TC, total cholesterol

TC,总胆固醇
  • 文章类型: Journal Article
    炎症性疾病,如牙周炎和动脉粥样硬化性冠心病(ASCHD),引发促炎介质的产生。这项研究的目的是评估使用唾液白细胞介素-1β(IL-1β)的准确性,白细胞介素-18(IL-18),和gasderminD(GSDMD)从健康个体中辨别患有和不患有ASCHD的牙周炎患者,并评估其与临床牙周参数和低密度脂蛋白(LDL)水平的相关性。该研究涉及120名参与者:30名是健康受试者(对照组,C),30例广泛性牙周炎(P组),30例患者有ASCHD和临床健康的牙周病(AS-C组),30例患有ASCHD和全身性牙周炎(AS-P组)。收集唾液和血液样本,和牙周特征,如菌斑指数,探查时出血,探测袋深度,并检查了临床附着丧失。IL-1β,使用ELISA测定来自唾液的IL-18和GSDMD水平。从血液样品中测定LDL水平。P组,AS-C,AS-P有较高水平的唾液IL-1β,IL-18和GSDMD高于C组。所有生物标志物的受试者工作特征(ROC)曲线显示出较高的诊断准确性,与临床参数和LDL水平呈显著正相关。所研究的促炎介质与疾病严重程度之间观察到的相关性表明,这些生物标志物可以作为牙周炎和ASCHD等疾病进展的指标。
    Inflammatory illnesses, such as periodontitis and atherosclerotic coronary heart disease (ASCHD), trigger the production of pro-inflammatory mediators. The aim of this study was to assess the accuracy of using salivary interleukin-1β (IL-1β), interleukin-18 (IL-18), and gasdermin D (GSDMD) in discerning patients with periodontitis with and without ASCHD from healthy individuals, and to assess their correlation with clinical periodontal parameters and low-density lipoprotein (LDL) levels. The study involved 120 participants: 30 were healthy subjects (control group, C), 30 had generalized periodontitis (group P), 30 had ASCHD and clinically healthy periodontium (group AS-C), and 30 had ASCHD and generalized periodontitis (group AS-P). Saliva and blood samples were collected, and periodontal characteristics such as plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss were examined. IL-1β, IL-18, and GSDMD levels from saliva were determined using ELISA. LDL levels were determined from the blood samples. Groups P, AS-C, and AS-P had higher levels of salivary IL-1β, IL-18, and GSDMD than group C. The receiver operating characteristic (ROC) curves of all biomarkers showed high diagnostic accuracy, with a significant positive correlation with the clinical parameters and LDL levels. The observed correlations between the studied pro-inflammatory mediators and disease severity suggest that these biomarkers could serve as indicators of disease progression in conditions such as periodontitis and ASCHD.
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  • 文章类型: Journal Article
    关于长期营养不良儿童的饮食如何影响心脏代谢生物标志物,人们知之甚少。这项探索性研究的目的是描述153名3-5岁的秘鲁儿童的饮食模式与心脏代谢谱之间的关系,这些儿童患有慢性营养不良。我们收集了9-24个月大的儿童每月的饮食回忆。在3-5年,收集了额外的饮食召回,还有血压,高度,体重,肩胛骨下皮肤皱褶和空腹血糖,对胰岛素和血脂进行了评估.营养素摄入量表示为每100千卡的平均密度(i)从9到24个月和(ii)随访。小树变换和稀疏降低秩回归(RRR)用于总结营养摄入量数据。然后使用线性回归模型将这些因素与心脏代谢结果和人体测量学进行比较。然后使用线性回归模型调整肩胛骨下皮褶年龄Z评分(SSFZ),以测试观察到的关系是否由身体成分介导。26%的儿童在3-5岁时发育迟缓。小树转化和稀疏RRR衍生的儿童饮食因素均与蛋白质摄入相关,并与总胆固醇和SSFZ相关。调整SSFZ后,饮食因素与胰岛素之间的关联减弱,表明身体成分介导了这些关系。儿童早期的饮食因素,受蛋白质摄入量的影响,与胆固醇分布有关,长期营养不良人群的空腹血糖和体内脂肪。
    Relatively little is known about how the diet of chronically undernourished children may impact cardiometabolic biomarkers. The objective of this exploratory study was to characterise relationships between dietary patterns and the cardiometabolic profile of 153 3-5-year-old Peruvian children with a high prevalence of chronic undernutrition. We collected monthly dietary recalls from children when they were 9-24 months old. At 3-5 years, additional dietary recalls were collected, and blood pressure, height, weight, subscapular skinfolds and fasting plasma glucose, insulin and lipid profiles were assessed. Nutrient intakes were expressed as average density per 100 kcals (i) from 9 to 24 months and (ii) at follow-up. The treelet transform and sparse reduced rank regress\'ion (RRR) were used to summarize nutrient intake data. Linear regression models were then used to compare these factors to cardiometabolic outcomes and anthropometry. Linear regression models adjusting for subscapular skinfold-for-age Z-scores (SSFZ) were then used to test whether observed relationships were mediated by body composition. 26 % of children were stunted at 3-5 years old. Both treelet transform and sparse RRR-derived child dietary factors are related to protein intake and associated with total cholesterol and SSFZ. Associations between dietary factors and insulin were attenuated after adjusting for SSFZ, suggesting that body composition mediated these relationships. Dietary factors in early childhood, influenced by protein intake, are associated with cholesterol profiles, fasting glucose and body fat in a chronically undernourished population.
