Pub Date : 2018-01-01DOI: 10.1080/17584299.2018.1505313
B. D. Pardhe, Ojashpi Singh Kapali, J. Mathias, Anjeela Bhetwal, Jyotsna Shakya, P. Shrestha, Meenu Prajapati, Sajan Prajapati, Nabina Adhikari Khanal, P. Khanal
ABSTRACT Background: Worldwide, the prevalence of the metabolic syndrome (MetS) is estimated to be 70% among those with type 2 diabetes mellitus (T2DM). T2DM and MetS are associated with abnormal liver enzyme levels, which can be the result of non-alcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma or acute liver failure. The present study investigated the association between transaminases and MetS in T2DM patients. Methods: A descriptive cross-sectional study was conducted over the period of 6 months among 540 diabetic patients attending a tertiary care hospital in Nepal. The diagnosis of MetS was based on International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and Harmonized definition 2009. Association between metabolic components and liver enzymes was established by crude and adjusted logistic regression analysis. Results: Overall, the prevalence of elevated enzyme levels was 58.9% for alanine aminotransferase (ALT), 42.2% for aspartate aminotransferase (AST) and 59.4% for gamma-glutamyl transferase (GGT). The presence of MetS was 23.3%, 36.1% and 51.9% according to NCEP ATP III, IDF and Harmonized criteria, respectively. In the binary logistic regression analysis, waist circumference > 102 cm (M) or > 88 cm (F) was only independently associated with all three elevated liver enzymes, odds ratio (OR) = 4.172 for ALT, OR = 2.795 for AST and OR = 0.245 for GGT. When all three criteria were entered for multivariate risk analysis, only the NCEP ATP III (+) was found to be associated independently with raised all three liver enzymes. Conclusion: Central obesity and MetS following NCEPATP III criteria were independently associated with elevated ALT, AST and GGT in our diabetic population. Clinicians may consider hepatic complication as a negligible component in T2DM. The present findings may encourage more attention.
背景:在世界范围内，代谢综合征(MetS)在2型糖尿病(T2DM)患者中的患病率估计为70%。T2DM和MetS与肝酶水平异常相关，这可能是非酒精性脂肪性肝病、肝硬化、肝细胞癌或急性肝衰竭的结果。本研究调查了T2DM患者转氨酶与MetS之间的关系。方法:对540名在尼泊尔三级医院就诊的糖尿病患者进行了为期6个月的描述性横断面研究。MetS的诊断基于国际糖尿病联合会(IDF)、国家胆固醇教育计划成人治疗小组III (NCEP ATP III)和2009年统一定义。通过粗逻辑回归和调整逻辑回归分析，确定代谢成分与肝酶之间的相关性。结果:总体而言，谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和谷氨酰转移酶(GGT)的酶水平升高的患病率分别为58.9%、42.2%和59.4%。根据NCEP ATP III、IDF和Harmonized标准，met的存在率分别为23.3%、36.1%和51.9%。在二元logistic回归分析中，腰围> 102 cm (M)或> 88 cm (F)仅与所有三种肝酶升高独立相关，ALT的比值比(or) = 4.172, AST的比值比(or) = 2.795, GGT的比值比(or) = 0.245。当所有三个标准被输入多变量风险分析时，只有NCEP ATP III(+)被发现与所有三种肝酶升高独立相关。结论:在我们的糖尿病人群中，中枢性肥胖和符合NCEPATP III标准的MetS与ALT、AST和GGT升高独立相关。临床医生可能认为肝脏并发症在T2DM中是一个可以忽略的因素。目前的研究结果可能会引起更多的关注。
{"title":"Elevated liver transaminases and their association with metabolic syndrome in type 2 diabetic patients attending tertiary care hospital of Nepal","authors":"B. D. Pardhe, Ojashpi Singh Kapali, J. Mathias, Anjeela Bhetwal, Jyotsna Shakya, P. Shrestha, Meenu Prajapati, Sajan Prajapati, Nabina Adhikari Khanal, P. Khanal","doi":"10.1080/17584299.2018.1505313","DOIUrl":"https://doi.org/10.1080/17584299.2018.1505313","url":null,"abstract":"ABSTRACT Background: Worldwide, the prevalence of the metabolic syndrome (MetS) is estimated to be 70% among those with type 2 diabetes mellitus (T2DM). T2DM and MetS are associated with abnormal liver enzyme levels, which can be the result of non-alcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma