Lipids in Health and Disease最新文献

Background: Youth with perinatally acquired HIV (PHIV) are at risk for cardiovascular disease (CVD) despite combination anti-retroviral therapy (cART). Longitudinal data on the impact of HIV and cART on lipid metabolism and CVD risk in PHIV youth is limited. We investigated lipid and lipoprotein levels in PHIV youth and matched controls over time and examined associations with cART and metabolic syndrome (MetS) markers.

Methods: We included 32 PHIV and 36 controls at three time points: 2013, 2018 and 2023. In 2023, we assessed lipid profiles cross-sectionally in a larger cohort of 53 PHIV participants and 45 controls. Measurements included lipoprotein (a) (Lp(a)), apolipoprotein B (ApoB), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), reduced high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) and markers related to MetS risk.

Results: The median age was 21.7 years (IQR 16.7-25.2) for PHIV participants and 21.2 years (16.8-22.3) for controls in 2023 for longitudinal assessment. No significant differences in lipid or lipoprotein levels were observed over time (p values > 0.05). TG levels were significantly higher in PHIV participants at second assessment (p = 0.043), but other levels were comparable (p values > 0.05). Higher Lp(a) levels were associated with higher LDL-C and ApoB levels, however associations were significantly weakened among PHIV participants. Furthermore, protease inhibitor (PI) use was associated with elevated TC, TG and LDL-C. During cross-sectional assessment median age was 17.4 years (IQR 12.7-22.4) and 19.1 years (IQR 15.0-21.8) for PHIV youth and controls. Lipid and MetS markers were comparable between groups (p values > 0.05).

Conclusion: PHIV youth on cART showed similar lipid and lipoprotein levels over time compared to matched controls. Lp(a) associations with lipid markers were weakened for PHIV youth and PI use was associated with lipid alterations. Our results imply that while lipid profiles, including Lp(a), are important components of cardiovascular health monitoring, the increased CVD risk observed in PHIV youth may be more substantially influenced by disease-specific or broader pathophysiological mechanisms related to HIV-infection and treatment.

Trial registration: Dutch clinical trial registration: Overview of Medical Research in the Netherlands (OMON) (ID: NL-OMON53727).

Background: Monocyte-to-HDL Ratio (MHR) biomarker reflects monocyte-driven inflammation and HDL's anti-inflammatory properties. MHR's reference ranges and prognostic utility remain undefined. We establish normal MHR reference ranges and examine its association with inflammatory diseases and mortality.

Methods: Using NHANES data (1999-2018, 2021-2023), two sets of sex-specific MHR reference ranges were generated using two healthy adult populations (monocyte count: 6,757; monocyte percentage: 6,817). Further analyses utilized MHR by monocyte count for more straightforward interpretation. Adjusted associations between MHR and inflammatory diseases were assessed in 49,929 adults, and disease-specific mortality in 35,781.

Results: The 2.5th-97.5th percentiles for MHR by monocyte count were 0.175 (90% CI: 0.167-0.184) to 0.709 (90% CI: 0.690-0.727) in males and 0.135 (90% CI: 0.130-0.140) to 0.511 (90% CI: 0.503-0.520) in females, with similar trends for MHR by monocyte percentage. High MHR was most strongly associated with diabetes (aOR = 1.76, p < 0.001) and cardiovascular disease (aOR = 1.69, p < 0.001), while mortality risk was highest for kidney disease (aHR = 3.13, p < 0.001) and diabetes (aHR = 2.26, p < 0.001).

Conclusion: MHR is a feasible and accessible biomarker of inflammation and lipid dysregulation that can be derived from routine laboratory tests and shows strong associations with cardiometabolic diseases and disease-related mortality.

Background: As non-alcoholic fatty liver disease (NAFLD) becomes increasingly common and affects population health, simple and effective screening tools for NAFLD are essential. The triglyceride high-density cholesterol-glucose body index (TyHGB), a novel metabolic index, has shown promise for predicting metabolic disorders. The objective of this research was to assess TyHGB's predictive capability for NAFLD across two distinct cohorts.

