Background: We tried to understand some undetermined missions of cholesterol and triglycerides (TG) in the plasma in patients with the sickle cell diseases (SCD). Methods: All patients with the SCD and age and gender-matched control cases were included into the study. Results: We studied 363 patients with the SCD (194 males) and 255 control cases (136 males), totally. Mean ages of the SCD patients were similar in males and females (31.1 vs. 31.0 years, respectively, P > 0.05). Although the body weight and body mass index (BMI) were significantly suppressed in the SCD patients (59.9 vs. 71.5 kg and 21.9 vs. 25.6 kg/m2, respectively, P = 0.000 for both), the body heights were similar in both groups (164.9 vs. 167.0 cm, P > 0.05). Parallel to the suppressed mean body weight and BMI, fasting plasma glucose (92.8 vs. 97.6 mg/dL, P = 0.005), total cholesterol (121.4 vs. 165.0 mg/dL, P = 0.000), low-density lipoproteins (70.4 vs. 102.4 mg/dL, P = 0.000), and high-density lipoproteins (26.0 vs. 39.6 mg/dL, P = 0.000) values were all suppressed in the SCD patients, significantly. Similarly, both systolic (115.2 vs. 122.6 mmHg, P = 0.000) and diastolic blood pressure (73.0 vs. 86.6 mmHg, P = 0.000) were also suppressed in them, significantly. Interestingly, only the plasma TG were increased in the SCD patients (129.4 vs. 117.3 mg/dL, P = 0.000), significantly. Similarly, mean alanine aminotransferase value was not suppressed in them, too (27.4 vs. 27.3 U/L, P > 0.05). Conclusion: Cholesterol may be a negative whereas TG positive acute phase reactants in the plasma.
Co relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Pati...ijtsrd
Pulmonary hypertension PH in sickle cell disease SCD is an emerging and important clinical problem. In a single institution adult cohort of 75 patients, we investigated lipid and lipoprotein levels and their relationship to markers of intravascular hemolysis, vascular dysfunction and PH. In agreement with prior studies, we confirm significantly decreased plasma levels of total cholesterol, high density lipoprotein cholesterol HDL C , and low density lipoprotein cholesterol LDL C in SCD vs. ethnically matched healthy controls. Several cholesterol parameters correlate significantly with markers of anemia, but not endothelial activation or PH. More importantly, serum triglyceride levels are significantly elevated in SCD compared to controls. Elevated triglyceride levels correlate significantly with markers of hemolysis lactate dehydrogenase and arginase both p 0.0005 , endothelial activation soluble E selectin, p 0.0001 soluble P selectin, p=0.02 soluble vascular cell adhesion molecule 1, p=0.01 , inflammation leukocyte count, p=0.0004 erythrocyte sedimentation rate, p=0.02 and PH amino terminal brain natriuretic peptide, p=0.002 prevalence of elevated tricuspid regurgitant velocity TRV , p 0.001 . In a multivariate analysis, triglyceride levels correlate independently with elevated TRV p=0.002 . Finally, forearm blood flow studies in adult patients with SCD demonstrate a significant association between increased triglyceride HDL C ratio and endothelial dysfunction p 0.05 . These results characterize elevated plasma triglyceride levels as a potential risk factor for PH in SCD. Dr. Prafull Dawale | Neha Jain "Co-relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Patients for Local Area of Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42438.pdf Paper URL: https://www.ijtsrd.commedicine/other/42438/corelation-of-lipid-profile-with-proteinuria-in-sickle-cell-nephropathy-patients-for-local-area-of-chhattisgarh/dr-prafull-dawale
30-RELETIONSHIP OF NITRIC (DR SADIA ISHAQUE) 607-611Aziza Qadeer
This document summarizes a study that examined the relationship between nitric oxide levels and other risk factors for hypertension. The study measured serum levels of nitric oxide, lipids, and estradiol in 42 hypertensive patients and 35 normal controls. It found that hypertensive patients had higher cholesterol, LDL, and triglycerides, but lower HDL, nitric oxide, and estradiol levels compared to controls. Nitric oxide levels correlated negatively with cholesterol, LDL, and triglycerides but positively with HDL. This suggests nitric oxide levels are strongly related to blood lipid levels in hypertensive patients.
Association of cardio metabolic risk factors, serum nitric oxide metabolite a...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
HDL-cholesterol concentrations are inversely associated with CVD.When we consider cardiovascular mortality in women in terms of HDL.Causes of low HDL cholesterol.Lipoprotein subfractions suffer a shift after menopause towards a more atherogenic lipid profile.associations of HDL-C and HDL-P with cIMT and CHD.MESA (Multi-Ethnic Study of therosclerosis. Functional Versus Dysfunctional HDL. High concentrations of HDL - cholesterol are associated with high all-cause mortality in men and women.Improvement of HDL function without necessarily raising HDL-C
A comparative study for some atherogenic indices in sera ofAlexander Decker
This document summarizes a study that evaluated lipid profiles and atherogenic indices in patients with myocardial infarction (MI), ischemic heart disease (IHD), and a control group. The study found:
1) Levels of total cholesterol and triglycerides did not significantly differ between MI/IHD patients and controls, while LDL cholesterol was significantly higher in MI/IHD patients.
2) VLDL cholesterol was significantly lower in MI patients and lower in IHD patients compared to controls.
3) Atherogenic indices like cardiogenic risk ratio, atherogenic coefficient, and atherogenic index of plasma were significantly higher in MI patients compared to controls, but only non-significantly higher in IHD
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
Co relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Pati...ijtsrd
Pulmonary hypertension PH in sickle cell disease SCD is an emerging and important clinical problem. In a single institution adult cohort of 75 patients, we investigated lipid and lipoprotein levels and their relationship to markers of intravascular hemolysis, vascular dysfunction and PH. In agreement with prior studies, we confirm significantly decreased plasma levels of total cholesterol, high density lipoprotein cholesterol HDL C , and low density lipoprotein cholesterol LDL C in SCD vs. ethnically matched healthy controls. Several cholesterol parameters correlate significantly with markers of anemia, but not endothelial activation or PH. More importantly, serum triglyceride levels are significantly elevated in SCD compared to controls. Elevated triglyceride levels correlate significantly with markers of hemolysis lactate dehydrogenase and arginase both p 0.0005 , endothelial activation soluble E selectin, p 0.0001 soluble P selectin, p=0.02 soluble vascular cell adhesion molecule 1, p=0.01 , inflammation leukocyte count, p=0.0004 erythrocyte sedimentation rate, p=0.02 and PH amino terminal brain natriuretic peptide, p=0.002 prevalence of elevated tricuspid regurgitant velocity TRV , p 0.001 . In a multivariate analysis, triglyceride levels correlate independently with elevated TRV p=0.002 . Finally, forearm blood flow studies in adult patients with SCD demonstrate a significant association between increased triglyceride HDL C ratio and endothelial dysfunction p 0.05 . These results characterize elevated plasma triglyceride levels as a potential risk factor for PH in SCD. Dr. Prafull Dawale | Neha Jain "Co-relation of Lipid Profile with Proteinuria in Sickle Cell Nephropathy Patients for Local Area of Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42438.pdf Paper URL: https://www.ijtsrd.commedicine/other/42438/corelation-of-lipid-profile-with-proteinuria-in-sickle-cell-nephropathy-patients-for-local-area-of-chhattisgarh/dr-prafull-dawale
30-RELETIONSHIP OF NITRIC (DR SADIA ISHAQUE) 607-611Aziza Qadeer
This document summarizes a study that examined the relationship between nitric oxide levels and other risk factors for hypertension. The study measured serum levels of nitric oxide, lipids, and estradiol in 42 hypertensive patients and 35 normal controls. It found that hypertensive patients had higher cholesterol, LDL, and triglycerides, but lower HDL, nitric oxide, and estradiol levels compared to controls. Nitric oxide levels correlated negatively with cholesterol, LDL, and triglycerides but positively with HDL. This suggests nitric oxide levels are strongly related to blood lipid levels in hypertensive patients.
Association of cardio metabolic risk factors, serum nitric oxide metabolite a...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
HDL-cholesterol concentrations are inversely associated with CVD.When we consider cardiovascular mortality in women in terms of HDL.Causes of low HDL cholesterol.Lipoprotein subfractions suffer a shift after menopause towards a more atherogenic lipid profile.associations of HDL-C and HDL-P with cIMT and CHD.MESA (Multi-Ethnic Study of therosclerosis. Functional Versus Dysfunctional HDL. High concentrations of HDL - cholesterol are associated with high all-cause mortality in men and women.Improvement of HDL function without necessarily raising HDL-C
A comparative study for some atherogenic indices in sera ofAlexander Decker
This document summarizes a study that evaluated lipid profiles and atherogenic indices in patients with myocardial infarction (MI), ischemic heart disease (IHD), and a control group. The study found:
1) Levels of total cholesterol and triglycerides did not significantly differ between MI/IHD patients and controls, while LDL cholesterol was significantly higher in MI/IHD patients.
2) VLDL cholesterol was significantly lower in MI patients and lower in IHD patients compared to controls.
3) Atherogenic indices like cardiogenic risk ratio, atherogenic coefficient, and atherogenic index of plasma were significantly higher in MI patients compared to controls, but only non-significantly higher in IHD
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
Correlations between Some Anthropometric Parameters, the Lipid Profile and Gl...inventionjournals
This document summarizes a study that investigated correlations between anthropometric parameters, lipid profiles, and glycated hemoglobin levels in 212 Bulgarian women with type 2 diabetes mellitus (T2DM) divided into two age groups, 40-60 years and 61-80 years. The study found moderate negative correlations between body mass index (BMI) and glycated hemoglobin in the younger group, and low negative correlations between BMI and total cholesterol and BMI and LDL cholesterol in the older group. A few other studies reporting correlations between these factors in T2DM patients were also summarized for comparison. The limited correlations found in this study contrast with more significant correlations reported in other populations, possibly due to lifestyle and dietary differences between nations.
