n=-522） and diabetes without stroke groups. The two groups were matched by gender, age and diabetes duration. Lipid and lipoprotein profile were measured. Serum level and control of lipids were assessed and classified according to American Diabetes Association （ADA） guidelines and an intensified low density lipoprotein-cholesterol （LDL-C） target recommended in Chinese dyslipidaemia control criteria. Results Diabetic patients suffering stroke displayed not only poorly-controlled lipid and lipoprotein profiles, including the significantly lower proportion of patients achieving intensified LDL-C target of 〈2.07 mmol/L （80 mg/dl）, and high density lipoprotein-cholesterol （HDL-C） target （14.4% vs 21.0%, P=0.005; 45.8% vs 51.9%, P=0.048 respectively）, but also less adherence to therapy prescribed for dyslipidaemia （30.8% vs 41.0%, P=0.001）, when compared with diabetic patients without stroke. For the diabetic women with stroke, situation of dyslipidaemia was worse, with significantly lower serum level of HDL-C and apoA1, higher LDL-C level and higher ratio of apoB/apoA1 when compared with diabetic counterparts without stroke. Conclusions Many diabetic patients with ischemic stroke remain uncontrolled for dyslipidaemia. Intensified LDL-C and overall lipid lowering clinical goals are potential precautions taken against ischemic stroke among diabetic patients in China.