Methods: This retrospective study utilized data obtained from two independent cohorts: a Chinese hospital cohort (n = 181,241) and the National Health and Nutrition Examination Survey (NHANES) cohort (n = 3,286). TyHGB was computed according to the following equation: triglyceride level/high-density lipoprotein cholesterol level + 0.7 × fasting blood glucose level (mmol/L) + 0.1 × body mass index (kg/m²). NAFLD was diagnosed using ultrasonography. The TyHGB-NAFLD association was evaluated using multivariable logistic regression analysis, restricted cubic spline methodology, and receiver operating characteristic (ROC) curves. To establish the added predictive capacity of TyHGB over the triglyceride-glucose (TyG) index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were determined.

Results: In both cohorts, participants with higher TyHGB values demonstrated a significantly higher prevalence of NAFLD. After full adjustment for potential confounders, the odds ratios for NAFLD on comparing the highest versus lowest quartiles of TyHGB were 12.22 (95% confidence interval [CI]: 10.73-13.93) in the Chinese cohort and 3.17 (95% CI: 2.25-4.46) in the NHANES cohort. Restricted cubic spline modeling demonstrated significant nonlinear associations between TyHGB values and NAFLD risk in both populations (P for nonlinearity < 0.001). TyHGB demonstrated superior discriminative ability for NAFLD in comparison with the TyG index, with area under the curve (AUC) values of 0.8410 versus 0.7995 in the Chinese cohort and 0.6492 versus 0.5952 in the NHANES cohort (both P < 0.001). Adding TyHGB to the baseline prediction models significantly improved risk discrimination, with greater improvements than those achieved by adding TyG (NRI: 0.0183, 95% CI: 0.015-0.0217; IDI: 0.0067, 95% CI: 0.0057-0.0076; both P < 0.001).

Conclusion: TyHGB demonstrated robust and superior performance in predicting NAFLD in comparison with the established TyG index across two diverse populations. Since TyHGB only requires routinely measured clinical parameters, it represents a practical and equitable tool for early NAFLD risk stratification across diverse healthcare settings, potentially reducing health disparities in liver disease detection and enabling cost-effective prevention strategies at the population level.

Background: Arthritis patients exhibit a higher stroke risk, but effective predictive biomarkers are scarce. This research sought to examine and compare the associations between the triglyceride-glucose (TyG) index, its integration with C-reactive protein (CRP) (TyG-CRP), and stroke risk in these patients.

Methods: This research examined data from 3,419 arthritis patients participating in the China Health and Retirement Longitudinal Study (CHARLS), focusing on the occurrence of new stroke events as the main outcome. Examination of the association between the TyG index, TyG-CRP and stroke risk relied on Kaplan-Meier, Cox regression, and restricted cubic splines (RCS) analyses.

Results: During the 9-year follow-up period, 339 arthritis patients (9.9%) had their initial stroke. Stroke incidence increased steadily from the lowest to highest tertile categories as determined by both TyG index and TyG-CRP (P < 0.05). After full covariate adjustment, each 1-unit increment in TyG-CRP raised stroke risk by 18% (HR, 1.18; 95% CI, 1.01-1.39), and individuals in the top TyG-CRP tertile were 1.4 times more likely to experience a stroke versus those in the bottom tertile (HR, 1.40; 95% CI, 1.03-1.92). There was no significant link between the TyG index and stroke risk, whether it was assessed continuously or by tertiles (P > 0.05) in the fully adjusted models. TyG-CRP was significantly linearly related to stroke incidence (P-overall: 0.047; P-nonlinear: 0.725), whereas the TyG index, although linear, also demonstrated an insignificance (P-overall: 0.165; P-nonlinear: 0.557). In sensitivity analyses conducted among complete cases, TyG-CRP demonstrated borderline statistical significance for stroke risk in the model with comprehensive covariate adjustment (P = 0.058 for the continuous variable analysis; P = 0.064 for tertile-based comparisons).