This document questions the strategy of lowering cholesterol to reduce cardiovascular risk. It argues that cholesterol is a vital substance in the body and highlights studies showing that cholesterol levels alone do not predict outcomes. While some drugs and interventions can lower cholesterol, they often do not reduce cardiovascular or total mortality. The document advocates considering total mortality as the most important outcome and questions overreliance on data from animal and genetic studies.
ASTASHINE CAPSULES: AN EXCELLENT CHOICE FOR A CARDIOVASCULAR HEALTH ABSTRACTPUGOS Products Pvt Ltd
- Astaxanthin is a carotenoid with strong antioxidant and anti-inflammatory properties that can help prevent cardiovascular disease.
- Studies show astaxanthin from microalgae improves blood lipid and insulin resistance levels, reduces inflammation and oxidative stress, prevents fatty liver disease, and lowers blood pressure.
- The article reviews research demonstrating that astaxanthin supplementation has beneficial effects on metabolic health and reduces risks for conditions like atherosclerosis, hypertension, and hyperglycemia.
Lipoproteins and Lipid Peroxidation in Thyroid disordersIOSR Journals
1) The study evaluated lipids and oxidative stress in 80 patients with thyroid dysfunction, including 53 hypothyroid and 27 hyperthyroid patients, compared to 40 healthy controls.
2) In hypothyroid patients, T3, T4 levels were significantly decreased while TSH was elevated. Total cholesterol, triglycerides, LDL, and VLDL were significantly increased compared to controls.
3) MDA levels were higher in both hypothyroid and hyperthyroid patients compared to controls, indicating oxidative damage in thyroid disorders.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
- Intracardiac echocardiography (ICE) provides images of intracardiac structures to guide interventional cardiac procedures, as an alternative to transoesophageal echocardiography.
- ICE catheters like the AcuNav provide high resolution ultrasound images through a catheter inserted into the heart. This allows procedures to be done with clearer imaging, less fluoroscopy, and without the risks of general anesthesia.
- ICE provides good views of the heart from within the right atrium. Withdrawing the catheter inferiorly brings other structures like the atrial septum into view to help guide interventions like defect closures.
This document summarizes a study that assessed lipid levels in cardiovascular patients. The study found that levels of blood sugar, triglycerides, and LDL cholesterol were higher in angina and heart attack patients compared to controls. HDL cholesterol was lower in patients. Lipid profiles did not significantly differ between angina and heart attack patients. Diabetic patients had higher lipid levels than non-diabetic patients. The study concludes that hyperlipidemia is present in both angina and heart attack patients, with no significant differences in lipid profiles between the two patient groups.
This study evaluated the impact of diabetes mellitus and obesity on male infertility in Iraqi patients. It found that:
1) Serum levels of HbA1C, a marker of long-term blood sugar control, were higher in diabetic patients regardless of BMI compared to healthy controls. HbA1C was also higher in normo-BMI diabetic patients compared to obese diabetic patients.
2) Serum free testosterone levels, important for male fertility, were significantly lower in obese diabetic patients compared to overweight diabetic and healthy patients.
3) There was a significant negative correlation between serum free testosterone levels and HbA1C in obese diabetic patients, suggesting poorer blood sugar control is associated with lower testosterone.
Raised Lipid Profile In Rheumatoid Arthritis- A Risk For CVDiosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Coronary Artery Disease and Menopause: A Consequence of Adverse Lipid Changesiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Cm2 4. association of the hind iii and s447x in t2dGibran Fadl
This study analyzed the association between two polymorphisms (HindIII and S447X) in the LPL gene and cardiovascular risk factors in Mexican families. The study population consisted of 90 members from 30 Mexican families with an obese index case. Anthropometric and biochemical measurements were taken, and genotyping for the two LPL polymorphisms was performed. The results showed that the TT genotype of the HindIII polymorphism was associated with increased diastolic blood pressure, while the CC genotype of the S447X polymorphism was associated with increased systolic and diastolic blood pressure, type 2 diabetes, and total cholesterol levels. These findings suggest that the HindIII and S447X polymorphisms in the LPL gene may confer
This document discusses coronary heart disease and the metabolic syndrome. It begins by outlining the increasing prevalence of coronary heart disease globally and in India. It then discusses several objectives of the study, including assessing the prevalence of metabolic syndrome in patients with proven coronary artery disease and the extent of coronary artery disease in patients with metabolic syndrome. The document provides definitions and components of metabolic syndrome from several leading health organizations. It reviews literature on the topic and discusses the prevalence of metabolic syndrome in various populations and age groups.
Relative risk of cardiovascular morbidity is increased in Chronic Kidney Disease (CKD). According to current KDIGO guideline
cardiovascular risk can be estimated from Glomerular Filtration Rate (GFR) and proteinuria.
- Dr. Kilmer McCully discovered in the 1960s that high levels of the amino acid homocysteine were linked to atherosclerosis and other diseases, but his work was rejected in favor of the cholesterol hypothesis.
- Homocysteine was "rediscovered" as a risk factor for heart disease and other illnesses in the 1980s and 1990s through large studies finding associations with cardiovascular and other diseases.
- Maintaining homocysteine levels below 9 μmol/L through diet and supplements can significantly reduce risks of heart disease, stroke, cancers, Alzheimer's, and early death.
Potential role of uric acid in correlation with epidemics of hypertension and...Apollo Hospitals
This document summarizes a study examining the potential role of uric acid in correlation with hypertension and albumin creatinine ratio in patients with diabetic nephropathy. The study included 180 subjects divided into three groups: healthy controls, those with type 2 diabetes but without nephropathy, and those with both type 2 diabetes and nephropathy. Results showed higher levels of factors like blood sugar, HbA1c, creatinine and albumin creatinine ratio in the nephropathy group compared to the other groups. While uric acid correlated positively with blood pressure and albumin creatinine ratio in the diabetes groups, no significant difference was found. Larger future studies are needed to better evaluate
Linking uric acid metabolism to diabetic complicationsMohamedKhamis77
This document discusses the relationship between uric acid metabolism and diabetic complications. It begins by providing background on uric acid metabolism and the factors that determine serum uric acid levels. It then discusses how uric acid levels are associated with type 2 diabetes and metabolic syndrome. Higher uric acid levels have been linked to an increased risk of developing type 2 diabetes. The document also reviews evidence that elevated uric acid levels are associated with a higher risk and worsening of diabetic complications, including neuropathy, retinopathy, nephropathy, foot ulcers, and macrovascular complications. Oxidative stress from xanthine oxidoreductase activity may play a role in these relationships through vascular endothelial damage and insulin resistance.
Saturated Fat - The Cochrane Collaboration 2012 ReviewZahccc
This document summarizes key findings from the 2012 Cochrane Collaboration review on reduced or modified dietary fat for preventing cardiovascular disease. The review found that changes in dietary fat had no effect on total or cardiovascular mortality based on sensitivity and subgroup analyses. A statistically significant result for combined cardiovascular events disappeared in sensitivity analyses and did not support increasing PUFA intake. Overall, the analysis does not provide evidence to replace saturated fat with unsaturated fat.
BODY FAT DEPOSITION AND RISK FACTORS OF CARDIOVASCULAR DISEASES IN MENProf William Alves Lima
This study examined the relationship between body fat percentage and cardiovascular disease risk factors in 112 Brazilian men. The men were divided into three groups based on body fat percentage: healthy (<19%), overweight (19-30%), and obese (>30%). Results showed that measures of body weight, circumference, blood pressure, and blood lipids differed significantly between the healthy and overweight/obese groups but not between the overweight and obese groups. The findings suggest that a body fat percentage above 19% may indicate increased cardiovascular risk in men.
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
This document summarizes recent evidence on cardiovascular disease risk factors and lipid management. Key points include:
- Lowering LDL cholesterol and other apoB-containing lipoproteins reduces cardiovascular risk in a linear, dose-dependent manner with no lower limit.
- HDL cholesterol raising therapies have not been shown to reduce cardiovascular risk beyond modest reductions in apoB.
- Triglycerides associate with risk, but this is mediated by changes in non-HDL cholesterol and apoB levels rather than triglyceride levels alone.
- Calculated and direct LDL cholesterol measurements provide similar risk information in most cases, but direct measurement may be needed in some patients with high triglycerides or metabolic conditions.
Frequency of metabolic syndrome and its’ variousSamiullah Shaikh
This study examined the frequency of metabolic syndrome and its components in 357 patients with ischemic stroke in Pakistan. The researchers found that metabolic syndrome was present in 46.2% of patients, with the three most common components being high waist circumference (34.5%), high fasting blood sugar (35.3%), and low HDL cholesterol (26.5-73.5%). Female patients accounted for 75.2% of those with metabolic syndrome. The results suggest metabolic syndrome is a frequent occurrence in patients with ischemic stroke and its components are strongly associated with increased risk of the condition.
High Density Lipoproteins May Actually be Some Negative Acute Phase Proteins ...JapaneseJournalofGas
Patients with plasma HDL values lower than 40 mg/dL were collected into the first group, and then age and gender matched patients with plasma HDL values of 40 mg/dL
Correlations between Some Anthropometric Parameters, the Lipid Profile and Gl...inventionjournals
This document summarizes a study that investigated correlations between anthropometric parameters, lipid profiles, and glycated hemoglobin levels in 212 Bulgarian women with type 2 diabetes mellitus (T2DM) divided into two age groups, 40-60 years and 61-80 years. The study found moderate negative correlations between body mass index (BMI) and glycated hemoglobin in the younger group, and low negative correlations between BMI and total cholesterol and BMI and LDL cholesterol in the older group. A few other studies reporting correlations between these factors in T2DM patients were also summarized for comparison. The limited correlations found in this study contrast with more significant correlations reported in other populations, possibly due to lifestyle and dietary differences between nations.
This document questions the strategy of lowering cholesterol to reduce cardiovascular risk. It argues that cholesterol is a vital substance in the body and highlights studies showing that cholesterol levels alone do not predict outcomes. While some drugs and interventions can lower cholesterol, they often do not reduce cardiovascular or total mortality. The document advocates considering total mortality as the most important outcome and questions overreliance on data from animal and genetic studies.
