早发冠心病患者发病的危险因素及RLP-C、AIP对短期预后的预测价值

目的探讨早发冠状动脉粥样硬化性心脏病(冠心病)患者发病的危险因素及残粒样脂蛋白-胆固醇(RLP-C)、血浆致动脉粥样硬化指数(AIP)对短期预后的预测价值。方法回顾性分析2022年1月至2024年1月于内蒙古医科大学附属医院就诊的120例早发冠心病患者作为观察组,另选择同期本院体检的健康人群100例作为对照组。分析早发冠心病患者发病的危险因素,并比较观察组不同预后患者RLP-C、AIP水平,采用受试者工作曲线(ROC)分析RLP-C、AIP及联合检测对早发冠心病患者短期预后的预测价值。结果多因素Logistic回归分析显示,体质指数(BMI)、高血压、吸烟、冠心病家族史、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、RLP-C、AIP均是早发冠心病患者发病的危险因素(P<0.05)。随访6个月,观察组预后不良组11例、预后良好组109例,预后不良组RLP-C、AIP均高于预后良好组,差异有统计学意义(P<0.05)。ROC分析显示,RLP-C、AIP联合检测对早发冠心病患者短期预后的预测价值[曲线下面积(AUC):0.992,95%CI:0.981~1.000]均高于RLP-C(AUC:0.927,95%CI:0.862~0.993)、AIP(AUC:0.982,95%CI:0.955~1.000)单独检测。结论早发冠心病患者发病的危险因素较多,且RLP-C、AIP联合检测对患者短期预后具有较好的预测价值。

血清LDL-C/HDL-C、non-HDL-C、RLP-C及sLOX-1水平与老年急性脑梗死的相关性研究

目的分析血清低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、残粒脂蛋白胆固醇(RLP-C)及可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)水平与老年急性脑梗死(ACI)的相关性。方法选取2022年1月—2023年8月收治的230例老年ACI作为研究组,另选择同期、同年龄段115例健康体检者作为对照组。比较2组LDL-C/HDL-C、non-HDL-C、RLP-C及sLOX-1水平,比较研究组不同斑块稳定性、神经功能缺损程度[采用美国国立卫生研究院卒中量表(NIHSS)评分评估]、颈动脉内中膜厚度(IMT)患者上述指标水平,偏回归分析上述指标与老年ACI的关系,并分析上述指标与斑块稳定性、IMT、NIHSS评分的相关性。结果研究组LDL-C/HDL-C、non-HDL-C、RLP-C、sLOX-1水平高于对照组(P<0.01)。老年ACI患者LDL-C/HDL-C、non-HDL-C、RLP-C及sLOX-1水平,无斑块患者<稳定斑块患者<不稳定斑块患者,轻度神经功能缺损患者<中度神经功能缺损患者<重度神经功能缺损患者,IMT正常患者<IMT增厚患者<斑块形成患者(P<0.05)。LDL-C/HDL-C、non-HDL-C、RLP-C、sLOX-1水平与老年ACI密切相关(P<0.01)。研究组LDL-C/HDL-C、non-HDL-C、RLP-C及sLOX-1水平分别与斑块稳定性、IMT、NIHSS评分呈正相关(P<0.01)。结论老年ACI患者LDL-C/HDL-C、non-HDL-C、RLP-C、sLOX-1水平明显升高,且与神经功能缺损程度及颈动脉粥样硬化斑块密切相关。

补肾活血方对自发性高血压大鼠血清残粒脂蛋白含量的影响

目的观察补肾活血方对自发性高血压大鼠(SHR)血清残粒脂蛋白(RLP-C)含量的影响。方法给药12周后,采用免疫沉淀分离法测定空白对照组、川芎组、淫羊藿组及补肾活血方组大鼠血清中RLP-C的含量。结果实验12周,与空白对照组比较,各组大鼠血清RLP-C含量均明显降低(P<0.01),与川芎组、淫羊藿组比较,补肾活血方组RLP-C含量明显降低(P<0.01),川芎组与淫羊藿组相比差异无统计学意义(P>0.05)。结论补肾活血方、川芎及淫羊藿均能降低SHR血清RLP-C含量,其中补肾活血方作用最强。

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.