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  • 文章类型: Randomized Controlled Trial
    我们试图研究每日食用澳洲坚果对体重和成分的影响,超重和肥胖成年人在自由生活环境中的血浆脂质和血糖参数在心脏代谢风险升高。利用随机交叉设计,35名患有腹部肥胖的成年人在8周(干预)内消耗了通常的饮食加澳洲坚果(约占每日卡路里的15%),在8周(对照)内没有坚果的日常饮食,进行了2周的冲洗。通过生物电阻抗确定身体成分;通过24小时饮食回顾评估饮食摄入量。食用澳洲坚果导致总脂肪和MUFA摄入量增加,而SFA摄入量不变。通过混合模型回归分析,平均体重没有显著变化,BMI,腰围,身体脂肪百分比或血糖参数,血浆总胆固醇无明显下降2·1%(-4·3mg/dl;95%CI-14·8,6·1)和低密度脂蛋白(LDL-C)4%(-4·7mg/dl;95%CI-14·3,4·8)。降低胆固醇的作用因肥胖而改变:在超重和肥胖的人群中发生了更大的降脂作用。以及那些身体脂肪百分比低于中位数的人。在超重或肥胖的成年人的自由生活条件下,每天食用澳洲坚果不会导致体重或体脂肪增加;在没有改变饱和脂肪摄入量与其他坚果降低胆固醇的幅度相似的情况下,发生了不显著的胆固醇降低。临床试验登记号和网站:NCT03801837https://clinicaltrials.gov/ct2/show/NCT03801837?term=澳洲坚果+坚果&draw=2&rank=1。
    We sought to examine the effects of daily consumption of macadamia nuts on body weight and composition, plasma lipids and glycaemic parameters in a free-living environment in overweight and obese adults at elevated cardiometabolic risk. Utilising a randomised cross-over design, thirty-five adults with abdominal obesity consumed their usual diet plus macadamia nuts (~15 % of daily calories) for 8 weeks (intervention) and their usual diet without nuts for 8 weeks (control), with a 2-week washout. Body composition was determined by bioelectrical impedance; dietary intake was assessed with 24-h dietary recalls. Consumption of macadamia nuts led to increased total fat and MUFA intake while SFA intake was unaltered. With mixed model regression analysis, no significant changes in mean weight, BMI, waist circumference, percent body fat or glycaemic parameters, and non-significant reductions in plasma total cholesterol of 2⋅1 % (-4⋅3 mg/dl; 95 % CI -14⋅8, 6⋅1) and low-density lipoprotein (LDL-C) of 4 % (-4⋅7 mg/dl; 95 % CI -14⋅3, 4⋅8) were observed. Cholesterol-lowering effects were modified by adiposity: greater lipid lowering occurred in those with overweight v. obesity, and in those with less than the median percent body fat. Daily consumption of macadamia nuts does not lead to gains in weight or body fat under free-living conditions in overweight or obese adults; non-significant cholesterol lowering occurred without altering saturated fat intake of similar magnitude to cholesterol lowering seen with other nuts. Clinical Trial Registry Number and Website: NCT03801837 https://clinicaltrials.gov/ct2/show/NCT03801837?term = macadamia + nut&draw = 2&rank = 1.
