Розрахункові параметри ліпідоґрами: сучасні погляди та кореляції з лабораторно-інструментальними показниками

Background & objectives: Atherogenic indices provide a broad picture of the risk of cardiovascular disease (CVD) in people with type 2 diabetes mellitus (T2DM). A broad range of factors influence atherogenic index values. Given the low-grade inflammatory characteristic of T2DM, we assessed three proteins in T2DM patients: 1-aminocyclopropane-1-carboxylate synthase (ACS), granulocyte-colony stimulating factor (G-CSF), and Mothers Against Decapentaplegic Homolog-4 (SMAD-4), and their association with the atherogenic indices. Methodology: The current case-control research included sixty T2DM patients with no severe complications and thirty healthy controls. The chosen proteins were quantified using the ELISA technique, while the remaining biomarkers were measured using a spectrophotometer. Results: T2DM patients exhibited significantly greater levels of ACS, G-CSF, and SMAD4 compared to control participants. After adjusting for all cofounders, serum ACS level may accurately predict a considerable portion of changes in the atherogenic index of plasma (AIP) and Castelli risk index (CRI)-I and II. AIP, CRI-II, and the atherogenic coefficient can all predict serum SMAD4 levels. Glucose levels may predict the amount of inflammatory cytokine (G-CSF), demonstrating that inflammation is dependent on hyperglycemia. Conclusion. T2DM patients had dyslipidemia, high atherogenic indices, and greater levels of SMAD4, ACS, and G-CSF compared to controls. Once confounders are accounted for, serum ACS levels are proven to be a significant predictor of atherogenic indices. These findings contribute to our understanding of these proteins and their role in T2DM consequences including CVD. Abbreviations: ACS - 1-aminocyclopropane-1-carboxylate synthase; AIP - atherogenic index of plasma; CRI - Castelli risk index; G-CSF - granulocyte-colony stimulating factor; SMAD-4 - Mothers Against Decapentaplegic Homolog-4 Keywords: Atherogenic Index; SMAD4; ACS; G-CSF; T2DM Citation: Abdulsaheb YS, Abdalsada HK, Moustafa SR, Al-Hakeim HK. The atherogenic indices in people with type 2 diabetes mellitus are predicted by serum levels of SMAD4, ACS, and G-CSF. Anaesth. pain intensive care 2024;29(1):21−31; DOI: 10.35975/apic.v29i1.2659 Received: April 18, 2024; Reviewed: April 19, 2024; Accepted: April 20, 2024

Effects of second-generation antipsychotics and long-term atherogenic indices trajectories on metabolic syndrome in patients with schizophrenia.

Background/Objectives: Diabetes is major metabolic disorder and rapidly increasing public health problem globally. The greatest way to reduce diabetic complications is adequate knowledge about the condition. Hence, the primary objectives of this study were to evaluate the psychometric properties of the Simplified Diabetes Knowledge Test-Arabic version (SDKT-A) among Iraqi insulin-dependent diabetic patients. Additionally, the secondary objectives were to assess the associated independent variables and the risk of atherosclerosis and cardiovascular risk event by using atherogenic indices and lipid ratios with the SDKT-A. Methods: A cross-sectional, descriptive study was conducted in primary healthcare clinics. The SDKT was translated into Arabic using forward-backward translation, reconciliation, and pilot testing. Thereafter, psychometric properties of the SDKT-A were evaluated depending on different criteria. Atherogenic indices of Castelli risk indices I and II (CRI-I and II), triglyceride/HDL ratio, non-HDL-C ratio, atherogenic coefficient (AC), and triglyceride-total cholesterol-body weight index (TCBI) were calculated using specific formulas. Results: The SDKT-A questionnaire showed acceptable readability and validity. Cronbach's alpha test (95% confidence interval) was 0.662 (0.59-0.73). The Pearson correlation coefficient of reliability for test-retest was found to be 0.659. The item difficulty index for most items was between 0.237 and 0.877. The point biserial correlation values ranged from 0.028 to 0.535 with Ferguson's sigma value equal to 0.962. The content validation results showed a significant content validity ratio (CVR) value for most of the questions, ranging from 0.8 to 1. The content validity index (CVI) value for SDKT-A was found to be 0.98, which showed good agreement between experts. In addition, the exploratory factor analysis with promax rotation identified four domains for the final 20 items of the SDKT-A that explained 41.83% of the scale total variance. The mean score of the SDKT-A was 11.09 ± 3.40. The total score of the SDKT-A was positively and significantly correlated with education level (r = 0.322, p < 0.01). In addition, the total scores of the SDKT-A were negatively and significantly correlated with glycemic control, age, CRI-I, CRI-II, triglyceride/HDL ratio, AC, non-HDL-C ratio, and TCBI. Furthermore, the glycemic control (HbA1c) was positively and significantly correlated with the preventive measures factor (r = 0.175, p < 0.05), and were negatively and significantly correlated with the lifestyle and modification factor (r = -0.169, p < 0.05), diet and monitoring factor (r = -0.158, p < 0.05), and awareness factor (r = -0.149, p < 0.05). Conclusions: This study showed acceptable psychometric properties for the SDKT-A, with low levels of knowledge of diabetic disease in the sample population. Finally, comprehensive and interactive educational programs regarding lifestyle and modification, diet, and monitoring and awareness in primary healthcare centers in Iraq are warranted.