MicroRNA alterations in senescent endothelial progenitor cells induced by remnant-like lipoproteins

Background Remnant-like lipoproteins （RLPs） have been demonstrated to accelerate the onset of endothelial progenitor cells （EPCs） senescence. Recent study has determined that microRNAs （miRNAs） were closely associated with cellular proliferation and senescence. This study aimed to examine whether RLPs lead to an alteration of miRNAs in senescent EPCs. Methods RLPs were prepared from plasma samples with immunoaffinity method. After 8 days of culture, EPCs were identified by flow cytometry analysis. Cells were incubated with RLPs for 72 hours. The senescent markers p161NK4a and senescence-associated beta-galactosidase （SA-^-gal） were detected by Western blotting analysis and 13-gal staining assay, respectively. A human miRNA microarray containing 723 miRNAs was used to detect the expression profile of miRNAs in control and senescent EPCs. The result from the above microarray was qualified by RT-PCR assay. Results RLPs dose-dependently up-regulated the protein level of p16INK4a in EPCs, and RLPs at a concentration of 100 pg/ml induced a significant increase in the percentage of SA-i3-gal-positive EPCs. Of 723 miRNAs, four miRNAs expressed differentially and significantly in RLPs-treated EPCs （P 〈0.05）, then their changes in expression were validated by real-time RT-PCR. Among them miR-148b and miR-155 were upregulated while miR-574-3p was down-regulated significantly when compared with control （P 〈0.01）. Conclusions RLPs result in the onset of EPCs senescence. Senescent EPCs induced by RLPs exhibit a different profile of miRNAs. These three miR-148b and miR-155 and miR-574-3p reach a significant difference when compared with control, indicating that microRNA might take part in RLPs-induced EPCs senescence.

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.

ANALYSIS OF SERUM LIPIDS IN PSORIASIS

Serum lipids were determined in 100 psoriatics and the results indicated (1) the incidences of hypercholesterolemia (9%) and hypertriglyceridemia (17%) in psoriatics were significantly higher than in controls; (2) the mean values of serum TC, LDL-C and TC/HDL-C in psoriatics were significantly higher as compared with normal healthy controls matched for sex and age; (3) serum TC, LDL-C and TG values were significantly higher in cases whose disease was progressive or whose lesions involved more than 20% of body surface area than in cases whose disease stationary or lesions less than 20%. As the incidences of hypertension and coronary heart disease were also significantly higher in psoriatics than in controls, the authors proposed that some integrated relationship would exist.

Plant-based diet and its effect on coronary artery disease:A narrative review

Coronary artery disease(CAD),a primary component of cardiovascular diseases,is one of the top contributors to mortality rates worldwide.In 2021,dietary risk was estimated to be attributed to 6.58 million cardiovascular deaths.Plant-based diets(PBDs),which encourage higher consumption of plant foods and lower intake of animal-based foods,have been shown to reduce the risk of CAD by up to 29% when compared to non-vegetarian diets in a meta-analysis.This article aims to summarize the array of PBDs and compare them with conventional Western diets that include meat.We review the various proposed mechanisms for how the bioactive nutrients of PBDs aid in preventing atherosclerosis and CAD events,as well as other cardiac diseases.We conducted a detailed search of PubMed using our exclusive search strategy using the keywords plant-based diet,vegan diet,phytosterols,CAD,myocardial ischemia,and atherosclerosis.A total of 162 pertinent articles published within the past decade were identified for qualitative synthesis.To ensure the accuracy and reliability of our review,we included a total of 55 full-text,peer-reviewed articles that demonstrated the effects of plant-based diets on CAD and were written in English.We excluded animal studies,in vitro or molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.In this article,we emphasize the importance of dietary interventions,such as PBDs,to prevent CAD and their benefits on environmental sustainability.Integrating plant foods and whole grains into one's daily eating habits leads to an increase in the intake of nutrient-rich foods while reducing the consumption of processed food could not only prevent millions of premature deaths but also provide prevention against many chronic gastrointestinal and metabolic diseases.