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  • 文章类型: Journal Article
    目的:羟基酪醇(HT)是一种具有广泛生物活性的多酚。过度饮酒会导致肝脏氧化应激和炎症,通常发展为酒精性肝病(ALD)。目前,没有特定的药物来治疗ALD。在本文中,研究了HT对ALD的保护作用及其机理。方法:将HepG2细胞体外暴露于乙醇中,并在体内饲喂C57BL/6J小鼠Lieber-DeCarli乙醇液体饮食。结果:血清甘油三酯(TG)水平和脂肪酸合成酶(FASN)表达显著降低,乙醛脱氢酶(ALDH)活性升高,血清丙二醛(MDA)水平降低,过氧化氢酶(CAT)和谷胱甘肽(GSH)增加,提示HT可能通过促进酒精代谢减少其对机体的氧化损伤。此外,根据tnf-α的mRNA水平,il-6和il-1β,HT显著抑制乙醇诱导的炎症。HT的抗炎机制可能与抑制STAT3/iNOS通路有关。破裂:我们的研究表明HT可以改善乙醇诱导的肝脏脂肪变性,氧化应激和炎症反应,为ALD的预防和治疗提供新的候选者。
    Objective: Hydroxytyrosol (HT) is a polyphenol with a wide range of biological activities. Excessive drinking can lead to oxidative stress and inflammation in the liver, which usually develop into alcohol liver disease (ALD). At present, there is no specific drug to treat ALD. In this paper, the protection effect of HT on ALD and the underline mechanism were studied.Methods: HepG2 cells were exposed to ethanol in vitro and C57BL/6J mice were fed with a Lieber-DeCarli ethanol liquid diet in vivo.Results: triglyceride (TG) level in serum and the expression of fatty acid synthase (FASN) were reduced significantly by the treatment with HT The acetaldehyde dehydrogenase (ALDH) activity was increased, the serum level of malondialdehyde (MDA) was decreased, catalase (CAT) and glutathione (GSH) were increased, suggesting that HT may reduce its oxidative damage to the body by promoting alcohol metabolism. Furthermore, according to the mRNA levels of tnf-α, il-6 and il-1β, HT inhibited ethanol-induced inflammation significantly. The anti-inflammatory mechanism of HT may be related to suppress the STAT3/iNOS pathway.Dissussion: Our study showed that HT could ameliorate ethanol-induced hepatic steatosis, oxidative stress and inflammation and provide a new candidate for the prevention and treatment of ALD.
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    求助全文

  • 文章类型: Journal Article
    未经批准:鱼腥草(L.)Vahl(莎草科)是一种草类草本植物,习惯性地在稻田中作为杂草繁殖,主要散布在南亚和东南亚的热带或亚热带国家,澳大利亚北部,和西非。传统上,该植物已被用作膏药的形式来治疗发烧。然而,没有关于其毒性特征的科学研究得到证实。
    UNASSIGNED:已经进行了这项研究,以确定从鱼尾草叶中提取的甲醇提取物的潜在毒性,在小鼠中采用急性和亚慢性口服给药技术。
    UNASSIGNED:在根据OECD指南425的急性毒性研究中,在两种性别的瑞士白化病小鼠中以2000和5000mg/kg的单剂量口服FM甲醇提取物。有毒症状,异常行为,体重的变化,和死亡率观察连续14天。在根据OECD指南407的亚慢性毒性研究中,植物提取物以每天100、500、1000和2000mg/kg的剂量口服施用28天。一般的中毒症状,异常行为,每天观察体重变化。血清生化分析,研究结束时进行肝脏组织病理学检查。
    未经批准:无死亡,异常行为和排尿,睡眠的变化,食物摄入量,不利影响,在2000和5000mg/kg剂量的急性毒性研究中,已经记录了体重的非线性。此外,在亚慢性毒性研究中,FM提取物在一般行为方面没有产生死亡率或任何不利影响,体重,排尿,睡眠常规,和食物摄入。在分析十三个不同的生化参数的情况下,在急性和亚慢性研究中,雄性和雌性小鼠的天冬氨酸转氨酶(AST)和葡萄糖浓度均发生显着变化。总胆固醇和甘油三酯在5000mg/kg。在急性毒性研究中,雄性小鼠的bw发生变化。另一方面,雌性小鼠在亚慢性试验中改变了甘油三酯。发现所有其他关键参数未受影响。在亚慢性测试中,肝脏的组织病理学检查显示细胞坏死为2000mg/kg。bw在雄性和雌性小鼠中,而在1000mg/kg时观察到轻微的坏死。bw.因此,没有观察到的不良反应水平(NOAEL)可以假设在1000mg/kg左右。bw.