Conclusion: TyG-CRP is a standalone predictor of stroke in arthritis individuals, whereas the TyG index does not significantly predict stroke risk.

Background: Smith-Lemli-Opitz syndrome (SLOS) is a rare autosomal recessive disorder of cholesterol biosynthesis. SLOS leads to increased levels of 7-dehydrocholesterol (7-DHC) and decreased levels of total cholesterol (TC). Dietary therapy usually involves supplementation with cholesterol in an oil-based or, less commonly, an aqueous cholesterol suspension. The limited solubility of cholesterol can result in uneven distribution, sedimentation and clumping.

Methods: In seven patients (6 m, 1 f, 1-12 years) the previously administered dose of cholesterol was replaced by a newly developed emulsion and primary parameters TC, 7-DHC, HDL, LDL, vitamin D (25; 1-25), height and weight were determined. In addition, a personal structured interview was conducted with the caregivers of five participants to determine their satisfaction with the product, the care, and the effects on behaviour and health.

Results: One patient was excluded due to non-compliance (N = 6). Before the intervention, the mean TC level was 42 ± 9 mg/dl (min = 29, max = 52; n = 5) and increased by at least 95% and at most 299% (163 ± 93%). 7-DHC levels showed a decrease of -28% to -96% (-63 ± 29%). No effect on anthropometric parameters was observed. Overall, the families were satisfied with the care and the effect of the emulsion was predominantly described as successful. The emulsion and its application were well tolerated with few side effects.

Conclusions: Overall, there was an improved effect on TC and 7-DHC levels compared to standard therapy, with high patient satisfaction and low side effects.

Background: Definitions of nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated FLD (MAFLD), and steatotic liver disease (SLD) have been proposed to better guide clinical practice and epidemiological studies. The effects of the nomenclature on the incidence of FLD and its associations with obesity phenotypes, insulin resistance (IR), and liver fibrosis were examined in this study.

Methods: NAFLD, MAFLD, and metabolic dysfunction-associated steatotic liver disease (MASLD) were diagnosed on the basis of ultrasound examination and metabolic disorders among 6,718 community-dwelling individuals from southeast China. Six obesity phenotypes, seven IR surrogates, and the NAFLD Fibrosis Score (NFS) were applied to evaluate their association with FLDs through multivariable logistic regression models, restricted cubic splines, and receiver operating characteristic curves.

Results: The prevalence of FLD, NAFLD, MAFLD, and MASLD was 35.47%, 33.34%, 34.77%, and 32.79%, respectively. The associations of obesity-FLD, IR-FLD, and FLD-NFS were statistically significant across all the FLD definitions. Patients with MAFLD demonstrated slightly higher odds ratios (ORs) than those with FLD, NAFLD, and MASLD. However, alcoholic-FLD (AFLD), which is included in the MAFLD nomenclature, showed lower ORs with obesity and IR and lower NFS, significantly differently from other FLDs. Among all obesity and IR indices, triglyceride and glucose index body mass index (TyG-BMI), the TyG-waist height ratio (TyG-WHtR), and the TyG-waist circumstance (TyG-WC) were the best at predicting FLDs and ORs with respect to NFS.

Conclusion: The nomenclature of MAFLD covers a wider range of FLD than NAFLD and MASLD do, but the heterogeneity of AFLD is nonnegligible. Compared with MASLD, NAFLD remains a practical and efficient definition for large-scale population screening, especially in resource-limited settings. TyG-BMI, TyG-WHtR, and TyG-WC could better predict FLD and associated fibrosis, affirming their potential as simple and cost-effective tools to support health monitoring and early intervention.

Background: Post-induction hypotension (PIH) is a frequent complication during general anesthesia and is linked to adverse outcomes. Abnormalities in serum total cholesterol (TC) have been associated with blood pressure dysregulation. This study investigated the relationship between preoperative serum TC levels and the risk of PIH in elderly patients undergoing non-cardiac surgery.