Association of Remnant-like Particle Cholesterol with Major Adverse Cardiovascular Events in Subjects with Different Levels of Proprotein Convertase Subtilisin/Kexin 9:A 9.5-year Follow-up Study in a Beijing Community Population

Objective::The purpose of this study was to determine the relationship between remnant-like particle cholesterol(RLP-C)and major adverse cardiovascular events(MACEs)in patients with different levels of proprotein convertase subtilisin/kexin 9(PCSK9).Methods::From September 2007 to January 2009,1,859 subjects in Pingguoyuan communities in Beijing were initially screened.After excluding those with bedridden status,mental illness,severe systemic diseases,and missing data,1,680 subjects were recruited for follow up.All recruited subjects were followed up from February 2013 to September 2013(181 subjects were lost to follow-up)and from June 2017 to September 2018(174 subjects were lost to follow up).Finally,1,325 subjects were included in the study.General demographic characteristics,lifestyle and behaviors,disease history and use of medication was collected.Levels of total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,fast blood glucose,RLP-C,low-density lipoprotein triglycerides and PCSK9 were measured.The levels of RLP-C(low:RLP-C≤157 mg/L;high:RLP-C>157 mg/L)and PCSK9(low:PCSK9≤135.87μg/L;high:PCSK9>135.87μg/L)were represented using quartiles.Subjects were categorized into 4 groups according to their RLP-C and PCSK9 levels:Q4,high levels of RLP-C with high levels of PCSK9;Q3,high levels of RLP-C with low levels of PCSK9;Q2,low levels of RLP-C with high levels of PCSK9;and Q1,low levels of RLP-C with low levels of PCSK9.The association of RLP-C with MACEs in subjects with different PCSK9 levels was evaluated.Results::After a median follow-up of 9.5 years,1,325 subjects were included in the study and a total of 191 MACEs had occurred.The incidence of MACEs was higher in the RLP-C>157 mg/L group than the RLP-C≤157 mg/L group(18.40%vs.10.42%).Cox proportional hazards regression model analysis showed that increased RLP-C levels were associated with an increased risk of MACEs(hazard ratio:1.405;95%confidence interval:1.005-1.964;P<0.005).The incidence of MACEs was higher in the high RLP-C/PCSK9 group vs.the low RLP-C/PCSK9 group(20.68%vs.8.76%).Cox proportional hazards regression model analysis showed that RLP-C was associated with an increased risk of MACEs in subjects with high PCSK9 levels independent of traditional risk factors(hazard ratio:1.791;95%confidence interval:1.168-2.825;P=0.001),but not in those with low PCSK9 levels.Conclusions::RLP-C was identified as a risk factor for MACEs,particularly in subjects with high PCSK9 levels.Lowering PCSK9 levels may reduce residual risk in subjects with elevated plasma RLP-C levels.

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.

Cardiovascular risks of postmenopausal women with low-density lipoprotein-cholesterol <130 mg/dL in Chaoshan region of China

Background Many postmenopausal women with low-density lipoprotein-cholesterol(LDL-C)<130 mg/dL from Chaoshan region suffer from coronary artery diseases,especially severe coronary artery lesions. However,few studies specifically focused on the cardiovascular risks of this subgroup of postmenopausal women.Methods A total of 270 postmenopausal women with LDL-C<130 mg/dL from Chaoshan region were enrolled in this cohort study. Patients with angiographically proven coronary artery diseases(CAD)served as CAD group(n=174),while the ones with angiographically proven normal coronary arteries served as Control group(n=96).Results The age of CAD group(68.5±8.4 years)was older than that of Control group(60.0±6.9 years)(P<0.001). The prevalence rates of hypertension,diabetes mellitus(DM)and hyperuricemia in CAD group were significantly higher than those of Control group(P<0.05 for both comparisons). The serum level of uric acid(UA)in CAD group was significantly higher than that in Control group(P<0.001). Age,DM and UA were independent cardiovascular predictors of postmenopausal women with LDL-C<130 mg/dL from Chaoshan Region[ORAGE:1.140(95%CI:1.095-1.188),ORDM:2.740(95%CI:1.368-5.486),ORUA:1.003(95%CI:1.001-1.006),PAGE<00.001,PDM=0.004,PUA=0.019]. Conclusions Postmenopausal women with LDL-C<130 mg/dL complicating CAD are elder with higher prevalence rates of hyperuricemia and DM. Age,DM and UA are considered as independent cardiovascular risk factors in the postmenopausal women with LDL-C <130 mg/dL from Chaoshan Region of China.[S Chin J Cardiol 2019;20(2):79-85]

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.