    未经证实:本研究表明,用FM提取物治疗未显示出明显的毒性。
    UNASSIGNED: Fimbristylis miliacea (L.) Vahl (Cyperaceae) is a grass like herb habitually breeds as weed in paddy fields and mostly disseminated in tropical or sub-tropical countries of south and south-east Asia, northern Australia, and west Africa. The plant has been traditionally used to treat fever as a form of poultice. However, no scientific study regarding its toxicity profile has been testified.
    UNASSIGNED: The study has been carried out to determine the potential toxicity of the methanol extract from leaves of the Fimbristylis miliacea, employing the technique of acute and subchronic oral administration in mice.
    UNASSIGNED: In the acute toxicity study according to OECD guideline 425, oral administration of FM methanol extract at single doses of 2000 and 5000 mg/kg in both sexes of Swiss albino mice was performed. Toxic symptoms, abnormal behavior, changes in body weight, and mortality were observed for 14 consecutive days. In subchronic toxicity study according to OECD guideline 407, plant extract was administered orally at doses of 100, 500, 1000, and 2000 mg/kg daily for 28 days. The general toxic symptoms, abnormal behavior, changes in body weight were observed daily. Biochemical analysis of serum, and histopathological examination of liver were performed at the end of the study.
    UNASSIGNED: No mortality, abnormal behavior and urination, changes in sleep, food intake, adverse effect, and non-linearity in body weight have been recorded during acute toxicity study at the doses of 2000 and 5000 mg/kg. Also, in subchronic toxicity study, FM extract produced no mortality or any kind of adverse effects in regards of general behavior, body weight, urination, sleeping routine, and food intake. In case of analysis of thirteen different biochemical parameters, concentrations of aspartate transaminase (AST) and glucose were altered significantly in male and female mice in both acute and subchronic study. Total cholesterol and triglycerides at 5000 mg/kg.bw were changed in male mice in acute toxicity study. On the other hand, female mice had altered triglycerides in subchronic test. All other critical parameters were found unaffected. In subchronic test, histopathological examination of liver demonstrated cellular necrosis at 2000 mg/kg.bw in both male and female mice while minor necrosis was observed at 1000 mg/kg.bw. Thus, the no observed adverse effect level (NOAEL) can be assumed around 1000 mg/kg.bw.
    UNASSIGNED: The present study suggests that treatment with FM extract does not reveal significant toxicity.
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  • 文章类型: Journal Article
    未经证实:主要心血管疾病(CVD)危险因素的患病率较低,如血脂异常,高血压和吸烟,可以解释西方国家过去几十年来心血管疾病死亡率和发病率下降的很大一部分。然而,一些研究表明,近年来风险因素的趋势较差。我们评估了2001年至2019年挪威年轻人血脂分布的时间趋势。
    未经证实:在奥斯陆一家大型医学实验室分析的血清脂质样本,挪威,主要由初级保健医生征用,进行了横断面分析,以估计18-49岁男性和女性的逐年趋势。我们还评估了脂质分布和比例与不良脂质水平。
    未经批准:总共,超过2600万份血液样本,包括来自挪威所有地区的100多万人(平均年龄37.7岁)。男女各年龄组的所有措施都有所改善,尤其是总胆固醇和非HDL胆固醇(每十年-0.22和-0.25mmol/l,分别)。总体人口分布有下降趋势,非HDL-C和LDL-C总胆固醇≥5.0mmol/l和非HDL-C≥3.9mmol/l的总体患病率相似地降低,从65%到46%,从52%到34%,分别。2019年,超过1/3的总HDL-C和/或非HDL-C水平升高。
    UNASSIGNED:在18-49岁的挪威人口中,在过去的二十年中,血脂状况有所改善。由于这个年龄组的降脂药物使用率较低,这可能反映了有利的长期趋势。
    UNASSIGNED: Lower prevalence of major cardiovascular disease (CVD) risk factors, such as dyslipidemia, hypertension and smoking, can explain a substantial part of the decline in CVD mortality and incidence for the past decades in Western countries. However, some studies have indicated less favorable trends in risk factors in recent years. We have assessed time trends in lipid profiles among young adults in Norway measured between 2001 and 2019.