or acute liver failure. The present study investigated the association between transaminases and MetS in T2DM patients. Methods: A descriptive cross-sectional study was conducted over the period of 6 months among 540 diabetic patients attending a tertiary care hospital in Nepal. The diagnosis of MetS was based on International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and Harmonized definition 2009. Association between metabolic components and liver enzymes was established by crude and adjusted logistic regression analysis. Results: Overall, the prevalence of elevated enzyme levels was 58.9% for alanine aminotransferase (ALT), 42.2% for aspartate aminotransferase (AST) and 59.4% for gamma-glutamyl transferase (GGT). The presence of MetS was 23.3%, 36.1% and 51.9% according to NCEP ATP III, IDF and Harmonized criteria, respectively. In the binary logistic regression analysis, waist circumference > 102 cm (M) or > 88 cm (F) was only independently associated with all three elevated liver enzymes, odds ratio (OR) = 4.172 for ALT, OR = 2.795 for AST and OR = 0.245 for GGT. When all three criteria were entered for multivariate risk analysis, only the NCEP ATP III (+) was found to be associated independently with raised all three liver enzymes. Conclusion: Central obesity and MetS following NCEPATP III criteria were independently associated with elevated ALT, AST and GGT in our diabetic population. Clinicians may consider hepatic complication as a negligible component in T2DM. The present findings may encourage more attention.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"92 1","pages":"12 - 4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85681611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-07DOI: 10.1080/17584299.2017.1411068
V. Athyros, N. Katsiki, M. Doumas
{"title":"Lipid association of India (LAI) expert consensus statement: part 2, specific patient categories","authors":"V. Athyros, N. Katsiki, M. Doumas","doi":"10.1080/17584299.2017.1411068","DOIUrl":"https://doi.org/10.1080/17584299.2017.1411068","url":null,"abstract":"","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"48 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2017-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85760656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1383700
S. Iyengar, R. Puri, S. Narasingan, D. Nair, V. Mehta, J. Mohan, S. Wangnoo, J. Dalal, V. Jha, S. Puri, A. Misra, M. Daga, M. Varma, S. Jasuja, S. Upadhyaya, R. Kasliwal, M. Bansal, R. Mehrotra, A. Jain, K. K. Talwar, R. Rajput, A. Pradhan, S. Seth, D. Kapoor, R. Melinkeri, S. Ramakrishnan, N. Khanna, R. Khadgawat, S. Puri, A. Shaikh, N. Kovalipati, N. Bordoloi, A. Zargar, R. Agarwal, A. Rastogi, M. Chag, D. Prabhakar, S. Mathur, H. Rehan, P. Sahoo, A. Dutta, A. Sharma, A. Pancholia, K. Natarajan, A. Mishra, K. Singh
ABSTRACT These Lipid Association of India (LAI) recommendations refer to specific patient populations. They follow the previously published LAI part 1 recommendations. These part 2 LAI recommendations focus on specific patient groups. These include patients with heart failure, chronic kidney disease, non-alcoholic fatty liver disease, cerebrovascular disease, thyroid disorders, inflammatory joint diseases, familial hypercholesterolaemia and human immunodeficiency virus infection. We also consider women, the elderly and post-transplantation patients. The current recommendations are based, as much as possible, on available data from Indian populations.