ASTASHINE CAPSULES: AN EXCELLENT CHOICE FOR A CARDIOVASCULAR HEALTH ABSTRACTPUGOS Products Pvt Ltd
- Astaxanthin is a carotenoid with strong antioxidant and anti-inflammatory properties that can help prevent cardiovascular disease.
- Studies show astaxanthin from microalgae improves blood lipid and insulin resistance levels, reduces inflammation and oxidative stress, prevents fatty liver disease, and lowers blood pressure.
- The article reviews research demonstrating that astaxanthin supplementation has beneficial effects on metabolic health and reduces risks for conditions like atherosclerosis, hypertension, and hyperglycemia.
Lipoproteins and Lipid Peroxidation in Thyroid disordersIOSR Journals
1) The study evaluated lipids and oxidative stress in 80 patients with thyroid dysfunction, including 53 hypothyroid and 27 hyperthyroid patients, compared to 40 healthy controls.
2) In hypothyroid patients, T3, T4 levels were significantly decreased while TSH was elevated. Total cholesterol, triglycerides, LDL, and VLDL were significantly increased compared to controls.
3) MDA levels were higher in both hypothyroid and hyperthyroid patients compared to controls, indicating oxidative damage in thyroid disorders.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
- Intracardiac echocardiography (ICE) provides images of intracardiac structures to guide interventional cardiac procedures, as an alternative to transoesophageal echocardiography.
- ICE catheters like the AcuNav provide high resolution ultrasound images through a catheter inserted into the heart. This allows procedures to be done with clearer imaging, less fluoroscopy, and without the risks of general anesthesia.
- ICE provides good views of the heart from within the right atrium. Withdrawing the catheter inferiorly brings other structures like the atrial septum into view to help guide interventions like defect closures.
This document summarizes a study that assessed lipid levels in cardiovascular patients. The study found that levels of blood sugar, triglycerides, and LDL cholesterol were higher in angina and heart attack patients compared to controls. HDL cholesterol was lower in patients. Lipid profiles did not significantly differ between angina and heart attack patients. Diabetic patients had higher lipid levels than non-diabetic patients. The study concludes that hyperlipidemia is present in both angina and heart attack patients, with no significant differences in lipid profiles between the two patient groups.
This study evaluated the impact of diabetes mellitus and obesity on male infertility in Iraqi patients. It found that:
1) Serum levels of HbA1C, a marker of long-term blood sugar control, were higher in diabetic patients regardless of BMI compared to healthy controls. HbA1C was also higher in normo-BMI diabetic patients compared to obese diabetic patients.
2) Serum free testosterone levels, important for male fertility, were significantly lower in obese diabetic patients compared to overweight diabetic and healthy patients.
3) There was a significant negative correlation between serum free testosterone levels and HbA1C in obese diabetic patients, suggesting poorer blood sugar control is associated with lower testosterone.
Raised Lipid Profile In Rheumatoid Arthritis- A Risk For CVDiosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Coronary Artery Disease and Menopause: A Consequence of Adverse Lipid Changesiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Cm2 4. association of the hind iii and s447x in t2dGibran Fadl
This study analyzed the association between two polymorphisms (HindIII and S447X) in the LPL gene and cardiovascular risk factors in Mexican families. The study population consisted of 90 members from 30 Mexican families with an obese index case. Anthropometric and biochemical measurements were taken, and genotyping for the two LPL polymorphisms was performed. The results showed that the TT genotype of the HindIII polymorphism was associated with increased diastolic blood pressure, while the CC genotype of the S447X polymorphism was associated with increased systolic and diastolic blood pressure, type 2 diabetes, and total cholesterol levels. These findings suggest that the HindIII and S447X polymorphisms in the LPL gene may confer
This document discusses coronary heart disease and the metabolic syndrome. It begins by outlining the increasing prevalence of coronary heart disease globally and in India. It then discusses several objectives of the study, including assessing the prevalence of metabolic syndrome in patients with proven coronary artery disease and the extent of coronary artery disease in patients with metabolic syndrome. The document provides definitions and components of metabolic syndrome from several leading health organizations. It reviews literature on the topic and discusses the prevalence of metabolic syndrome in various populations and age groups.
Relative risk of cardiovascular morbidity is increased in Chronic Kidney Disease (CKD). According to current KDIGO guideline
cardiovascular risk can be estimated from Glomerular Filtration Rate (GFR) and proteinuria.
- Dr. Kilmer McCully discovered in the 1960s that high levels of the amino acid homocysteine were linked to atherosclerosis and other diseases, but his work was rejected in favor of the cholesterol hypothesis.
- Homocysteine was "rediscovered" as a risk factor for heart disease and other illnesses in the 1980s and 1990s through large studies finding associations with cardiovascular and other diseases.
- Maintaining homocysteine levels below 9 μmol/L through diet and supplements can significantly reduce risks of heart disease, stroke, cancers, Alzheimer's, and early death.
Potential role of uric acid in correlation with epidemics of hypertension and...Apollo Hospitals
This document summarizes a study examining the potential role of uric acid in correlation with hypertension and albumin creatinine ratio in patients with diabetic nephropathy. The study included 180 subjects divided into three groups: healthy controls, those with type 2 diabetes but without nephropathy, and those with both type 2 diabetes and nephropathy. Results showed higher levels of factors like blood sugar, HbA1c, creatinine and albumin creatinine ratio in the nephropathy group compared to the other groups. While uric acid correlated positively with blood pressure and albumin creatinine ratio in the diabetes groups, no significant difference was found. Larger future studies are needed to better evaluate
Linking uric acid metabolism to diabetic complicationsMohamedKhamis77
This document discusses the relationship between uric acid metabolism and diabetic complications. It begins by providing background on uric acid metabolism and the factors that determine serum uric acid levels. It then discusses how uric acid levels are associated with type 2 diabetes and metabolic syndrome. Higher uric acid levels have been linked to an increased risk of developing type 2 diabetes. The document also reviews evidence that elevated uric acid levels are associated with a higher risk and worsening of diabetic complications, including neuropathy, retinopathy, nephropathy, foot ulcers, and macrovascular complications. Oxidative stress from xanthine oxidoreductase activity may play a role in these relationships through vascular endothelial damage and insulin resistance.
Saturated Fat - The Cochrane Collaboration 2012 ReviewZahccc
This document summarizes key findings from the 2012 Cochrane Collaboration review on reduced or modified dietary fat for preventing cardiovascular disease. The review found that changes in dietary fat had no effect on total or cardiovascular mortality based on sensitivity and subgroup analyses. A statistically significant result for combined cardiovascular events disappeared in sensitivity analyses and did not support increasing PUFA intake. Overall, the analysis does not provide evidence to replace saturated fat with unsaturated fat.
BODY FAT DEPOSITION AND RISK FACTORS OF CARDIOVASCULAR DISEASES IN MENProf William Alves Lima
This study examined the relationship between body fat percentage and cardiovascular disease risk factors in 112 Brazilian men. The men were divided into three groups based on body fat percentage: healthy (<19%), overweight (19-30%), and obese (>30%). Results showed that measures of body weight, circumference, blood pressure, and blood lipids differed significantly between the healthy and overweight/obese groups but not between the overweight and obese groups. The findings suggest that a body fat percentage above 19% may indicate increased cardiovascular risk in men.
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
This document summarizes recent evidence on cardiovascular disease risk factors and lipid management. Key points include:
- Lowering LDL cholesterol and other apoB-containing lipoproteins reduces cardiovascular risk in a linear, dose-dependent manner with no lower limit.
- HDL cholesterol raising therapies have not been shown to reduce cardiovascular risk beyond modest reductions in apoB.
- Triglycerides associate with risk, but this is mediated by changes in non-HDL cholesterol and apoB levels rather than triglyceride levels alone.
- Calculated and direct LDL cholesterol measurements provide similar risk information in most cases, but direct measurement may be needed in some patients with high triglycerides or metabolic conditions.
Frequency of metabolic syndrome and its’ variousSamiullah Shaikh
This study examined the frequency of metabolic syndrome and its components in 357 patients with ischemic stroke in Pakistan. The researchers found that metabolic syndrome was present in 46.2% of patients, with the three most common components being high waist circumference (34.5%), high fasting blood sugar (35.3%), and low HDL cholesterol (26.5-73.5%). Female patients accounted for 75.2% of those with metabolic syndrome. The results suggest metabolic syndrome is a frequent occurrence in patients with ischemic stroke and its components are strongly associated with increased risk of the condition.
High Density Lipoproteins May Actually be Some Negative Acute Phase Proteins ...JapaneseJournalofGas
Patients with plasma HDL values lower than 40 mg/dL were collected into the first group, and then age and gender matched patients with plasma HDL values of 40 mg/dL
High Density Lipoproteins May Actually be Some Negative Acute Phase Proteins ...JohnJulie1
Patients with plasma HDL values lower than 40 mg/dL were collected into the first group, and then age and gender matched patients with plasma HDL values of 40 mg/dL and greater were collected into the second group, and compared in between
This document discusses cardiovascular disorders, specifically hyperlipidemia and coronary heart disease. It covers the pathophysiology of lipid metabolism and atherosclerosis, conditions that can cause angina, distinguishing characteristics of chronic stable angina versus unstable angina, and treatments including lifestyle modifications, pharmacotherapy, percutaneous coronary intervention, and coronary artery bypass graft surgery. The goal of treatment is to prevent acute coronary events and death, alleviate acute ischemic symptoms, prevent recurrent ischemia, and minimize adverse effects of treatment.
Endothelial dysfunction in indian scenarioheartsense
www,heartsense.in. Endothelial dysfunction is the root pathology in the pathogenesis of hypertension, diabetes and IHD. This technical article is aimed towards health care professionals. For patient information on health and heart disease, visit www.heartsense.in.
The document discusses triglycerides and lipoprotein metabolism. It provides details on:
1) The classification of lipoproteins and their characteristics including triglyceride-rich lipoproteins.
2) The processes of digestion and absorption of dietary fats and cholesterol, and the formation and metabolism of chylomicrons, VLDL, LDL, and HDL.
3) The risks associated with elevated triglyceride levels, causes of high triglycerides, and their role in cardiovascular disease risk.