    UNASSIGNED: Samples of serum lipids analyzed at one large medical laboratory in Oslo, Norway, mainly requisitioned by primary care physicians, were analyzed cross-sectionally to estimate year-to-year trends among men and women aged 18-49 years. We also assessed the lipid distributions and proportions with adverse lipid levels.
    UNASSIGNED: In total, more than 2,6 million blood samples, comprising more than 1 million individuals (mean age 37.7 years) from all regions of Norway were included. All measures improved among all age groups in both women and men, especially in total and non-HDL cholesterol (-0.22 and -0.25 mmol/l per decade, respectively). There were downward shifts in the population distribution of total, non-HDL-C and LDL-C. The overall prevalences of total cholesterol ≥5.0 mmol/l and non-HDL-C ≥3.9 mmol/l similarly decreased, from ∼63 to 46% and from ∼52 to 34%, respectively. More than 1/3 had elevated levels of total and/or non-HDL-C in 2019.
    UNASSIGNED: In a large proportion of the Norwegian population aged 18-49 years old, the lipid profiles improved during the last two decades. As the use of lipid-lowering medications is low in this age group, this likely reflects favorable secular trends.
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  • 文章类型: Journal Article
    关于四氯化碳(CCl4)肝毒性对凝血谱的影响的报道一直不一致。然而,多个研究人员已经证明了水飞蓟素在CCl4引起的异常的分辨率的有效性,尽管水飞蓟素对CCl4肝毒性的影响,特别是凝血曲线和渗透脆性尚未研究。肝脏,凝血蛋白分泌的主要部位,CCl4肝毒性可能受损,据报道,水飞蓟素增加肝蛋白合成作为其肝脏保护机制的一部分。本研究评估了水飞蓟素对CCl4诱导的大鼠肝毒性的凝血特性和红细胞渗透脆性的影响。20只雄性Wistar大鼠随机分为4组(n=5),即:控制,CCl4给予CCl4(1ml/kg),每周两次腹膜内给药,水飞蓟素(S)口服水飞蓟素(100mg/kg/天),和S+CCl4给予水飞蓟素(100毫克/千克/天)口服和(1毫升/千克)CCl4后一小时,每周两次腹膜内注射,持续四周。结果显示活化部分凝血活酶时间和凝血酶时间延长,红细胞渗透脆性增加,肝损伤,血脂异常,给予CCl4大鼠的氧化应激和脂质过氧化。如从CCl4和S+CCl4大鼠之间的比较所观察到的,水飞蓟素减弱了大多数这些作用。这项研究的结果表明,水飞蓟素预处理可以减轻CCl4引起的Wistar大鼠肝毒性对凝血功能和红细胞渗透脆性的破坏。
    Reports about the impact of Carbon tetrachloride (CCl4) hepatotoxicity on coagulation profile have been inconsistent. Multiple investigators have however demonstrated the effectiveness of silymarin in the resolution of anomalies induced by CCl4, although the effect of silymarin on the impact of CCl4 hepatotoxicity, especially coagulation profile and osmotic fragility have not been investigated. The liver, the primary site for the secretion of coagulation proteins, can become impaired in CCl4 hepatotoxicity, and silymarin reportedly increases hepatic protein synthesis as part of its hepatoprotective mechanism. This study assessed the effect of silymarin on blood coagulation profile and erythrocyte osmotic fragility in CCl4 induced hepatotoxicity in rats. Twenty male Wistar rats were allocated into four groups (n = 5) at random, namely: Control, CCl4 given CCl4 (1 ml/kg) administered intraperitoneally twice a week, Silymarin (S) given silymarin (100 mg/kg/day) orally, and S+CCl4 given silymarin (100 mg/kg/day) orally and (1 ml/kg) CCl4 one hour after, intraperitoneally twice a week for a duration of four weeks. Results showed protraction of activated partial thromboplastin time and thrombin time, increased erythrocyte osmotic fragility, liver damage, dyslipidemia, oxidative stress and lipid peroxidation in rats given CCl4. Silymarin attenuated most of these effects as observed from comparison between CCl4 and S+CCl4 rats. The findings of this study suggests that pretreatment with silymarin attenuated disruption in coagulation profile and erythrocyte osmotic fragility in CCl4 induced hepatotoxicity in Wistar rats.