Methods: We retrospectively reviewed 821 elderly patients who received general anesthesia for non-cardiac surgery at our hospital between January 2019 and December 2021. Patients were categorized into a high TC group (≥ 5.2 mmol/L) and a normal TC group (< 5.2 mmol/L). Propensity score matching (PSM) was performed to reduce baseline differences, and perioperative hemodynamic outcomes were compared.

Results: PIH incidence was significantly higher in the high TC group than in the normal TC group (50.6% vs. 27.3%, p = 0.003). After PSM (n = 144 per group), the unadjusted risk of PIH was 1.74 times higher in the high TC group (95% confidence intervals [CI]: 1.24-2.45). Following adjustment for residual confounders, the increased risk persisted (adjusted risk ratio: 1.58; 95% CI: 1.12-2.23). Patients with high TC also showed greater reductions in blood pressure before (32% vs. 26%, p = 0.009) and after intubation (23% vs. 17%, p = 0.011).

Conclusions: Elevated preoperative serum TC is independently associated with a higher risk of PIH in elderly patients undergoing non-cardiac surgery. These results suggest that cholesterol metabolism contributes to perioperative hemodynamic instability and underscores the importance of including lipid status in preoperative risk assessment and anesthetic planning.

Background: Subclinical hypothyroidism (SCH) often occurs in association with the emergence of the metabolic disorder like insulin resistance (IR). This study aimed to determine the relationship between the Triglyceride Glucose (TyG) index and thyroid function in patients with subclinical hypothyroidism (SCH), to identify metabolic predictors of thyroid dysfunction.

Methods: This cross-sectional study used convenience sampling, and data were collected after written informed consent. This study was conducted at tertiary care hospitals in Peshawar, Pakistan, and included 2024 subclinical hypothyroid patients with an age > 19 years. Individuals with any thyroid condition, diabetes, cardiovascular disorders or chronic liver conditions were excluded. Regression, ANOVA, and long short-term memory (LSTM) models were used to predict the TyG index, TSH, T3, and FT4 levels. All analyses were performed using R version 4.3.0 and Python. The result was considered statistically significant with P < 0.05.

Results: The male-to-female ratio was 1:2, and the highest group included 41 50-year-olds (40.3%). Regression analysis revealed an inverse association between the TyG index and T3 level (β = -0.313, P < 0.0001) and a positive association with HbA1c (β = 0.198; P < 0.0001), indicating a relationship between a higher TyG index and IR and poor glycemic control. The values of HDL were negatively correlated with the TyG index (β = -0.221, P < 0.0001); conversely, LDL was positively correlated to TyG (β = 0.234, P < 0.0001). The LSTM model presented high predictive accuracy with small mean squared errors, 0.00034 for the TyG index, 0.0015 for T3, and 0.0113 for T4.

Conclusion: The findings of this study demonstrated that the TyG index can be an effective and important parameter of metabolic health and a predictor of thyroid function in subclinical hypothyroid patients. These findings underscore the importance of early identification of metabolic risk factors for thyroid dysfunction, which can contribute to improved health outcomes and reduce the long-term burden of endocrine and cardiovascular diseases at the population level. Moreover, the results of the current research cannot be generalized, as it is a cross-sectional study.

Aquaporins (AQPs), mainly divided into classical AQPs, aquaglyceroporins, and superaquaporins, constitute a channel protein family facilitating the movement of small molecules, such as H₂O, H₂O₂, and glycerol, across cell membrane. AQPs are widely found in kidneys, pancreas, liver, muscle, skin, brain, fatty tissues, and other tissues related to lipid metabolism, playing important roles in lipid metabolism in these tissues by affecting glycerol's cell membrane permeability or indirectly through secondary pathways. This review provides a comprehensive analysis of AQP expression patterns across various tissues and elucidates their correlation with lipid metabolism, with the purpose of ascertaining the possible clinical significance of these proteins. This investigation provides novel insights and perspectives for future research on lipid metabolism disorders, with a specific focus on AQPs as therapeutic targets to support metabolic health and sustainable disease management strategies.