Fasting and Caloric Restriction Show Promise for Reducing Type 2 Diabetes Bio...Premier Publishers
The global epidemic of type 2 diabetes (T2D) and its co-morbidities threatens to overwhelm public health services and urgent patient intervention is necessary. A review of mainly randomised controlled trials investigating the reduction of biochemical T2D risk markers through fasting or caloric restriction (CR) found that in T2D or where baseline fasting glucose or HbA1c were elevated, there were significant improvements in fasting glucose and HbA1c, while fasting insulin and insulin resistance may show improvement regardless of condition or baseline levels. There may, however, be ethnic differences, with a clear positive correlation found only in Caucasians. Intermittent CR (i.e. non-continuous periods of fasting) is at least as effective as isocaloric continuous CR, while CR of 400-800 kcal/day is possibly more effective than higher levels for reducing fasting glucose and HbA1c. Time restricted feeding also shows promise but there are few human studies. The findings suggest that the optimum regimen to reduce biochemical risk markers for T2D is an intermittent fasting programme employing a very low-calorie diet with the longest possible number of consecutive days of fasting. The addition of liquid meal replacements, low carbohydrate CR and supplementation of vitamin D, ω-3 PUFAs and L-carnitine may also be of benefit.
Background and Aim: Many studies have found association between Red Cell Distribution Width (RDW) values and hypertension, dipping pattern, and end-organ damage. RDW values are affected by blood vitamin B12, iron, and folic acid levels, parameters that were not assessed in the previous studies. The aim of our study was to evaluate the relation between RDW and hypertension, dipper pattern, and end-organ damage independently from vitamin B12, folic acid, and ferritin levels in newly diagnosed hypertensive patients.
Correlations between Some Anthropometric Parameters, the Lipid Profile and Gl...inventionjournals
The study aimed to investigate the correlations between some anthropometric and lipid profile parameters, as well the glycated hemoglobin (HbA1c) values of Bulgarian females with type 2 Diabetes mellitus (T2DM). 212 women of Bulgarian ethnicity with T2DM of the age groups 40-60 and 61-80 years were included in the research. The anthropometric parameters: waist and hip circumferences were measured, and body mass index (BMI) and waist/hip ratio (WHR) were calculated. We also studied the lipid profile parameters: total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL) and very low density lipoprotein (VLDL). A comparative study of the lipid profile criteria revealed significant differences in the levels of triglycerides, HDL-cholesterol and VLDL between the two age groups. Differences were found with regard to the values of glycated hemoglobin too. Correlations between the above anthropometric parameters and the lipid profile of patients with T2DM were examined. In patients of the age group 40-60 years a moderate strength correlation in opposite direction (negative or inverse correlation) was found between HbA1c and BMI (Pearson correlation coefficient 0.30-0.50, p<0.05). In the age group 61-80 years a low strength negative correlation was found between BMI and total cholesterol, as well as between BMI and LDL.
Biochemical Study on Endothelial Nitric Oxide Gene Polymorphism in Fatty Live...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
This document contains a student portfolio from their clinical clerkship at Northside Medical Center. It includes a patient log with 18 patient encounters listing the chief complaint, subjective and objective findings, assessment, plan, and final diagnosis. It also includes 3 case discussions on atherosclerosis, Clostridium difficile colitis, and a lateral ankle sprain. Each case discussion covers the pathophysiology, differential diagnosis, findings to support the final diagnosis, and treatment options.
This document discusses aging and the aging kidney. It begins by outlining the epidemiology and theories of aging, including how aging is a cumulative process influenced by both genetic and environmental factors. It then examines age-related changes in the kidney, including morphological changes like glomerulosclerosis, interstitial fibrosis, and vascular sclerosis. These changes are thought to be caused by factors like telomere shortening, oxidative stress, inflammation, and accumulation of advanced glycation end products over time. Managing these age-related changes and underlying disease processes is an important part of caring for the growing elderly population.
Nephrotic syndrome in Sickle Cell Disease of Western Odisha, India: A case re...inventionjournals
Sickle cell disease causes a distinct pattern of glomerular dysfunction. Subjects with sickle cell disease (SCD) are known to develop many potential functional and structural renal abnormalities. Glomerular hypertension and hyper filtration are thought to play a major role in the development of glomerular disease in subjects with SCD. We reported 5 unusual cases of sickle cell disease presenting as nephrotic syndrome. KEYWORDS- Nephrotic syndrome, sickle cell disease
Nephrotic syndrome in Sickle Cell Disease of Western Odisha, India: A case re...inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The document discusses the paradoxical relationship between obesity and mortality in patients with kidney disease undergoing dialysis. Several studies are reviewed that found higher BMI in dialysis patients was associated with lower risks of death and hospitalization, unlike the general population where obesity increases health risks. The studies accounted for various factors and found even extreme obesity was protective. Weight gain over time was also associated with reduced mortality risk. The reasons for this reverse epidemiology are unclear but proposed mechanisms include increased stores of nutrients and anti-inflammatory proteins in adipose tissue.
Ischemic heart disease (IHD) is caused by an inadequate blood supply to the heart muscle due to narrowed coronary arteries. The most common cause is atherosclerosis which develops over many years and is worsened by risk factors like smoking, high cholesterol, and hypertension. Symptoms include chest pain and shortness of breath during physical exertion. Diagnosis involves tests like electrocardiograms, stress tests, and cardiac catheterization. Treatment aims to improve symptoms, prevent heart attacks, and includes risk factor modification, medications like nitrates, beta blockers, and calcium channel blockers, and revascularization procedures like angioplasty and bypass surgery.
This document discusses different types of arteriosclerosis including atherosclerosis. It defines atherosclerosis as the thickening of the arterial walls due to buildup of fatty plaques. The major risk factors for atherosclerosis include dyslipidemia, hypertension, diabetes, and smoking. The document discusses the pathogenesis of atherosclerosis, describing how abnormalities in lipoproteins and cholesterol levels contribute to plaque formation in the arteries over time. It also outlines strategies for prevention through modifying risk factors like maintaining healthy cholesterol levels.
Similar to Cholesterol May be a Negative Whereas Triglycerides Positive Acute Phase Reactants in the Plasma (20)
Convalescent Plasma and COVID-19: Ancient Therapy Re-emergedasclepiuspdfs
Convalescent plasma has been used as a treatment for infectious diseases for over a century. It involves transfusing plasma from patients who have recovered from an infection into patients who are currently ill with that same infection. Clinical trials are now investigating its use for COVID-19. While some early studies showed promising results, larger randomized controlled trials found no significant benefit of convalescent plasma for severe COVID-19. Further research is still needed to determine whether certain patient populations or plasma dosages may be more effective.
The Negative Clinical Consequences Due to the Lack of the Elaboration of a Sc...asclepiuspdfs
Until a few years ago, the immune system was considered as responsible for the only defense against microbial infections and other external agents. On the contrary, the immune cells have been proven to be linked not only through cell-cell contact but also by releasing proteins capable of influencing the immune-inflammatory response, the so-called cytokines or interleukins. Moreover, the cytokines have appeared to play not only immune activities but also metabolic and systemic effects influencing the overall biological systems, including the nervous, the endocrine, and the cardiovascular systems, by representing the main endogenous molecules responsible for the maintenance of the unity of the biological life. Therefore, only the systematic clinical consideration of cytokine effects may allow the generation of real future holistic medicine.
The great benefit of blood/blood constitutes therapy is the ability to provide transfusion support for patients with many unique hematologic conditions. For some patients, such as patients with sickle cell disease, thalassemia major, immune hemolytic anemia, anemia of kidney disease, and aplastic anemia may need for this consolidation extends throughout their life. By knowing the alteration mechanisms of these conditions, we can appreciate the stationary, urgency, and the value of the transfused red blood cell (RBC).
Decreasing or Increasing Role of Autologous Stem Cell Transplantation in Mult...asclepiuspdfs
During the past four decades, autologous stem cell transplantation (ASCT) has been the first choice and the standard option for the treatment of newly diagnosed patients with multiple myeloma. The introduction of new agents such as thalidomide, lenalidomide, and bortezomib has led to a clear improvement in basic approach and those agents became the standard of care in the induction phase; however, they were not able to play the role of ASCT in term of progression-free survival and overall survival. Debate continues about the best induction, consolidation, and maintenance taking into account the toxicities of these new agents. The new monoclonal antibody (anti CD38) starts to take its place in the induction setting and it seems to be a promising agent in the high-risk group. Until recently, ASCT is the standard treatment for newly diagnosed patients.
Comparison of the Hypocalcemic Effects of Erythropoietin and U-74389Gasclepiuspdfs
Aim: This study calculated the effects on serum calcium (Ca) levels, after treatment with either of two drugs: The erythropoietin (Epo) and the antioxidant lazaroid (L) drug U-74389G. The calculation was based on the results of two preliminary studies, each one of which estimated the certain influence, after the respective drug usage in an induced ischemia-reperfusion animal experiment. Materials and Methods: The two main experimental endpoints at which the serum Ca levels were evaluated were the 60th reperfusion min (for the Groups A, C, and E) and the 120th reperfusion min (for the Groups B, D, and F). Especially, the Groups A and B were processed without drugs, Groups C and D after Epo administration, whereas Groups E and F after the L administration. Results: The first preliminary study of Epo presented a non-significant hypocalcemic effect by 0.34% ± 0.68% (P = 0.6095). However, the second preliminary study of U-74389G presented a non-significant hypercalcemic effect by 0.14% ± 0.66% (P = 0.8245). These two studies were coevaluated since they came from the same experimental setting. The outcome of the coevaluation was that L is 2.3623042-fold (2.3482723–2.3764196) more hypercalcemic than Epo (P = 0.0000). Conclusions: The antioxidant capacities of U-74389G ascribe 2.3623042-fold more hypercalcemic effects than Epo (P = 0.0000).
The term refractory anemia (RA) may be confusing to those who are not hematologists. RA should be well defined because it means more than what it says. RA is defined as anemia that is not responsive to therapy except transfusion.[1] The term RA is used to rule out those types of anemia with a known cause such as anemia of systemic diseases (liver and kidney) and anemia of inflammation even though they are considered refractory to therapy.[2] RA with cellular or hypercellular bone marrow was formerly used to exclude aplastic anemia.