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  • 文章类型: Journal Article
    未经证实:胰岛素抵抗可以通过甘油三酯-葡萄糖指数(TyG)来评估,一个简单的,低成本,和易于应用的方法。
    UNASSIGNED:评估TyG指数对心血管风险的预测能力,并确定其在心血管代谢风险人群中的临界点。
    未经评估:对264名处于心血管代谢风险的个体进行的横断面研究(54.9%为女性,年龄:43.1±16.3岁)。人口统计,人体测量学,临床实验室,收集生活方式数据。使用公式Ln[空腹甘油三酯(mg/dL)X空腹血浆葡萄糖(mg(dL)/2]测定TyG指数。通过Framingham风险评分(FRS)评估十年心血管风险。受试者工作特征曲线(ROC)用于定义TyG指数的截止点,并通过泊松回归检验其相关性。
    UNASSIGNED:ROC曲线分析表明曲线下面积为0.678(95%CI=0.618-0.734;p<0.001),截止值为9.04(灵敏度=62.5%,特异性=66.7%,阳性预测值=29.4%,阴性预测值=88.9%)。升高的TyG值(≥9.04)与心脏代谢危险因素(总胆固醇,LDL,VLDL,尿酸,丙氨酸氨基转移酶,天冬氨酸转氨酶,腰臀比,收缩压,HOMA-IR,吸烟,代谢综合征,糖尿病,和肝脂肪变性)。在对混杂因素进行调整后,高TyG的个体在FRS的中/高风险患病率中增加了69%(RP=1.69;95CI=1.03-2.78),与那些低TyG相比。
    UNASSIGNED:通过FRS评估,TyG指数在十年内显示出良好的心血管风险预测能力。
    UNASSIGNED: Insulin resistance can be assessed by the Triglyceride-Glucose Index (TyG), a simple, low-cost, and easy-to-apply method.
    UNASSIGNED: To assess the predictive capacity of the TyG index about cardiovascular risk and identify its cutoff point in a population at cardiometabolic risk.
    UNASSIGNED: Cross-sectional study with 264 individuals at cardiometabolic risk (54.9% women, age: 43.1 ± 16.3 years). Demographic, anthropometric, clinical-laboratory, and lifestyle data were collected. The TyG index was determined using the formula Ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg (dL)/2]. The ten-year cardiovascular risk was assessed by the Framingham risk score (FRS). The receiver operating characteristic curve (ROC) was used to define the cutoff point for the TyG index, and the associations were tested by Poisson regression.
    UNASSIGNED: ROC curve analysis indicated an area under the curve of 0.678 (95% CI = 0.618-0.734; p < 0.001), with a cutoff of 9.04 (sensitivity = 62.5%, specificity = 66.7%, positive predictive value = 29.4% and negative predictive value = 88.9%). Elevated TyG values ​​(≥9.04) were positively associated with cardiometabolic risk factors (total cholesterol, LDL, VLDL, uric acid, alanine aminotransferase, aspartate aminotransferase, waist-hip ratio, systolic blood pressure, HOMA-IR, smoking, metabolic syndrome, diabetes, and hepatic steatosis). After adjustment for confounding factors, individuals with high TyG showed an increase of 69% (RP = 1.69; 95%CI = 1.03-2.78) in the prevalence of intermediate/high risk by FRS, compared to those with low TyG.
    UNASSIGNED: The TyG index showed a good predictive capacity for cardiovascular risk in ten years assessed by the FRS.