Fatty acid desaturase 1 polymorphisms are associated with coronary heart disease in a Chinese population

Background A recent genome-wide association study in Caucasians revealed that three loci （rs174547 in fatty acid desaturase 1 （FADS1）, rs2338104 near mevalonate kinase/methylmalonic aciduria, cobalamin deficiency, cblB type （MVK/MMAB） and rs10468017 near hepatic lipase （LIPC）） influence the plasma concentrations of high-density lipoprotein-cholesterol （HDL-C） and triglycerides （TG）. However, there are few reports on the associations between these polymorphisms and plasma lipid concentrations in Chinese individuals. This study aimed to evaluate the associations between these three polymorphisms with HDL-C and TG concentrations, as well as coronary heart disease （CHD） susceptibility in Chinese individuals.

Efficacy and Safety of Herbal Medicine Yun-Cai Tea in the Treatment of Hyperlipidemia:A Double-Blind Placebo-Controlled Clinical Trial

Objective： Animal studies have demonstrated a lipid-modulating effect of yun-cai tea. However, little is known about the lipid-lowering effect in humans.The aim of this study was to evaluate the lipid lowering effects and safety of yun-cai tea in patients with elevated lipid levels in a human clinical trial. Methods： This was a 12-week, randomly assigned, parallel-group, double-blind, and placebo-controlled pilot clinical study. Sixty primary hyperlipidemia patients were included and randomly assigned to the yun-cai tea group （30 patients） and the placebo group （30 patients）, for 8 weeks of treatment and 4 weeks of follow-up. The primary endpoint was changes in plasma low-density lipoprotein-cholesterol （LDL-C） at 8 weeks. The secondary endpoints included total cholesterol （TC） and triglycerides （TG）. Results： Our results revealed no statistically significant differences in LDL-C and TC between the two groups. Despite the lack of a statistically significant difference in the level of TG between the two groups, a declining trend was noted. A significant reduction of TG was observed in the yun-cai tea group at week 8, compared to baseline （P=0.048）. The incidence of stomach discomfort, gastroesophageal reflux, diarrhea, and constipation was slightly higher in the yun-cai tea group. No other significant adverse events were found. Conclusions： It is unlikely that yun-cai tea used had a blood lipid reduction effect. Further larger scale clinical trials with a longer duration and larger dose are necessary.

Relationship between baseline monocyte to high-density lipoprotein cholesterol ratio and acute heart failure in postmenopausal women with acute coronary syndromes

Monocyte to high-density lipoprotein cholesterol ratio(MHR)becomes a novel cardiovascular prognostic predictor.The retrospective study was performed to investigate the relationship between MHR and acute heart failure(AHF)in postmenopausal women with acute coronary syndromes(ACS).Methods A cohort of 127 postmenopausal women diagnosed with ACS were enrolled.They underwent coronary angiography in Shantou Central Hospital(Shantou,China)from December 2014 and July 2016.The patients were assigned to two groups based on the admission MHR:low MHR group(MHR≤0.3677,n=51)and high MHR group(MHR>0.3677,n=76).The relationship between MHR and AHF was assessed by logistic regression analysis.Results Left ventricular ejection fraction of the low MHR group(64.2%±8.8%)was higher than that of the high MHR group(57.6%±12.9%)(P=0.002).Fractional shortening of the low MHR group(35.4%±6.4%)was higher than that of the high MHR group(30.6%±8.9%)(P=0.001).Hospitalization days of high MHR group(11.4±6.6 days)was longer than that of low MHR group(8.4±3.5 days)(P=0.006).Incidence of AHF(21%)in the high MHR group was higher than that in the low MHR group(4%)(P=0.008).MHR(OR:25.701,95%CI:3.099-213.143,P=0.003)could be an independent predictor for AHF in postmenopausal women with acute coronary syndromes.Conclusions The incidence of AHF in high baseline MHR group was higher than that in low baseline MHR group.This study demonstrated that high MHR level was a risk factor for AHF in postmenopausal women with ACS.