{"title":"Lipid Association of India (LAI) expert consensus statement on management of dyslipidaemia in Indians 2017: part 2","authors":"S. Iyengar, R. Puri, S. Narasingan, D. Nair, V. Mehta, J. Mohan, S. Wangnoo, J. Dalal, V. Jha, S. Puri, A. Misra, M. Daga, M. Varma, S. Jasuja, S. Upadhyaya, R. Kasliwal, M. Bansal, R. Mehrotra, A. Jain, K. K. Talwar, R. Rajput, A. Pradhan, S. Seth, D. Kapoor, R. Melinkeri, S. Ramakrishnan, N. Khanna, R. Khadgawat, S. Puri, A. Shaikh, N. Kovalipati, N. Bordoloi, A. Zargar, R. Agarwal, A. Rastogi, M. Chag, D. Prabhakar, S. Mathur, H. Rehan, P. Sahoo, A. Dutta, A. Sharma, A. Pancholia, K. Natarajan, A. Mishra, K. Singh","doi":"10.1080/17584299.2017.1383700","DOIUrl":"https://doi.org/10.1080/17584299.2017.1383700","url":null,"abstract":"ABSTRACT These Lipid Association of India (LAI) recommendations refer to specific patient populations. They follow the previously published LAI part 1 recommendations. These part 2 LAI recommendations focus on specific patient groups. These include patients with heart failure, chronic kidney disease, non-alcoholic fatty liver disease, cerebrovascular disease, thyroid disorders, inflammatory joint diseases, familial hypercholesterolaemia and human immunodeficiency virus infection. We also consider women, the elderly and post-transplantation patients. The current recommendations are based, as much as possible, on available data from Indian populations.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"2 1","pages":"109 - 56"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73262866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1337952
R. D. G. Neely, C. Boot
{"title":"Laboratory investigation of lipoprotein X","authors":"R. D. G. Neely, C. Boot","doi":"10.1080/17584299.2017.1337952","DOIUrl":"https://doi.org/10.1080/17584299.2017.1337952","url":null,"abstract":"","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"44 1","pages":"43 - 44"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84581966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1319787
A. Reiss, Nicolle M. Siegart, J. De Leon
ABSTRACT Interleukin-6 (IL-6) is a unique pleiotropic cytokine exhibiting both pro- and anti-inflammatory properties depending on the target cell type. Plasma IL-6 levels are associated with cardiovascular risk. IL-6 elevation in atherosclerosis results in effects on multiple cells involved in lipid processing and plaque formation. IL-6 is also the primary determinant of acute phase protein production. IL-6 has a number of properties that foster development of cardiovascular disease. These include activation of endothelial cells, pro-thrombotic effects on platelets and promotion of smooth muscle proliferation and macrophage lipid accumulation. Despite these overall unfavourable effect on cells involved in atheroma formation, IL-6 also has a positive impact on the lipid handling system through upregulation of ATP binding cassette transporter (ABC)A1, a protein involved in macrophage lipid efflux. Further, IL-6 can inhibit other inflammatory cytokines. Based on its possible role in accelerating atherosclerosis, blockade of IL-6 action with the antibody tocalizumab, a treatment for rheumatoid arthritis and juvenile rheumatoid arthritis, has been evaluated as an atheroprotective agent, but studies are inconclusive. This review discusses multiple aspects of IL-6 effects on parameters related to development of atherosclerosis and highlights their manifestations in cell culture, murine models and human studies.
{"title":"Interleukin-6 in atherosclerosis: atherogenic or atheroprotective?","authors":"A. Reiss, Nicolle M. Siegart, J. De Leon","doi":"10.1080/17584299.2017.1319787","DOIUrl":"https://doi.org/10.1080/17584299.2017.1319787","url":null,"abstract":"ABSTRACT Interleukin-6 (IL-6) is a unique pleiotropic cytokine exhibiting both pro- and anti-inflammatory properties depending on the target cell type. Plasma IL-6 levels are associated with cardiovascular risk. IL-6 elevation in atherosclerosis results in effects on multiple cells involved in lipid processing and plaque formation. IL-6 is also the primary determinant of acute phase protein production. IL-6 has a number of properties that foster development of cardiovascular disease. These include activation of endothelial cells, pro-thrombotic effects on platelets and promotion of smooth muscle proliferation and macrophage lipid accumulation. Despite these overall unfavourable effect on cells involved in atheroma formation, IL-6 also has a positive impact on the lipid handling system through upregulation of ATP binding cassette transporter (ABC)A1, a protein involved in macrophage lipid efflux. Further, IL-6 can inhibit other inflammatory cytokines. Based on its possible role in accelerating atherosclerosis, blockade of IL-6 action with the antibody tocalizumab, a treatment for rheumatoid arthritis and juvenile rheumatoid arthritis, has been evaluated as an atheroprotective agent, but studies are inconclusive. This review discusses multiple aspects of IL-6 effects on parameters related to development of atherosclerosis and highlights their manifestations in cell culture, murine models and human studies.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"33 1","pages":"14 - 23"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75406918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2016.1274529
I. Miñambres, J. L. Sánchez-Quesada, Antonio Pérez
We appreciate the interest of Katsiki et al. [1] in our review entitled The Association of hypovitaminosis D and metabolic syndrome: current understanding, published in Clinical Lipidology [2].We c...