Cardiovascular disease (CVD) risk factors, and particularly decreased high density lipoprotein cholesterol (HDL-C) dyslipidemia are prevalent in Assam, India. This study was undertaken to investigate whether Apolipoprotein A-I (APOA1) gene polymorphisms (G-75A and C+83T) were associated with i) the risk for decreased HDL-C, and ii) other CVD risk factors, viz. serum lipids, atherogenic indices, obesity, and blood pressure (BP). A total of 649 subjects were screened, from which 200 eligible individuals, classified as case group with decreased HDL-C levels (100 subjects) and control group with normal HDL-C levels (100 subjects) were enrolled and genotyped using polymersase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing. Lipid fractions [HDL-C, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), triglycerides (TG)] and atherogenic indices [Castelli’s Risk Indices-I and -II (CRI-I and -II), non-HDL-C fraction, atherogenic index of plasma (AIP), atherogenic coefficient (AC)] were estimated. The G-75A and C+83T loci were not associated with decreased HDL-C risk. This was confirmed across different genetic models (dominant, recessive, additive and allelic). Association was also absent with BP and obesity. However, the G-75A locus was associated with LDL-C, whereas the C+83T locus was associated with TG and VLDL-C. Furthermore, these sites had effects on atherogenic indices. The rare A allele at the G-75A locus was associated with adverse CRI-I, CRI-II, non-HDL-C and AC values, while the major C allele at the C+83T locus was associated with adverse AIP values. Thus, the pro-atherogenic G-75A polymorphism and the anti-atherogenic C+83T polymorphism represent important genetic loci that modulate CVD risk factors in subjects from Assam.

Aim: This study investigated the effects of e-waste occupational exposure on lipid profile and atherogenic indices in Waste Electrical and Electronic Workers in South-South Nigeria. Matrials and methods: Whole blood levels of lead and cadmium were analyzed using ICPMS (Inductively Coupled Plasma Mass Spectrometry). Total serum cholesterol (TC), high density lipoprotein (HDL) cholesterol and triglycerides (TG) were determined using spectrophotometric method. Low density lipoprotein (LDL) cholesterol value was calculated by the Friedewald equation using analyzed values of TC, HDL cholesterol and TG. Atherogenic index of plasma (AIP) was calculated as log TG/HDLc, atherogenic coefficient (AC) as [(TC-HDLc)/HDLc], Castelli risk index (CRI-1) as (TC/HDLc) and CRI-II as (LDLc/HDLc). Results: Total cholesterol, LDL cholesterol, AC, CRI-1 and CRI-11 significantly increased in the e-waste exposed participants compared to the unexposed group. Significant positive correlations between lead and cadmium, cadmium and total cholesterol as well as between cadmium and LDL-cholesterol were observed Conclusion: Occupational exposure to e-waste borne chemicals may cause changes in lipid levels and increase risk of cardiovascular disease in the Nigerian e-waste workers included in the present study. The level of artisanal involvement in crude e-waste reprocessing should be considered critical in cardiovascular health risk assessment.