Management of Immunogenic Heparin-induced Thrombocytopeniaasclepiuspdfs
Immunogenic heparin-induced thrombocytopenia (HIT) is an immune response to heparin associated with significant morbidity and mortality in hospitalized patients if unidentified as soon as possible, due to thromboembolic complications involving both arterial and venous systems. Early diagnoses based on a comprehensive interpretation of clinical and laboratory information improve clinical outcomes. Management principles of strongly suspected HIT should not be delayed for laboratory result confirmation. Treatment strategies have been introduced including new, safe, and effective agents. This review summarizes the clinical therapeutic options for HIT addressing the use of parenteral direct thrombin inhibitors and indirect factor Xa inhibitors as well as the potential non-Vitamin K antagonist oral anticoagulants.
A 73-year-old woman presented with fever and linearly arranged erythema on her chest, back, and abdomen. She was initially diagnosed with drug-related scratch dermatitis due to antibiotic use. However, her fever persisted and lab work showed abnormal liver enzymes and very high ferritin levels. Biopsies ruled out infection and malignancy. She was ultimately diagnosed with adult Still's disease (ASD) based on her symptoms and lab results. Treatment with prednisolone resolved her symptoms within a week. This case demonstrates that ASD can present with various skin lesions, and a high index of suspicion is needed for diagnosis.
Bone Marrow Histology is a Pathognomonic Clue to Each of the JAK2V617F, MPL,5...asclepiuspdfs
According to the World Health Organization and Clinical Laboratory Molecular and Pathological criteria bone marrow pathology in JAK2V617F mutated trilinear myeloproliferative neoplasm (MPN) patients essential thrombocythemia (ET) and polycythemia vera are indistinguishably featured by clustered medium to large pleomorphic megakaryocytes and increased cellularity (60–90%) due to increased erythropoiesis and megakaryopoiesis. MPL515 mutated ET is the second distinct clonal MPN characterized by thrombocythemia in a normocellular bone marrow showing clustered increased large to giant mature megakaryocytes with staghorn-like hyperlobulated nuclei. Calreticulin (CALR) mutated hypercellular thrombocythemia associated with prefibrotic megakaryocytic, granulocytic myeloproliferation (MGM) recently became the third distinct MPN featured by dense clusters of immature megakaryocytes with cloud-like nuclei. Bone marrow pathology in newly diagnosed MPN patients appears to be a pathognomonic clue for diagnostic differentiation between JAK2V617F mutated trilinear MPN, MPL515 normocellular thrombocythemia, and CALR thrombocythemia with MGM characteristics followed by secondary reticulin fibrosis. Their natural histories clearly differ featured by an increase of erythro/granulopoiesis and cellularity in JAK2V617F, decrease of erythropoiesis and cellularity in MPL515 and increase of dual megakaryo/granulopoiesis and cellularity in CALR mutated MPN.
Helicobacter pylori Frequency in Polycythemia Vera Patients without Dyspeptic...asclepiuspdfs
Introduction: In polycythemia vera (PV) patients, peptic ulcer and gastroduodenal erosions are more common than the general population, but there are insufficient data on the frequency of Helicobacter pylori (HP) and its role in etiopathogenesis. In this study, we aimed to compare the prevalence of HP infection in PV patients without dyspeptic complaints with a healthy control group without dyspeptic complaints. Materials and Methods: Fifty patients with PV without dyspeptic complaints and 50 controls without dyspeptic complaints were enrolled in this study after informed consent obtained. Stool samples of selected patients were analyzed using HP stool antigen test (True Line®). Results: There was surprisingly striking difference between HP prevalence in PV patients without dyspeptic complaints and asymptomatic healthy controls (64% vs. 2%) (P < 0.05). There was no significant relationship found between HP presence and age, gender, treatment modalities, complete blood count, positivity of JAK2 V617F, serum erythropoietin level, and splenomegaly in PV patients (P > 0.05). Conclusion: As the susceptibility of HP infections in PV patients are higher, it is recommended to have close surveillance of these patients by screening HP presence. In addition, when HP positivity is determined, the eradication of HP is essential to prevent possible future gastrointestinal lesions in patients with PV.
Lymphoma of the Tonsil in a Developing Communityasclepiuspdfs
The lymphoma of the tonsil is a rarity. Single case reports have appeared in countries as disparate as China, Greece, India, Japan, and Turkey. Therefore, this paper presents cases found in Nigeria among the Ibo ethnic group. The epidemiological comparisons are deemed to be worthy of documentation such as age ranges and sides of involvement.
Should Metformin Be Continued after Hospital Admission in Patients with Coron...asclepiuspdfs
Background: In most patients with diabetes, guidelines recommend discontinuation of oral anti-diabetic agents. Preliminary data suggest that pre-admission metformin use may have a mortality benefit in patients with coronavirus disease (COVID)-19 admitted to the hospital. Objective: The objective of the study was to review the impact of metformin on morbidity and mortality among hospitalized patients with COVID-19. Methods: Review of English literature by PUBMED search until November 10, 2020. Search terms included diabetes, COVID-19, metformin, retrospective studies, meta-analyses, pertinent reviews, pre-print articles, and consensus guidelines are reviewed.
Clinical Significance of Hypocalcemia in COVID-19asclepiuspdfs
- Several retrospective studies found that hypocalcemia is common in hospitalized patients with COVID-19, occurring in 62-78% of patients.
- Hypocalcemia is associated with more severe disease and worse outcomes, including increased risk of hospitalization, longer hospital stays, multi-organ failure, acute respiratory distress syndrome, and death.
- The cause of hypocalcemia in COVID-19 patients is unclear but may involve consumption of calcium for viral entry into cells or reflect severity of illness. Further study is needed.
Excess of Maternal Transmission of Type 2 Diabetes: Is there a Role of Bioche...asclepiuspdfs
Objective: An excess of maternal transmission of Type 2 diabetes (T2D) has been reported in some populations but not confirmed in other studies. Mitochondrial inheritance has been proposed to explain such excess. In the present paper, we have considered the presence of T2D in the mother and/or in the father in relation to the risk of T2D and to age at onset of the disease in the offspring. The distribution of two genetic polymorphisms involved in glucose metabolism in relation to the presence of T2D in the mother has been also considered. Materials and Methods: Two hundred and seventy-nine participants with T2D were studied in the population of Penne, a small rural town in the eastern side of central Italy. Adenosine deaminase locus 1 (ADA1) and phosphoglucomutase locus 1 (PGM1) phenotypes were determined by starch gel electrophoresis. Statistical analyses were carried out using commercial software (SPSS). Results: The proportion of patients from T2D mothers is much greater as compared to the proportion of the patients from T2D fathers (P < 0.0001). Age at onset of the disease in patients in whom one or both parents are T2D is lower as compared to other patients. The distribution of ADA1 and PGM1 phenotypes in participants with T2D depends on the presence of diabetes in the mother. Conclusions: About the transmission of T2D, our data confirm the high proportion of maternal T2D and show the role of two common biochemical polymorphisms involved in glucose metabolism.
The Effect of Demographic Data and Hemoglobin A 1c on Treatment Outcomes in P...asclepiuspdfs
Objective: Diabetes mellitus, the most common cause of non-traumatic foot amputations, is a life-threatening condition due to its high mortality and morbidity. In our study, we retrospectively evaluated our patients with diabetic foot syndrome in our clinic. Materials and Methods: The demographic data, duration of diabetes, Wagner classification, haemoglobin A 1c (HbA1c) levels, white blood cell, C-reactive protein sedimentation levels, hospital stay, and treatment results were evaluated retrospectively in 14 patients with diabetic foot between January 2017 and December 2018. Results: The mean age of the patients was 62.43 ± 7.7 years. Of the 14 patients, 3 were females and 11 were males. All 14 patients were type 2 diabetes mellitus. When diabetic foot Wagner classification was performed, 6 patients were evaluated as Wagner 2, five patients were Wagner 3, and three patients were evaluated as Wagner 4. Nine patients had complete amputation and 3 had vascular surgery. Conclusion: Although the level of HbA1c is below the target level, the risk of diabetic foot is increased when there is no adequate diabetes mellitus foot training. Inadequate diabetic patient education and hospitalization of patients after infection progress the amputation rate.
Self-efficacy Impact Adherence in Diabetes Mellitusasclepiuspdfs
The aim of the paper is to explore how self-efficacy (SE) is associated with adherence among adults with diabetes mellitus (DM). Methods: The search of electronic databases identified 564 records from 2007 to 2017 on SE and adherence from different perspectives and its effect on adults with DM. Discussions: SE increases the confidence in adults in their self-care behaviors. Non-adherence continues to be a significant barrier to SE. SE and adherence should be informed by an understanding of theoretical frameworks and the individual characteristics. Conclusion: Adherence is likely among adults with better SE to empower them to make valid decisions about their health. Interventions to improve SE should be tailored based on different types of non-adherence such as intentional and unintentional non-adherence. Implications: An intercollaborative professional practice approach is crucial to improve SE and adherence for sound judgment and valid decision-making.
Uncoiling the Tightening Obesity Spiralasclepiuspdfs
While an underweight prevalence was once more than twice that of obesity, now more people are obese than underweight. Obesity is one of the leading causes of preventable death in the world. There are an estimated 2,100,000,000 obese people worldwide and that number is forecast to grow to 51% of the world’s population by 2030. Escalating obesity-related disease costs threaten to bankrupt the world’s health-care systems.
Prevalence of Chronic Kidney disease in Patients with Metabolic Syndrome in S...asclepiuspdfs
Background and Objective: Chronic kidney disease (CKD) which is an increasingly important clinical and public health issue is associated with cardiovascular disease. Epidemiologic studies have also linked metabolic syndrome (MetS) with an increased risk of incident CKD. Therefore, the present study was designed retrospectively to find the prevalence and potential risk factors of CKD in patients with MetS in Saudi Arabia.