{"title":"Vitamin D deficiency and metabolic syndrome: any link with statin intolerance and adipokines dysregulation? A response","authors":"I. Miñambres, J. L. Sánchez-Quesada, Antonio Pérez","doi":"10.1080/17584299.2016.1274529","DOIUrl":"https://doi.org/10.1080/17584299.2016.1274529","url":null,"abstract":"We appreciate the interest of Katsiki et al. [1] in our review entitled The Association of hypovitaminosis D and metabolic syndrome: current understanding, published in Clinical Lipidology [2].We c...","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"20 1","pages":"7 - 7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74160386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1368913
Yi-Chung Shih, Huan Lin
ABSTRACT Background: Combining statins with ezetimibe synergistically enhances lipid lowering, thereby reducing the need to prescribe maximal statin doses to achieve low-density lipoprotein cholesterol (LDL-C) goals. Real-world data on concurrent ezetimibe + statin therapy in Asians are sparse. Therefore, we evaluated the effectiveness of a single combined tablet of ezetimibe + simvastatin 10.0 + 20.0 mg (EZE + SIM) in Taiwanese patients with hypercholesterolaemia. Methods: We analysed retrospective data from patients who received EZE + SIM at a community hospital in New Taipei City, Taiwan, took EZE + SIM continuously for ≥24 weeks, and had before and after lipid data. Outcomes including lipid lowering, LDL-C goal attainment and safety (non-lipid serum biochemistry), were compared between diabetic versus non-diabetic patients and subgroups prescribed different EZE + SIM doses. Results: Among 157 EZE + SIM users, more than half had diabetes (64.3%) and/or hypertension (52%) and 24.1% had coronary artery disease. A mean EZE + SIM dose of 6.5 + 13.0 (median 5.0 + 10.0) mg/day for a mean of 51.6 weeks, significantly reduced total cholesterol (−30.4%), LDL-C (−36.2%) and triglycerides (−14.5%); consequently, attainment rates of LDL-C ≤ 100 mg/dl and ≤70 mg/dl goals were significantly higher after EZE + SIM treatment. There were no clinically significant changes in biomarkers of hepatic or renal function. Consistent with other reports, we observed indications of greater lipid-lowering efficacy and LDL-C goal attainment among patients with diabetes versus those without, at equivalent EZE + SIM doses. Conclusions: Our findings affirm the lipid-lowering efficacy of single-tablet fixed-dose EZE + SIM in real-world Taiwanese-Chinese patients with hypercholesterolaemia, especially at the recommended dose. Trends towards greater efficacy in diabetic than non-diabetic patients suggest that EZE + SIM may be a rational choice for treating patients with hypercholesterolaemia and diabetes.