Considering the close link between metabolic syndrome (MetSyn) and cardiovascular diseases, considerable attention has been devoted to the identification of their shared underlying pathological mechanisms in recent decades. This study aimed to investigate the association between pro-inflammatory factors and newly-diagnosed MetSyn. This case-control study recruited obese and nonobese individuals who were newly diagnosed with MetSyn (cases, n = 84) and healthy individuals (controls, n = 83). The medical and sociodemographic data of the participants were collected on enrollment. Serum analysis was performed to ascertain the concentrations of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), fasting blood sugar (FBS), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and atherogenic coefficient (AC). Multiple regression analysis was carried out to explore the relationship between inflammatory markers and AC with MetSyn odds. The Pearson correlation test was also performed to investigate the correlations between metabolic and inflammatory parameters. Positive relationships were observed between the serum levels of TNF-α and CRP with the odds of MetSyn following controlling for confounders (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI]: 1.01 - 1.72; AOR = 1.29; 95% CI: 1.18 - 1.41; respectively, P ≤ 0.03). Additionally, higher AC was accompanied by increased odds of MetSyn (AOR = 1.98; 95% CI: 1.31 - 2.98; P = 0.001). The Pearson correlation analysis also showed positive correlations between TNF-α levels and serum metabolic abnormalities, including elevated LDL-C, FBS, and AC and lowered HDL-C levels (P ≤ 0.02). The present results revealed that higher serum concentrations of pro-inflammatory and atherogenic indices, including CRP, TNF-α, and AC, might be associated with elevated odds of newly diagnosed MetSyn regardless of potential confounders, particularly body mass index. The obtained findings might be moderated by the positive correlations observed between serum TNF-α, as the chronic inflammatory state indicator, and impaired lipid and glycemic markers.

Introduction. The development of diagnostic techniques of diabetes mellitus microvascular complications is an urgent task. One such method is laser Doppler flowmetry (LDF). Purpose was to analyze the correlations of clinical and laboratory parameters and LDF spectral parameters in patients with type 2 diabetes mellitus. Materials and methods. The study involved 50 patients with type 2 diabetes and diabetic foot syndrome. Microcirculation was assessed using the BIOPAC LDF 100C system. In parallel, monitoring of transcutaneous oximetry in the probed area was carried out using the TCM400 device. For correlation analysis, the Spearman correlation coefficient was used. Results. While studying, a positive correlation was noted between the contribution of pulse fluctuations and the duration of diabetes (p&lt;0.05). For the level of glycosylated hemoglobin, it was positively correlated with the value of the contribution of pulsed fluxmotions and negatively correlated with the contribution of low-frequency fluxmotions and the fluxmotion index (p&lt;0.05). When assessing transcutaneous oxygen tension, a negative correlation was found with the value of the contribution of pulse fluxmotions (p&lt;0.05). These correlations can be explained in the light of modern concepts of the pathogenesis of type 2 diabetes mellitus microvascular complications. Conclusion. In the course of the work, spectral parameters of LDF were found correlated with clinical, laboratory, and instrumental parameters. The dynamics of changes in LDF parameters corresponds to the ideas about the pathogenesis of diabetic microangiopathy. A promising direction for further research is the study of the progressive development of diabetic microangiopathy and the role of individual pathogenetic factors in this process.

BackgroundDue to the contribution of coronary artery disease (CAD) to serious cardiovascular events, determining biomarkers that could robustly predict its risk would be of utmost importance. Thus, this research was designed to assess the value of traditional cardio-metabolic indices, and more novel atherogenicity indices and insulin resistance surrogate markers in the identification of individuals at risk of CAD.MethodsA case‒control survey was conducted, in which 3085 individuals were enrolled. Their clinical and biochemical data were gathered at baseline. The investigated indices included the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), lipoprotein combine index (LCI), cholesterol index (CHOLINDEX), Castelli’s risk indices-I, II (CRI-I, CRI-II), and metabolic score for insulin resistance (METS − IR). To examine the relationship between these variables and CAD risk, multiple regression analyses adjusted for potential confounders were conducted.ResultsOverall, 774 angiographically confirmed CAD patients (mean age = 54 years) were compared with 3085 controls (mean age = 51 years). Higher triglyceride, total cholesterol and fasting blood sugar levels and lower HDL-C levels were related to an elevated risk of CAD (P-for-trend < 0.001), while the direct association between increased serum LDL-C concentrations and a greater risk of CAD only became apparent when excluding those with diabetes, and statin users. Among novel indices, greater values of the majority of these markers, including AIP, CRI-I, and -II, CHOLINDEX, LCI, and TyG-index, in comparison to the lower values, significantly elevated CAD risk (P-for-trend < 0.001).ConclusionAccording to the current findings, novel atherogenicity indices and insulin resistance surrogate markers, in particular, AIP, CRI-I and II, CHOLINDEX, LCI, and TyG-index, may be useful in predicting CAD risk.