Management Of Hypoglycemia In Patients With Type 2 Diabetesasclepiuspdfs
Hypoglycemia is the rate-limiting step of intensive management in patients with diabetes. Lowering one’s A1C to a prescribed target is expected to mitigate one’s risk of developing long- and short-term diabetes-related complications. Several of the less expensive and commonly prescribed glucose lowering agents favored by practitioners result in weight gain, hypoglycemia, and even an increased risk of cardiovascular (CV) mortality. Although achieving a targeted A1C of <7 % is the standard of care, clinicians often fail to evaluate patients for glycemic variability which can increase oxidative stress driving long-term diabetes-related complications including CV death. The use of concentrated insulins and glucagon-like peptide-1 receptor agonists separately or in combination with each other reduces glycemic variability and one’s risk of hypoglycemia. Pharmaceutical agents which allow patients to safely achieve their targeted A1C without weight gain and hypoglycemia should be preferred in patients with type 2 diabetes.
Predictive and Preventive Care: Metabolic Diseasesasclepiuspdfs
South Asians have a very high incidence of ischemic heart disease and stroke. In addition, they also have a very high incidence of metabolic diseases such as prehypertension, hypertension, visceral obesity, metabolic syndrome, prediabetes, type-2 diabetes, and its clinical complications. Currently, there are over 75 million diabetic subjects in India and an equal number of prediabetics. Republic of China has taken over India as the diabetes capital of the world, with over 115 million diabetics. Modern medicine is disease focused and has failed to address the prevention of these chronic diseases. According to the reports from the United Nations (Millennium Development Goals [MDGs], the World Health Organization, Global Health Initiatives, and the non-communicable disease risk task force), obesity has increased by 2-fold and type-2 diabetes by 4-fold worldwide. Experts in this field predict that chances of meeting the MDGs set by the UN members of reducing the incidence of these diseases at 2025 to the level of 2020 are very little. Western medicine has failed to reduce or reverse the trend in the incidence of these diseases. We feel that an integrated approach to health care may be a better option, to reduce the disease burden in developing and resource-poor countries. Having said that, one cannot prevent something that one is not aware of, as such it is the need of the hour for us, to develop a robust predictive and preventive health-care platform. In an earlier article, we presented our views on reducing or reversing cardiometabolic diseases. There is great enthusiasm among the health-care providers and professional bodies that integration of emerging technologies will help develop personalized, precision medicine, as well as reduce the cost of health-care worldwide.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
2. Helvaci, et al.: Mission of cholesterol and triglycerides
Asclepius Medical Research and Reviews • Vol 4 • Issue 1 • 2021
the process. Therefore, the term of venosclerosis is not
as famous as atherosclerosis in the literature. Due to the
repeated endothelial damage, inflammation, edema, and
fibrosis, vascular walls thicken, their lumens narrow, and
they lose their elastic natures, those eventually reduce
blood supply to the terminal organs and increase systolic
BP further. Some of the well-known triggering cause or
signs of the inflammatory process are physical inactivity,
sedentary lifestyle, animal-rich diet, smoking, alcohol,
overweight, hypertriglyceridemia, dyslipidemia, impaired
fasting glucose, impaired glucose tolerance, white coat HT,
chronic inflammations, prolonged infections, and cancers
for the development of terminal consequences including
obesity, HT, diabetes mellitus (DM), cirrhosis, chronic
obstructive pulmonary disease (COPD), coronary heart
disease (CHD), chronic renal disease (CRD), peripheral
artery disease (PAD), mesenteric ischemia, osteoporosis,
stroke, dementia, other end-organ insufficiencies, aging,
and death.[3,4]
Although early withdrawal of the triggering
causes can delay terminal consequences, endothelial changes
cannot be reversed completely due to their fibrotic natures
after development of the terminal consequences. The issue
is researched under the titles of metabolic syndrome, aging
syndrome, or accelerated endothelial damage syndrome
in the literature, extensively.[5,6]
On the other hand, sickle
cell diseases (SCD) are chronic inflammatory process
on vascular endothelium terminating with accelerated
atherosclerosis-induced end-organ failures and shortened
survivals in both genders.[7,8]
Hemoglobin S (Hb S) causes
loss of elastic and biconcave disk-shaped structures of
red blood cells (RBC). Probably loss of elasticity instead
of shape is the main problem because sickling is rare
in peripheral blood samples of thalassemia minors, and
human survival is not affected in hereditary spherocytosis
or elliptocytosis. Loss of elasticity is present during whole
lifespan, but exaggerated with inflammation, infection,
and various stresses of the body. The hard RBC-induced
repeated vascular endothelial damage, inflammation,
edema, and fibrosis terminate with disseminated tissue
hypoxia all over the body.[9,10]
As a difference from other
causes of chronic endothelial damage, the SCD may keep
vascular endothelium, particularly at the capillary level,[11]
since the capillary system is the main distributor of the
hard cells into the tissues. The hard RBC-induced chronic
endothelial damage builds up an advanced atherosclerosis
in much younger ages. Vascular narrowing and occlusions-
induced tissue ischemia and infarctions are the terminal
endpoints, so the mean life expectancy is decreased by
25–30 years in the SCD patients.[12]
Actually, the SCD and
metabolic syndrome may have similar pathophysiologic
effects on human body, and SCD can be a chance for us
that we can see several consequences of the metabolic
syndrome on human body in much earlier ages. We tried to
understand some undetermined missions of cholesterol and
triglycerides (TG) in the plasma in patients with the SCD.
MATERIALS AND METHODS
The study was performed in the Medical Faculty of the
Mustafa Kemal University on all patients with the SCD and
age and gender-matched control cases between March 2007
and June 2016. The SCD are diagnosed with the hemoglobin
electrophoresis performed through high-performance liquid
chromatography. Medical histories of the SCD patients were
learned. A complete physical examination was performed
by the Same Internist. Body mass index (BMI) of each case
was calculated by the measurements instead of the verbal
expressions. Weight in kilogram is divided by height in meter
squared.[13]
SystolicanddiastolicBPwerecheckedaftera5-min
of rest in seated position using a mercury sphygmomanometer
(ERKA, Germany), and no smoking was permitted during
the previous 2-h. Cases with acute painful crisis or any other
inflammatory event were treated at first, and the laboratory tests
and clinical measurements were performed on the silent phase.
A checkup procedure including fasting plasma glucose (FPG),
total cholesterol (TC), high-density lipoproteins (HDLs), TG,
serum creatinine, alanine aminotransferase (ALT), markers of
hepatitis viruses A, B, C, and human immunodeficiency virus,
a posterior-anterior chest X-ray film, and an electrocardiogram
was performed. Eventually, the mean body weight, height,
BMI, FPG, TC, low-density lipoproteins (LDL), HDL, TG,
ALT, and systolic and diastolic BP were detected in each
group, and compared in between. Mann–Whitney U test,
independent-samples t-test, and comparison of proportions
were used as the methods of statistical analyses.
RESULTS
The study included 363 patients with the SCD (194 males) and
255 control cases (136 males), totally. The mean ages of the
SCD patients were similar in males and females (31.1 vs. 31.0
years, respectively, P 0.05). Although the mean weight and
BMI were significantly suppressed in the SCD patients (59.9 vs.
71.5 kg and 21.9 vs. 25.6 kg/m2
, respectively, P = 0.000 for
both), the mean heights were similar in both groups (164.9 vs.
167.0 cm, P 0.05). Parallel to the suppressed mean weight
and BMI, FPG (92.8 vs. 97.6 mg/dL, P = 0.005), TC (121.4 vs.
165.0 mg/dL, P = 0.000), LDL (70.4 vs. 102.4 mg/dL,
P = 0.000), and HDL (26.0 vs. 39.6 mg/dL, P = 0.000) were all
suppressed in the SCD patients, significantly. Similarly, both
systolic (115.2 vs. 122.6 mmHg, P = 0.000) and diastolic BP
(73.0 vs. 86.6 mmHg, P = 0.000) were also suppressed in them,
significantly. Interestingly, only the plasma TG were increased
in the SCD patients (129.4 vs. 117.3 mg/dL, P = 0.000),
significantly. Similarly, mean ALT value was not suppressed in
them, too (27.4 vs. 27.3 U/L, P 0.05) [Table 1].
DISCUSSION
Cholesterol, TG, and phospholipids are the major lipids of
the body. Actually, cholesterol is a waxy substance that is
3. Helvaci, et al.: Mission of cholesterol and triglycerides
Asclepius Medical Research and Reviews • Vol 4 • Issue 1 • 2021 5
classified as a steroid. It is synthesized by the liver, adrenal
glands, reproductive organs, and intestines. It plays a central
role in many biochemical processes in human body. It is an
essential structural component of animal cell membrane, bile
acids, adrenal and gonadal steroid hormones, and Vitamin D.
Cholesterol crystallizes in the gall bladder and forms the major
constituent of most gallstones. Cholesterol is oxidized by the
liver into a variety of bile acids. These, in turn, are conjugated.
A mixture of conjugated and nonconjugated bile acids, along
with cholesterol itself, is excreted from the liver into the bile.
Approximately, 95% of the bile acids are reabsorbed from
the intestines. By this way, 50% of the excreted cholesterol
is reabsorbed by the small bowel again. The excretion and
reabsorption of bile acids form the basis of the enterohepatic
circulation, which is essential for digestion and absorption
of dietary fats. Cholesterol is kept in balance by homeostatic
mechanisms in human body, and cholesterol biosynthesis is
directly regulated by the cholesterol levels present. The higher
dietary intake leads to reduced synthesis of cholesterol in the
body and vice versa. In addition, most of dietary cholesterol is
esterified, and esterified cholesterol is poorly absorbed by the
bowels. For these reasons, dietary cholesterol has little effect
on plasma cholesterol values. On the other hand, when the cell
has abundant cholesterol, LDL receptor synthesis is blocked
so new cholesterol in the form of LDL molecules cannot be
taken up and vice versa again. Cholesterol is found only in
foods that come from animals but not in fruit, vegetable,
cereal, nut, and other plants. On the other hand, TG are the fat
found in our foods. Most of the fat in the human body is stored
in the form of TG again. Calories not burned by the body are
automatically converted into TG, which explains why eating
too much of anything can lead to excess weight. Fatty acids
in stored TG are used to provide energy for muscles. On
the other hand, when stored by the body, TG help to protect
and insulate internal organs and cushion the blow of a fall.