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  • 文章类型: Journal Article
    未经证实:亚临床甲状腺功能减退症(SCH)常导致血脂改变,这可能会对人类健康产生负面影响。脂质是否反过来影响SCH的自然史尚不清楚。我们旨在评估血清脂质水平的纵向变化与SCH的自然史之间的关联。
    UNASSIGNED:这项回顾性队列研究使用了来自REACTION研究的数据,纳入了2011年7月1日至2014年12月19日之间的581例SCH患者,中位随访时间为3[IQR,2·86-3·21]年。排除数据缺失或可能影响甲状腺功能的患者。从相隔3年的血清脂质测量值计算血清脂质水平的变化,并以两种方式分类:1)第一,第二,以及基线和随访之间差异的第三个三分位数,以及2)从基线的百分比变化,即,血脂下降≥25%,微小的变化,和血脂增加≥25%。SCH的自然史包括甲状腺功能恢复,SCH持久性,或进展为明显的甲状腺功能减退症(OH)。通过多变量逻辑回归估计赔率(ORs)。对2012年1月1日至2016年12月31日进行的健康管理队列研究的数据进行了验证,中位随访时间为2[IQR,1·92-2·08]年。在使用与反应队列研究相同的纳入和排除标准后,412例SCH患者符合验证分析的条件。
    未经评估:研究中有132名(22·7%)男性和449名(77·3%)女性,平均年龄为56岁[IQR,49-62]年随访期间,270(46·5%),266(45·8%),27例(4.6%)患者甲状腺功能恢复,持久性SCH,进展到OH,分别。两种分组方式均显示脂质水平的变化与SCH的自然史之间存在显着关联。总胆固醇(TC)水平升高与进展为OH的更大风险独立相关(OR≥25%TC升高与微小变化:5·40;95%CI1·46-21·65),而TC水平下降则增加了向甲状腺功能正常消退的可能性(TC下降≥25%与小变化:3·45;95%CI1·09-12·43)。同样,根据甘油三酯(TG)水平变化的回归可能性与根据TC水平变化的回归趋势一致.在验证队列中观察到相似的关联模式。
    UNASSIGNED:SCH的血脂水平变化与未来的进展或消退风险相关,提示血脂水平的变化可能会影响SCH的自然史。临床医生应注意SCH患者血脂水平的长期控制,这可能有利于甲状腺功能。
    UNASSIGNED:这项工作得到了中国国家重点研究发展计划(2017YFC1309800)的资助,国家自然科学基金(81430020,82070818),和山东第一医科大学“人才驱动卓越大学”计划和学术促进计划(2019LJ007)。
    UNASSIGNED: Subclinical hypothyroidism (SCH) often leads to alterations in lipid profile, which may negatively impact humans health. Whether lipids in turn affect the natural history of SCH is unknown. We aimed to assess the association between longitudinal changes in serum lipid levels and the natural history of SCH.
    UNASSIGNED: This retrospective cohort study using data from the REACTION study included 581 patients with SCH who were enrolled between July 1, 2011, and December 19, 2014, with a median follow-up of three [IQR, 2·86-3·21] years. Patients with missing data or conditions that can affect thyroid function were excluded. Changes in serum lipid levels were calculated from serum lipid measurements 3 years apart and classified in two ways: 1) the first, second, and third tertiles of the difference between baseline and follow-up and 2) the percent change from baseline, namely, serum lipid decrease ≥ 25%, minor change, and serum lipid increase ≥ 25%. The natural history of SCH includes regression to euthyroidism, SCH persistence, or progression to overt hypothyroidism (OH). Odds ratios (ORs) were estimated by multivariable logistic regression. Validation was performed on data from a health management cohort study conducted from January 1, 2012, to December 31, 2016, with a median follow-up of two [IQR, 1·92-2·08] years. After using the same inclusion and exclusion criteria as the REACTION cohort study, 412 patients with SCH were eligible for the validation analysis.
    UNASSIGNED: There were 132 (22·7%) men and 449 (77·3%) women in the study, with a median age of 56 [IQR,49-62] years. During follow-up, 270 (46·5%), 266 (45·8%), and 27 (4·6%) patients had regression to euthyroidism, persistent SCH, and progression to OH, respectively. Both grouping manners showed a significant association between changes in lipid levels and the natural history of SCH. A total cholesterol (TC)-level increase was independently associated with a greater risk of progression to OH (OR for ≥ 25% TC increase vs. minor change: 5·40; 95% CI 1·46-21·65), whereas TC-level declines increased the likelihood of regressing to euthyroidism (OR for ≥ 25% TC decrease vs. minor change: 3·45; 95% CI 1·09-12·43). Similarly, the likelihood of regression according to changes in triglyceride (TG) levels exhibited a consistent trend with that according to TC-level changes. A similar pattern of association was observed in the validation cohort.