{"title":"Effectiveness of fixed-dose ezetimibe+simvastatin in real-life hypercholesterolaemia treatment: a retrospective observational study in Taiwan","authors":"Yi-Chung Shih, Huan Lin","doi":"10.1080/17584299.2017.1368913","DOIUrl":"https://doi.org/10.1080/17584299.2017.1368913","url":null,"abstract":"ABSTRACT Background: Combining statins with ezetimibe synergistically enhances lipid lowering, thereby reducing the need to prescribe maximal statin doses to achieve low-density lipoprotein cholesterol (LDL-C) goals. Real-world data on concurrent ezetimibe + statin therapy in Asians are sparse. Therefore, we evaluated the effectiveness of a single combined tablet of ezetimibe + simvastatin 10.0 + 20.0 mg (EZE + SIM) in Taiwanese patients with hypercholesterolaemia. Methods: We analysed retrospective data from patients who received EZE + SIM at a community hospital in New Taipei City, Taiwan, took EZE + SIM continuously for ≥24 weeks, and had before and after lipid data. Outcomes including lipid lowering, LDL-C goal attainment and safety (non-lipid serum biochemistry), were compared between diabetic versus non-diabetic patients and subgroups prescribed different EZE + SIM doses. Results: Among 157 EZE + SIM users, more than half had diabetes (64.3%) and/or hypertension (52%) and 24.1% had coronary artery disease. A mean EZE + SIM dose of 6.5 + 13.0 (median 5.0 + 10.0) mg/day for a mean of 51.6 weeks, significantly reduced total cholesterol (−30.4%), LDL-C (−36.2%) and triglycerides (−14.5%); consequently, attainment rates of LDL-C ≤ 100 mg/dl and ≤70 mg/dl goals were significantly higher after EZE + SIM treatment. There were no clinically significant changes in biomarkers of hepatic or renal function. Consistent with other reports, we observed indications of greater lipid-lowering efficacy and LDL-C goal attainment among patients with diabetes versus those without, at equivalent EZE + SIM doses. Conclusions: Our findings affirm the lipid-lowering efficacy of single-tablet fixed-dose EZE + SIM in real-world Taiwanese-Chinese patients with hypercholesterolaemia, especially at the recommended dose. Trends towards greater efficacy in diabetic than non-diabetic patients suggest that EZE + SIM may be a rational choice for treating patients with hypercholesterolaemia and diabetes.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"120 1","pages":"45 - 55"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87701318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2016.1268316
F. Spanoudi, E. Vassilatou, E. Maratou, P. Mitrou, E. Hatziagelaki, N. Papanas, G. Dimitriadis, V. Lambadiari
ABSTRACT Background: Although several studies have assessed the association between thyroid hormones and dyslipidaemia, whether influencing thyroid function improves the lipid profile in euthyroid diabetic patients has not been studied. Methods: Fasting lipids were assessed in 11 euthyroid, treatment naive patients with type 2 diabetes (T2DM) and a micronodular texture of the thyroid gland (age: 43 ± 3.8 years, body mass index (BMI) 27.5 ± 1.4 kg/m2, triiodothyronine (T3) 119 ± 5.7 ng/dl, thyroxine (T4) 8.13 ± 0.46 μg/dl, thyroid- stimulating hormone (TSH) 1.51 ± 0.14 μIU/ml, free thyroxine (FT4) 1.272 ± 0.047 ng/dl) before and after administration of 50 μg of T4 once daily for 2 months. A placebo was given to 11 age, sex and BMI-matched euthyroid, treatment naive patients with T2DM. Care was taken to avoid even subclinical hyperthyroidism. Results: TSH fell significantly post-treatment (1.51 ± 0.11 vs. 0.79 ± 0.11 μIU/ml, p < 0.0001), but remained within the reference range. Total cholesterol (212 ± 21 vs. 158 ± 10 mg/dl, p = 0.003), low-density lipoprotein cholesterol (146 ± 17 vs. 112 ± 9 mg/dl, p = 0.007), high density lipoprotein cholesterol (51 ± 4 vs. 40 ± 3 mg/dl p = 0.001), triglycerides (93 ± 13 vs. 72 ± 8 mg/dl, p = 0.015), apolipoprotein A1 (167 ± 15 vs. 127 ± 8 mg/dl, p = 0.004), apolipoprotein B (101 ± 13 vs. 72 ± 7 mg/dl, p = 0.009) and lipoprotein (a) (60 ± 15 vs. 41 ± 11 mg/dl p = 0.009) all fell significantly after T4 administration for 2 months. No changes were observed in the placebo group. Conclusions: Small doses of T4 administered to euthyroid patients with T2DM significantly improved lipid levels. This could contribute to a reduced risk of macrovascular complications.