Actually, the number of fat cells in the body does not fluctuate
along with changes in weight instead the fat cells themselves
get bigger or smaller. In addition, TG are the major lipids
transported in the blood. In another word, TG provide energy
for muscles, are stored as body fat, and are used to produce
LDL in the body. TG are composed of even smaller units of
fat called as fatty acids that are attached to a chemical base
of glycerol. Fatty acids are known as the building blocks of
fat. Fatty acids are described as saturated, polyunsaturated,
or monounsaturated depending on how much hydrogen they
contain. Saturated fatty acids contain the most hydrogen, and
they are considered as the most dangerous ones for the health.
Interestingly, along with the cholesterol we get from foods,
saturated fats can raise the blood cholesterol levels more
than anything else in the foods. Saturated fats may increase
blood cholesterol levels by slowing down the removal of
LDL. Therefore, blood cholesterol values may increase even
if the diet is rich for saturated fats but poor for cholesterol.
Foods containing saturated fats mainly come from animals,
too. These foods also contain too much cholesterol actually,
so they can raise blood cholesterol levels in two ways at the
same time. Phospholipids are TG that are covalently bound
to a phosphate group. Phospholipids regulate membrane
permeability, remove cholesterol from the body, provide
signal transmission across the membranes, act as detergents,
and help in solubilization of cholesterol.
Cholesterol, TG, and phospholipids do not circulate freely
in the plasma instead they are bound to proteins, and
Table 1: Characteristic features of the study cases
Variables Patients with SCD* P-value Control cases
Number 363 255
Age (year) 31.0±9.2 (17–59) Ns† 31.2±8.6 (16–45)
Male ratio 53.4% (194) Ns 53.3% (136)
Body weight (kg) 59.9±11.8 (30–122) 0.000 71.5±16.4 (40–128)
Body height (cm) 164.9±9.1 (142–194) Ns 167.0±8.6 (147–192)
BMI‡ (kg/m2
) 21.9±3.6 (14.3–46.4) 0.000 25.6±5.8 (15.8–53.5)
FPG§ (mg/dL) 92.8±12.5 (57–125) 0.005 97.6±19.7 (66–269)
TC ║ (mg/dL) 121.4±32.2 (65–296) 0.000 165.0±54.3 (72–510)
LDL¶ (mg/dL) 70.4±28.4 (20–270) 0.000 102.4±41.1 (29–313)
HDL** (mg/dL) 26.0±9.4 (4–60) 0.000 39.6±13.2 (7–95)
TG*** (mg/dL) 129.4±90.4 (31–1216) 0.000 117.3±107.4 (24–931)
ALT**** (U/L) 27.4±16.2 (4–118) Ns 27.3±21.6 (6–117)
Systolic BP***** (mmHg) 115.2±15.7 (80–190) 0.000 122.6±19.4 (80–200)
Diastolic BP (mmHg) 73.0±12.3 (50–120) 0.000 86.6±13.6 (60–120)
*Sickle cell diseases †Nonsignificant (p0.05) ‡BMI §FPG ║TC ¶LDLs **HDLs ***Triglycerides ****ALT *****Blood pressure.
TG: Triglyceride, SCD: Sickle cell disease, BMI: Body mass index, TC: Total cholesterol, LDLs: Low-density lipoproteins, HDLs: High-
density lipoproteins, BP: Blood pressure, FPG: Fasting plasma glucose, ALT: Alanine aminotransferase
4. Helvaci, et al.: Mission of cholesterol and triglycerides
6 Asclepius Medical Research and Reviews • Vol 4 • Issue 1 • 2021
transported as lipoproteins. There are five major classes
of lipoproteins including chylomicrons, very low-density
lipoproteins (VLDL), intermediate density lipoproteins
(IDL), LDL, and HDL in the plasma. They are classified by
their density of protein. The lower the protein, the less dense
it is, the higher the cholesterol. The cholesterol within all the
various lipoproteins is identical. In another word, there is
really only one kind of cholesterol in the body. Chylomicrons
are the least dense types of cholesterol transport molecules.
Chylomicrons are made of TG, cholesterol, and protein in
the intestines, and released into the bloodstream after a meal.
Chylomicrons mainly carry exogenous TG from the intestine
to the liver through the thoracic duct. VLDL also contains
TG, cholesterol, and protein. VLDL are produced in the
liver and mainly carry endogenous TG from the liver to the
peripheral organs. In the capillaries of adipose and muscle
tissues, 90% of TG is removed by a specific group of lipases.
Hence, VLDL are converted into IDL by removal of TG.
Then, IDL are degraded into LDL by removal of more TG.
Hence, VLDL are the main sources of LDL in the plasma.
LDL are the major carriers of cholesterol in the blood.
LDL deliver cholesterol from the liver to other parts of the
body. Although the liver removes majority of LDL from the
circulation, a small amount is uptake by macrophages those
may migrate into the inner intima layer of arterial walls and
become the foam cells of atherosclerotic plaques. The foam
cells are filled with fat and cholesterol. They make up most
of plaques. The plaques contain mainly cholesterol, calcium,
fibrin, and cellular debris. This process can be accelerated
when LDL become oxidized by free oxygen radicals that are
produced as a byproduct while our cells are using oxygen to
burn fat. Remnants of chylomicrons and VLDL may be able
to deposit cholesterol onto artery walls in the same manner
with LDL. When TG are high, there is a larger number of
these remnants in the plasma, and a greater risk that arteries
are being exposed to their LDL-like effects. Cholesterol that
reaches the intima by way of these remnants may be used
to produce new foam cells and that results in more artery-
clogging plaque. These remnants may also be vulnerable to
oxidation, in which case they pose an even greater threat.
Over time these hard deposits thicken the wall of the
arteries, forcing blood to squeeze through a narrower space.
HDL remove fats and cholesterol from cells including within
arterial wall atheroma, and carry the cholesterol back to the
liver, adrenals, ovaries, and testes for excretion, reutilization,
or disposal. All of the carrier lipoproteins are under dynamic
control in the plasma and are readily affected by diet, illness,
drug, and BMI. Thus, lipid analysis should be performed
during a steady state. However, the metabolic syndrome alone
is a low grade inflammatory process on vascular endothelium
and may be a cause of the abnormal lipoproteins levels in the
plasma. Similarly, due to the severe inflammatory nature of
the SCD, plasma TC (121.4 vs. 165.0 mg/dL, P 0.000),
and LDL values (70.4 vs. 102.4 mg/dL, P 0.000) were
suppressed parallel to the suppressed body weight (59.9
vs. 71.5 kg, P 0.000) and BMI (21.9 vs. 25.6 kg/m2
,
P 0.000), here. On the other hand, although HDL are
commonly called as “the good cholesterol” due to their roles
in removing excess cholesterol from the blood and protecting
the arterial wall against atherosclerosis,[14]
recent studies did
not show similar results. Instead low HDL values should
alert clinicians about searching of additional metabolic or
inflammatory pathologies in human body.[15,16]
Normally,
HDL may show various anti-atherogenic properties
including reverse cholesterol transport and anti-oxidative
and anti-inflammatory properties.[15]
However, HDL may
become “dysfunctional” in pathologic conditions, which
means that relative compositions of lipids and proteins, as
well as the enzymatic activities of HDL are altered.[15]
For
example, properties of HDL are compromised in patients
with DM due to the oxidative modification and glycation
as well as the transformation of HDL proteomes into pro-
inflammatory proteins. In addition, the highly effective
agents of increasing HDL levels such as niacin, fibrates, and
cholesteryl ester transfer protein inhibitors did not reduce
all-cause mortality, CHD mortality, myocardial infarction,
or stroke.[17]
While higher HDL levels are correlated with
cardiovascular health, medications used to increase HDL
did not improve the health.[17]
Hence, HDL may actually
be some indicators instead of being the main actors of the
human health. Similarly, BMI, FPG, DM, and CHD were
the lowest between the HDL values of 40 and 46 mg/dL,
and the prevalence DM was only 3.1% between these
values against 22.2% outside of these limits.[18]
In another
definition, the moderate HDL values may also be the
results instead of causes of the better human health status.
Similarly, plasma HDL value was suppressed significantly
(39.6 vs. 26.0 mg/dL, P 0.000) parallel to the suppressed
body weight and BMI in the patients, probably due to the
severe inflammatory nature of the SCD in the present study.
BP is the force that blood exerts on the elastic wall
of arteries. Higher BP indicates that heart and blood
vessels are being overworked. In most people with HT,
increased peripheral vascular resistance accounts for HT
while cardiac output remains normal.[19]
The increased
peripheral vascular resistance is mainly attributable to
structural narrowing of small arteries and arterioles,
although a reduction of the number of capillaries may
also contribute.[20]
HT is more common in patients with
sedentary lifestyle, obesity, alcoholism, and associated
diseases such as DM, CRD, and COPD.[21]
HT is rarely
accompanied by symptoms in short-term. Symptoms
attributed to HT in that period may actually be related with
associated anxiety rather than HT itself. However, HT may
be the major risk factor for CRD, cirrhosis, COPD, stroke,
dementia, and PAD-like end-organ insufficiencies in long-
term since it damages the inner lining of arteries and sets the
stage for atherosclerosis. Plaque deposits are more likely to
develop in the areas of damage. If untreated, HT can also
5. Helvaci, et al.: Mission of cholesterol and triglycerides
Asclepius Medical Research and Reviews • Vol 4 • Issue 1 • 2021 7
increase the heart’s workload terminating with CHD. For
example, a reduction of the BP by 5 mmHg can decrease
the risk of stroke by 34% and CHD by 21% and reduce the
likelihood of dementia, heart failure, and mortality from
cardiovascular diseases.[22]
On the other hand, we cannot
detect any absolute cause in majority of patients with HT.