    UNASSIGNED: Changes in serum lipid levels in SCH are associated with future progression or regression risk, suggesting that the changes in serum lipid levels may affect the natural history of SCH. Clinicians should pay attention to the long-term control of serum lipids levels in populations with SCH, which may benefit thyroid function.
    UNASSIGNED: This work was supported by grants from the National Key Research and Development Program of China (2017YFC1309800), the National Natural Science Foundation (81430020, 82070818), and the \"Outstanding University Driven by Talents\" Program and Academic Promotion Program of Shandong First Medical University (2019LJ007).
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  • 文章类型: Journal Article
    未经证实:他汀类药物已被证明可延缓天然冠状动脉和隐静脉移植物中动脉粥样硬化的不可避免的进展,从而减少手术冠状动脉血运重建后的缺血事件。然而,对于针对具体的胆固醇目标滴定他汀类药物治疗是否合适,存在重大争议.
    UNASSIGNED:对2007年和2008年接受孤立冠状动脉搭桥术的309例连续患者进行了单中心回顾性分析。脂质分布亚组分的测量,即总胆固醇,高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),和甘油三酯,mmol/L,是通过对电子健康记录的回顾性审查获得的。主要终点是心脏死亡。次要终点是心脏事件的复合,包括心脏死亡,非致死性心肌梗死,不稳定型心绞痛住院,和靶病变血运重建。数据库锁定日期为2020年8月15日。
    UNASSIGNED:中位随访时间为12.5年。6.8%的队列患者发生心源性死亡。21.7%的队列发生心脏事件。新发心肌梗死发生率为8.7%(n=27),其中48.1%(n=13)接受了重复血运重建。构建2水平嵌套Cox比例风险回归模型,以确定胆固醇目标是否与心脏事件独立相关。风险调整后,LDL-C,非HDL-C,总胆固醇(TC),TC/HDL-C比值与心源性死亡独立相关。在接收机工作特性分析中,非HDL-C的最佳截止值,LDL-C,TC/HDL-C比值为3.2mmol/L,2.3mmol/L,和3.5,分别。
    UNASSIGNED:暴露于升高的LDL-C和非HDL-C胆固醇水平独立预测冠状动脉旁路移植术后的长期心脏死亡。
    UNASSIGNED: Statins have been shown to delay the inevitable progression of atherosclerosis in native coronaries and saphenous vein grafts, thereby reducing ischemic events after surgical coronary revascularization. However, there is significant controversy as to whether titrating statin therapy to concrete cholesterol targets is appropriate.
    UNASSIGNED: A single-center retrospective analysis of 309 consecutive patients who underwent isolated coronary artery bypass graft in 2007 and 2008 was performed. Measurements of lipid profile subcomponents, namely total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides, in mmol/L, were obtained by retrospective review of electronic health records. The primary end point was cardiac death. The secondary end point was the composite of cardiac events, including cardiac death, nonfatal myocardial infarction, hospitalization for unstable angina, and target lesion revascularization. Database lock date was August 15, 2020.
    UNASSIGNED: The median follow-up duration was 12.5 years. Cardiac death occurred in 6.8% of the cohort. Cardiac events occurred in 21.7% of the cohort. New-onset myocardial infarction occurred in 8.7% (n = 27), of which 48.1% (n = 13) underwent repeat revascularization. A 2-level nested Cox proportional hazards regression model was constructed to determine whether cholesterol target attainment was independently associated with cardiac events. After risk adjustment, LDL-C, non-HDL-C, total cholesterol (TC), and TC/HDL-C ratio were independently associated with cardiac death. In receiver operating characteristics analyses, the optimal cut-off values for non-HDL-C, LDL-C, and TC/HDL-C ratio were 3.2 mmol/L, 2.3 mmol/L, and 3.5, respectively.
    UNASSIGNED: Exposure to elevated LDL-C and non-HDL-C cholesterol levels independently predicted long-term cardiac death after coronary artery bypass graft.
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