背景:虽然有几项研究评估了甲状腺激素与血脂异常血症之间的关系，但影响甲状腺功能是否能改善甲状腺功能正常的糖尿病患者的血脂状况尚未得到研究。方法:禁食脂肪在11 euthyroid评估,天真的患者治疗2型糖尿病(T2DM)病人体内和甲状腺结节性结构(年龄:43±3.8年,身体质量指数(BMI) 27.5±1.4 kg / m2,三碘甲状腺氨酸(T3) 119±5.7毫微克/分升,甲状腺素(T4) 8.13±0.46μg / dl -刺激甲状腺激素(TSH) 1.51±0.14μ国际单位/毫升,游离甲状腺素(FT4) 1.272±0.047 ng / dl)之前和之后政府50μg的T4每天2个月一次。给11名年龄、性别和bmi匹配的甲状腺功能正常的T2DM患者服用安慰剂。注意甚至避免亚临床甲状腺功能亢进。结果:治疗后TSH显著下降(1.51±0.11 vs. 0.79±0.11 μIU/ml, p < 0.0001)，但仍在参考范围内。总胆固醇(212±21比158±10 mg / dl, p = 0.003),低密度脂蛋白胆固醇(146±17和112±9 mg / dl, p = 0.007),高密度脂蛋白胆固醇(51±4和40±3 mg / dl p = 0.001),甘油三酯(93±13和72±8 mg / dl, p = 0.015),载脂蛋白A1(167±15和127±8 mg / dl, p = 0.004),载脂蛋白B(101±13和72±7 mg / dl, p = 0.009)和脂蛋白(a)(60±15和41±11 mg / dl p = 0.009)所有T4管理2个月后下降明显。安慰剂组没有观察到任何变化。结论:小剂量T4给予甲状腺功能正常的T2DM患者可显著改善血脂水平。这可能有助于降低大血管并发症的风险。
{"title":"Short-term administration of a small thyroxine dose to euthyroid type 2 diabetic patients improves the fasting lipoprotein profile#","authors":"F. Spanoudi, E. Vassilatou, E. Maratou, P. Mitrou, E. Hatziagelaki, N. Papanas, G. Dimitriadis, V. Lambadiari","doi":"10.1080/17584299.2016.1268316","DOIUrl":"https://doi.org/10.1080/17584299.2016.1268316","url":null,"abstract":"ABSTRACT Background: Although several studies have assessed the association between thyroid hormones and dyslipidaemia, whether influencing thyroid function improves the lipid profile in euthyroid diabetic patients has not been studied. Methods: Fasting lipids were assessed in 11 euthyroid, treatment naive patients with type 2 diabetes (T2DM) and a micronodular texture of the thyroid gland (age: 43 ± 3.8 years, body mass index (BMI) 27.5 ± 1.4 kg/m2, triiodothyronine (T3) 119 ± 5.7 ng/dl, thyroxine (T4) 8.13 ± 0.46 μg/dl, thyroid- stimulating hormone (TSH) 1.51 ± 0.14 μIU/ml, free thyroxine (FT4) 1.272 ± 0.047 ng/dl) before and after administration of 50 μg of T4 once daily for 2 months. A placebo was given to 11 age, sex and BMI-matched euthyroid, treatment naive patients with T2DM. Care was taken to avoid even subclinical hyperthyroidism. Results: TSH fell significantly post-treatment (1.51 ± 0.11 vs. 0.79 ± 0.11 μIU/ml, p < 0.0001), but remained within the reference range. Total cholesterol (212 ± 21 vs. 158 ± 10 mg/dl, p = 0.003), low-density lipoprotein cholesterol (146 ± 17 vs. 112 ± 9 mg/dl, p = 0.007), high density lipoprotein cholesterol (51 ± 4 vs. 40 ± 3 mg/dl p = 0.001), triglycerides (93 ± 13 vs. 72 ± 8 mg/dl, p = 0.015), apolipoprotein A1 (167 ± 15 vs. 127 ± 8 mg/dl, p = 0.004), apolipoprotein B (101 ± 13 vs. 72 ± 7 mg/dl, p = 0.009) and lipoprotein (a) (60 ± 15 vs. 41 ± 11 mg/dl p = 0.009) all fell significantly after T4 administration for 2 months. No changes were observed in the placebo group. Conclusions: Small doses of T4 administered to euthyroid patients with T2DM significantly improved lipid levels. This could contribute to a reduced risk of macrovascular complications.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"101 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77401335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1333206
V. Athyros, N. Katsiki, C. Mantzoros
{"title":"Non-alcoholic fatty liver disease in South and South-east Asians living in Western Countries: a major health problem calling for action","authors":"V. Athyros, N. Katsiki, C. Mantzoros","doi":"10.1080/17584299.2017.1333206","DOIUrl":"https://doi.org/10.1080/17584299.2017.1333206","url":null,"abstract":"","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"97 1","pages":"40 - 42"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74164750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1080/17584299.2017.1326709
K. Neukam, S. Bhagani, A. Rodger, J. Oben, Divyabala Nirmal, Anjly Jain, D. Nair