Aside from the ordinary plasma lipid level measurements, the ratios based on individual plasma lipid levels such as atherogenic index of plasma (AIP), Castelli’s risk index 1/2 (CRI-1/2), and atherogenic coefficient (AC) are the novel parameters to evaluate the patients with a high risk of CVD. In this study, we aim to evaluate the relationship between AIP, AC, and CRI-1/2 with increased risk of ED. Between April 2018 and February 2019, 253 patients, who were diagnosed as a vasculogenic ED in our clinic, were enrolled in the study. While the first group (n = 134) consisted of patients with moderate and mild ED (IIEF-EF: 17–30), the second group (n = 119) consisted of patients with severe ED. In addition to the mean values of lipid parameters; CRI-1 (total cholesterol/HDL), CRI-2 (LDL/HDL) AIP (log10(triglycerides/HDL), and AC (non-HDL/HDL) were calculated. The mean age was 44.02 ± 10.41 (24–70), and the mean BMI was 27.80 ± 4.12 (18.52 ± 41.97). However, CRI-1 and AIP values were found to be higher in the severe ED group compared to the mild ED group (CRI-1: 4.50 ± 1.47, 4.88 ± 1.30; p = .039; AIP: 0.489 ± 0.315, 0.617 ± 0.283; p = .007). Our results demonstrated that CR-1 and AIP have a positive correlation with the severity of ED. Moreover, we can suggest that patients with higher CR-1 and AIP values are likely to have more severe ED in the future.

Lung ultrasound to detect cardiopulmonary interactions in acutely ill children.

Atherogenic Combined Index: Validation of a Coronary Artery Disease Predictive Biomarker

Background/Objectives: Habitual dietary changes that could help reduce the potential consequences of excessive body mass, such as hyperlipidemia and increased cardiovascular disease risk, are needed. The aim of this study is to assess the impact of a farmed-salmon-based dietary intervention on lipid profile parameters in young women with excessive body mass. Methods: The 8-week intervention involved 38 pair-matched women aged 18–30 years with excessive body weight defined as BMI ≥ 25.0 kg/m2. Participants were randomly assigned to the intervention (200 g of smoked salmon weekly) or the control group. Lipid profile parameters (total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TAG)), as well as atherogenic indices (Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Cholesterol Index (Cholindex), Castelli Risk Index 1 (CRI-1), Castelli Risk Index 2 (CRI-2) and the TAG/HDL ratio) were assessed before, during, and after the intervention. Results: At baseline, 47% of participants had at least one of the lipid profile parameters outside the recommended range. No statistically significant differences were observed in the TC, HDL, non-HDL, LDL, or TAG concentrations or in the various atherogenic indices between the intervention and the control group after the 8-week-long intervention. However, differences in the change of the LDL concentration were noted, with a decrease of 8.2 ± 20.7 mg/dL in the intervention group compared to an increase of 9.5 ± 20.0 mg/dL in the control group (p = 0.011), as well as in the change of the Cholindex for which a median decrease of 4.4 mg/dL was noted in the intervention group, while a median increase of 0.8 mg/dL in the control group was observed (p = 0.040). Additionally, across participants with a waist-to-height ratio (WHtR) greater than 0.5, an increase of 50.0 ± 68.3 mg/dL in the intervention group and a decrease of 8.6 ± 56.6 mg/dL in the control group was noted for the TAG concentration change (p = 0.040). Conclusions: Concerning the observed beneficial influence of increasing farmed salmon intake to the recommended fish-intake amounts on decreasing LDL and Cholindex in young women with excessive body weight after 8 weeks, it seems that such a diet alteration might be recommended for this group to decrease their risk of cardiovascular disease in the future. Nonetheless, regarding the diverse influence on TAG, further studies are needed to assess the influence of increasing the intake of fatty fish available on the market at present on human health.