Physical inactivity, sedentary lifestyle, animal-rich diet,
excess weight, smoking, alcohol, chronic inflammations,
prolonged infections, and cancers may be found among
the possible risk factors of HT. Particularly, excess weight
may be the major underlying cause of HT in the world,
now. Adipose tissue produces leptin, tumor necrosis factor
(TNF)-alpha, plasminogen activator inhibitor-1, and
adiponectin-like cytokines, acting as acute phase reactants
(APR) in the plasma.[23]
Similarly, excess weight-induced
chronic low-grade vascular endothelial inflammation may
play a significant role in the pathogenesis of accelerated
atherosclerosis in human body.[24]
In addition, excess
weight leads to myocardial hypertrophy terminating with
a decreased cardiac compliance. Combination of these
cardiovascular risk factors eventually terminates with
increased risks of arrhythmias, cardiac failure, and sudden
death.Similarly,theprevalenceofCHDandstrokeincreased
parallel to the increased BMI in the other studies,[25,26]
and
risk of death from all causes including cancers increased
throughout the range of moderate to severe weight excess
in all age groups.[27]
The relationship between excess
weight, elevated BP, and hypertriglyceridemia is described
in the metabolic syndrome.[28]
Similarly, prevalence of
excess weight, DM, HT, and smoking were all higher in
the hypertriglyceridemia group (200 mg/dL and higher)
in another study.[29]
Carbon monoxide in cigarette smoke
damages the smooth inner surface of arteries. This damage
encourages the buildup of plaque on artery walls and makes
them hard and narrow. The carbon monoxide molecules
hitch a ride on RBC, occupying valuable space that is
normally reserved for the oxygen. In addition to narrowing
arteries and taking the place of oxygen, cigarette smoke
thickens the blood itself by boosting levels of fibrinogen.
Furthermore, smoking may also reduce HDL in the plasma
probably due to the systemic inflammatory effects on
vascular endothelium. On the other hand, the greatest
number of deteriorations in the metabolic parameters was
observed just above the plasma TG value of 60 mg/dL in
another study.[30]
Interestingly, plasma TG were the only
lipids those were not suppressed instead increased parallel
to the suppressed body weight and BMI in the SCD patients
in the present study.
The acute phase response is a facet of the innate immune
system that occurs in response to infection, infarction, foreign
body, autoimmune disorder, allergy, neoplasm, trauma, and
burns. Certain mediators, known as APR, are increased or
decreased in the context of acute inflammation.[31,32]
These
markers are commonly measured in clinical practice as
indicators of acute illness. The terms of acute phase proteins
and APR are usually used synonymously, although some
APR are polypeptides rather than proteins. An acute phase
reaction classically presents with fever, tachycardia, and
leukocytosis. Positive APR are those whose concentrations
increase with inflammation. Negative APR are those whose
concentrations decrease in an acute phase response. The
acute phase response is predominantly mediated by the pro-
inflammatory cytokines including TNF, interleukin (IL-1),
and IL-6 secreted by macrophages and other immune cells.
In case of inflammation, infection, and tissue damages,
neutrophils and macrophages release such cytokines into
the circulation. The liver and some other organs respond
by producing many positive APR to them. Some of the
well-known positive APR are C-reactive protein (CRP),
erythrocyte sedimentation rate (ESR), fibrinogen, ferritin,
procalcitonin, hepcidin, haptoglobin, ceruloplasmin,
complement proteins, and serum amyloid A. CRP is
involved in innate immunity, and responsible for activating
the complement pathway. Serum CRP rises rapidly, with a
maximal concentration reached within 2 days, and it falls
quickly once the inflammation has resolved. Measurement of
CRP is a useful marker of inflammation in clinic. It correlates
with ESR, however, not always directly. This is due to the
ESR being largely dependent on elevation of fibrinogen
with a half-life of approximately 1 week. Therefore, this
protein remains higher for a longer period despite removal
of the inflammatory stimulus. In contrast, CRP, with a half-
life of 6–8 h, rises rapidly, and returns to normal in case of
a successful treatment, quickly. Thus, an elevated ESR is
classically used as a marker of chronic inflammation. On the
other hand, productions of some other APR are suppressed
at the same time, which are called as negative APR. Some
of the well-known negative APR is albumin, transferrin,
retinol-binding protein, antithrombin, transcortin, and alpha-
fetoprotein. The suppression of such proteins is also used
as an indicator of inflammation. The physiological role of
suppressed synthesis of such proteins may be protection of
amino acids for production of positive APR, sufficiently.
Due to the same underlying cause, productions of HDL
and LDL may also be suppressed in the liver. By this way,
although the similar mean age, gender distribution, smoking,
and BMI in both groups, TG, DM, and CHD were higher,
whereas LDL and HDL were lower in patients with plasma
HDL lower than 40 mg/dL, significantly.[33]
Hence, HDL and
LDL may be some negative APR of the metabolic syndrome.
Similarly, although the lower age, BMI, FPG, LDL, and
HDL, the highest CHD of the group with HDL of lower
than 40 mg/dL can also be explained by the same theory.[34]
Beside that although the mean TG, fibrinogen, CRP, and
glucose values were higher in cases with ischemic stroke,
the oxidized LDL values did not correlate with the age,
stroke severity, and outcome in another study.[35]
In addition,
significant alterations occurred in the lipid metabolism and
lipoproteins compositions during infections, and plasma
6. Helvaci, et al.: Mission of cholesterol and triglycerides
8 Asclepius Medical Research and Reviews • Vol 4 • Issue 1 • 2021
TG increased whereas HDL and LDL decreased in another
study.[36]
Furthermore, a 10 mg/dL increase of plasma LDL
value was associated with a 3% lower risk of hemorrhagic
stroke in another study.[37]
Similarly, the highest prevalence
of HT and DM parallel to the increased values of LDL and
HDL, and the highest prevalence of COPD, CHD, and CRD
in contrast to the lowest values of LDL and HDL may show
initially positive but eventually negative APR functions of
LDL and HDL in the plasma.[38]
Hence, the most desired
values were between 80 and 100 mg/dL for LDL, between
40 and 46 mg/dL for HDL, and lower than 60 mg/dL for TG
in the plasma.[30,34]
SCD are hereditary hemolytic anemia characterized by the
presence of Hb S. Hb S causes RBC to change their normal
biconcave disk shape to a sickle shape under the effects of
various stresses. The RBC can take their normal shapes after
normalization of the stressful conditions, but after repeated
cycles of sickling and unsickling, hemolysis occurs. Hence,
lifespan of the RBC decreases from the normal 120 days
to 15–25 days. The chronic hemolytic anemia is mainly
responsible for the anemia that is the hallmark of the SCD.
Painful crises are the most disabling symptoms of the
SCD. Although painful crises may not be life threatening
directly,[39]
infections are the most common triggering factors
of them. Hence, the risk of mortality is significantly higher
during the crises. On the other hand, the severe pain may
be the result of complex interactions between RBC, white
blood cells (WBC), PLT, and endothelial cells. Probably,
leukocytosis contributes to the pathogenesis by releasing
several cytotoxic enzymes. The adverse actions of WBC
and PLT on the endothelial cells are of particular interest
with regard to the stroke and cerebrovascular diseases in
the SCD.[40]
For example, leukocytosis in the absence of
any infection was an independent predictor of the severity
of the SCD,[41]
and it was associated with an increased risk
of stroke.[42]
Occlusions of vasculature of the bone marrow,
bone infarctions, inflammatory mediators, and activation of
afferent nerves may take role in the pathophysiology of the
severe pain. Due to the severity of pain, narcotic analgesics
are generally used. Due to the repeated infarctions and
subsequent fibrosis, a functional and anatomic asplenism
develops due to the decreased antibody production, prevented
opsonization, and reticuloendothelial dysfunction in adults.
Terminal consequence of the asplenism is an increased risk
of infections with Streptococcus pneumoniae, Haemophilus
influenzae, and Neisseria meningitidis-like encapsulated
bacteria. Particularly, pneumococcal infections are so
common in early childhood with higher mortality rates.
The causes of death were infections in 56% of infants in a
previous study.[41]
In another study, the peak incidence of
death among children occurred between 1 and 3 years of age,
and the deaths under the age of 20 years were predominantly
caused by pneumococcal sepsis.[43]
Adult patients, even those
who appear relatively fit, are susceptible to sepsis, multiorgan
failures, and sudden death during acute painful crises due
to the severe and prolonged inflammatory process initiated
at birth in the SCD.[44,45]
SCD can affect all vascular organ
systems of the body.[46,47]
Aplastic crises, sequestration crises,
hemolytic crises, acute chest syndrome, avascular necrosis
of the femoral and humeral heads, priapism and infarction
of the penis, osteomyelitis, acute papillary necrosis of the
kidneys, CRD, occlusions of retinal arteries and blindness,
pulmonary HT, bone marrow necrosis induced dactylitis
in children, chronic punched-out ulcers around ankles,
hemiplegia, and cranial nerve palsies are only some of the
several presentation types. Eventually, the median ages of
death were 42 years in males and 48 years in females in the
literature.[12]
Delayed initiation of hydroxyurea therapy and
inadequate RBC supports during medical or surgical problems
may decrease the expected survival further.[48]
Actually, RBC
supports must be given immediately during all medical
or surgical emergencies, in which there is an evidence of
clinical deterioration.[49]
RBC supports decrease sickle cell
concentration in the circulation and suppress bone marrow
for the production of abnormal RBC. Hence, it decreases
sickling-induced endothelial damage and inflammation in
whole body. Due to the great variety of clinical presentation
types, it is not surprising to see that the mean weight and
BMI were significantly suppressed in patients with the SCD
(P 0.000 for both) in the present study. Probably parallel
to the significantly suppressed body weight and BMI, the
FPG, TC, LDL, HDL, systolic BP, and diastolic BP were also
suppressed in the SCD, which can be explained by definition
of the metabolic syndrome.[33,50]
On the other hand, the non-
suppressed ALT value may indicate the hepatic involvement
in the SCD.[51]
CONCLUSION
As a conclusion, cholesterol may be a negative whereas TG
positive APR in the plasma.
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How to cite this article: Helvaci MR, Salaz S, Yalcin A,
Muftuoglu OE, Abyad A, Pocock L. Cholesterol May
be a Negative Whereas Triglycerides Positive Acute
Phase Reactants in the Plasma. Asclepius Med Res Rev
2021;4(1):3-10.