ABSTRACT Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) among Indian Asians in high-income countries is not well studied, but appears to be different from that for Western populations. Design: Cross-sectional study of subjects recruited through a community cardiovascular (CV) screening programme at two London Hindu temples from 2010–2012. NAFLD was diagnosed using the fatty liver index (FLI) and fibrosis stage through the BARD (Body Mass Index (BMI), Aspartate aminotransferase to Alanine aminotransferase ratio and Diabetes Mellitus) score. Results: 597 subjects were assessed; 306 (51%) female. Median (interquartile range) age and BMI were 49 (40.6–55.0) years and 26.4 (23.5–29.2) kg/m2, respectively. NAFLD was diagnosed in 184 (30.8%) cases, but 175 (29.3%) subjects could not be categorised. Overall, 117 (40.2%) men and 67 (21.9%) women had evidence of NAFLD (p < 0.001). In those with evidence of NAFLD, 142 (78.5%) had a BARD score suggestive of advanced fibrosis. Advanced fibrosis could be excluded in 5 (7.6%) women and 34 (29.6%) men (p < 0.001). Total cholesterol (TC), triglycerides (TG) and non-HDL (high-density lipoprotein cholesterol) were higher in the NAFLD group (p < 0.001), whereas HDL-C was lower (p < 0.001). Conclusion: There is evidence of a high prevalence of asymptomatic NAFLD, possibly in combination with advanced liver damage, among UK-based Gujarati Indians living in London. NAFLD is emerging as an independent risk factor for CV disease. Screening programmes should be developed in order to decrease liver and CV mortality and morbidity in these high-risk patients.
{"title":"High prevalence of non-alcoholic fatty liver disease (NAFLD) among Gujarati Indians in North London: a population-based study","authors":"K. Neukam, S. Bhagani, A. Rodger, J. Oben, Divyabala Nirmal, Anjly Jain, D. Nair","doi":"10.1080/17584299.2017.1326709","DOIUrl":"https://doi.org/10.1080/17584299.2017.1326709","url":null,"abstract":"ABSTRACT Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) among Indian Asians in high-income countries is not well studied, but appears to be different from that for Western populations. Design: Cross-sectional study of subjects recruited through a community cardiovascular (CV) screening programme at two London Hindu temples from 2010–2012. NAFLD was diagnosed using the fatty liver index (FLI) and fibrosis stage through the BARD (Body Mass Index (BMI), Aspartate aminotransferase to Alanine aminotransferase ratio and Diabetes Mellitus) score. Results: 597 subjects were assessed; 306 (51%) female. Median (interquartile range) age and BMI were 49 (40.6–55.0) years and 26.4 (23.5–29.2) kg/m2, respectively. NAFLD was diagnosed in 184 (30.8%) cases, but 175 (29.3%) subjects could not be categorised. Overall, 117 (40.2%) men and 67 (21.9%) women had evidence of NAFLD (p < 0.001). In those with evidence of NAFLD, 142 (78.5%) had a BARD score suggestive of advanced fibrosis. Advanced fibrosis could be excluded in 5 (7.6%) women and 34 (29.6%) men (p < 0.001). Total cholesterol (TC), triglycerides (TG) and non-HDL (high-density lipoprotein cholesterol) were higher in the NAFLD group (p < 0.001), whereas HDL-C was lower (p < 0.001). Conclusion: There is evidence of a high prevalence of asymptomatic NAFLD, possibly in combination with advanced liver damage, among UK-based Gujarati Indians living in London. NAFLD is emerging as an independent risk factor for CV disease. Screening programmes should be developed in order to decrease liver and CV mortality and morbidity in these high-risk patients.","PeriodicalId":55252,"journal":{"name":"Clinical Lipidology","volume":"25 1","pages":"33 - 39"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74105288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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