Food grains' ability to promote health is widely recognized as a result of their rich nutritional profile and presence of antioxidants. The present study aimed to investigate the antioxidant, antidyslipidemic, and cardiac risk preventive effects of unpolished whole rice extracts of Keteki and Kola Joha of Assam, India, and to profile the polyphenolic compounds present. Whole unpolished rice samples were extracted with ethanol and the efficacy of the extract of both rice cultivars was evaluated against high-fat and high-sugar induced hyperlipidemia in rats. The effects of extracts on lipid profile, hepatic enzyme, endogenous antioxidants, lipid peroxidation, creatine kinase-NAC, lactate dehydrogenase, C-reactive protein and lipoprotein(s) were evaluated. Atherogenic indices were calculated to find the effect of the extract on cardiac risk. HPLC analysis of whole unpolished rice samples was also carried out to profile the polyphenolics present. HPLC analysis revealed the presence of gallic acid, vanillic acid, caffeic acid, sinapic acid, o-coumaric acid, t-coumaric acid, rosamarinic acid, chlorogenic acid, phytic acid in both rice samples. Protocatechuic acid, syringic acid, and p-coumaric acid were detected in keteki joha, and ferulic acid was detected in kola joha only. Ethanol extracts (200 and 400 mg/kg) of both rice varieties for 30 days significantly averted dyslipidemia, preserved the level of endogenous antioxidants, and prevented lipid peroxidation. Levels of creatine kinase-NAC, lactate dehydrogenase, Creactive protein, and lipoprotein (a) were significantly (P < 0.01) less in the extract-treated group compared to the disease-control group. Extract treatment enhanced ApoA1 level while the reduced level of ApoB. ApoB/ApoA1 ratio was found more in the disease control group, which was significantly reduced in the extract-treated group. The atherogenic index, atherogenic coefficient, and cardiac risk ratio were reduced, while the cardioprotective index was enhanced in treatment groups. This paper profiled polyphenolic compounds for the first time. Keteki joha exhibited better results than Kola joha. Observations offer novel insights into the hypothesis for the first time that unpolished Keteki and Kola Joha rice can be beneficial in averting hyperlipidemia and its associated coronary events.

The aim of this study is to evaluate blood lipid parameters and level of atherogenic indices in acquired premature ejaculation (PE) patients. Between 2020 January and June 2020, 96 patients diagnosed with PE in our clinic and 84 control patients who applied to the urology outpatient clinic for other urological reasons were included in the study. Detailed medical and sexual histories of the patients were taken, and physical examination findings were recorded. In addition, 5-question premature ejaculation diagnostic tool (PEDT) was applied to patients and estimated intravaginal ejaculation latency times (IELT) were recorded. The mean values of lipid parameters; Risk Index of Castelli-1 (CRI-1 (Total cholesterol/ HDL)), CRI-2 (LDL/ HDL), Atherogenic Index of Plasma (AIP (log10 (triglyceride/ HDL)) and Atherogenic Coefficient (AC (HDL/ non-HDL)) were calculated. The average PEDT score was 7.68+5.05 (2-22), and the IELT arithmetic mean was 150.39+121.53 (5-900) seconds. In the APE group, triglyceride and AIP values were found to be higher than the control group (triglyceride: 188.75+76.39 versus 157.20+87.45; p=.049; AIP: 0.46+0.33 versus 0.35+0.35; p=.040). A fair positive correlation was found between PEDT scores and AIP values (r=.355, p<.001). AIP was found to be related to APE, and it was also found to be related to symptom severity.

Polycystic ovary syndrome (PCOS) contributes to endocrine and metabolic complications for women worldwide. The aim of this study was to establish the usefulness of new anthropometric indices and atherogenic indices in the evaluation of metabolic disorders, in particular, glucose and insulin abnormalities in the profiles of women with polycystic ovary syndrome (PCOS). In the study, a total of 49 women with PCOS aged between 18 and 39 years were recruited. All patients were tested for fasting glucose and insulin, lipid parameters, oral-glucose administration, and biochemical parameters. All of them underwent anthropometric measurements, such as BMI (body mass index), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), BAI (body adiposity index), VAI (visceral adiposity index), LAP (lipid accumulation product), BRI (body roundness index), ABSI (A body shape index), AIP (atherogenic risk of plasma), AC (atherogenic coefficient), Castelli risk index-I, Castelli risk index-II and (LCI) lipoprotein combine index, TG/HDL-C ratio, METS-IR (The metabolic score of insulin resistance), triglyceride glucose index (TyG index), triglyceride glucose-body mass index (TyG-BMI index) and triglyceride glucose-waist circumference index (TyG-WC index) were calculated. The analyzed anthropometric measurements/indices and atherogenic indices demonstrated significant correlations in PCOS women. T A strong relationship was found between fasting glucose, fasting insulin, glucose after 60 min, HOMA-IR index in the patients with PCOS. There was no significant relationship between HbA1c and other analyzed parameters and indices. Most of the analyzed anthropometric and atherogenic indices may be useful tools in evaluating metabolic disorders, and, in particular, glucose and insulin abnormalities in PCOS women.