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At least 19 recordsLinked to original sources
PubMed2004

Clinical practice guidelines for managing dyslipidemias in kidney transplant patients: a report from the Managing Dyslipidemias in Chronic Kidney Disease Work Group of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative.

The incidence of cardiovascular disease (CVD) is very high in patients with chronic kidney (CKD) disease and in kidney transplant recipients. Indeed, available evidence for these patients suggests that the 10-year cumulative risk of coronary heart disease is at least 20%, or roughly equivalent to the risk seen in patients with previous CVD. Recently, the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) published guidelines for the diagnosis and treatment of dyslipidemias in patients with CKD, including transplant patients. It was the conclusion of this Work Group that the National Cholesterol Education Program Guidelines are generally applicable to patients with CKD, but that there are significant differences in the approach and treatment of dyslipidemias in patients with CKD compared with the general population. In the present document we present the guidelines generated by this workgroup as they apply to kidney transplant recipients. Evidence from the general population indicates that treatment of dyslipidemias reduces CVD, and evidence in kidney transplant patients suggests that judicious treatment can be safe and effective in improving dyslipidemias. Dyslipidemias are very common in CKD and in transplant patients. However, until recently there have been no adequately powered, randomized, controlled trials examining the effects of dyslipidemia treatment on CVD in patients with CKD. Since completion of the K/DOQI guidelines on dyslipidemia in CKD, the results of the Assessment of Lescol in Renal Transplantation (ALERT) Study have been presented and published. Based on information from randomized trials conducted in the general population and the single study conducted in kidney transplant patients, these guidelines, which are a modified version of the K/DOQI dyslipidemia guidelines, were developed to aid clinicians in the management of dyslipidemias in kidney transplant patients. These guidelines are divided into four sections. The first section (Introduction) provides the rationale for the guidelines, and describes the target population, scope, intended users, and methods. The second section presents guidelines on the assessment of dyslipidemias (guidelines 1-3), while the third section offers guidelines for the treatment of dyslipidemias (guidelines 4-5). The key guideline statements are supported mainly by data from studies in the general population, but there is an urgent need for additional studies in CKD and in transplant patients. Therefore, the last section outlines recommendations for research.

Adolescent↗
PubMed2001

The effect of aggressive versus standard lipid lowering by atorvastatin on diabetic dyslipidemia: the DALI study: a double-blind, randomized, placebo-controlled trial in patients with type 2 diabetes and diabetic dyslipidemia.

OBJECTIVE: In patients with type 2 diabetes, intensive glucose regulation, although effective for microangiopathy, has not been shown to have unambiguous preventive effects on the occurrence of cardiovascular disease. Patients with diabetes show a characteristic dyslipidemia (high triglyceride level, low HDL cholesterol level). Aggressive reduction of triglycerides might be an effective method to reduce the cardiovascular risk in these patients. RESEARCH DESIGN AND METHODS: A double-blind, placebo-controlled, randomized study to assess the effect of 30 weeks of administration of atorvastatin 10 and 80 mg on plasma triglyceride levels in 217 patients with type 2 diabetes and fasting triglyceride levels between 1.5 and 6.0 mmol/l. RESULTS: Administration of atorvastatin 10 and 80 mg resulted in significant reductions (25 and 35%, respectively) of plasma triglyceride levels (both P < 0.001). The difference between 10 and 80 mg was not statistically significant (P > 0.5). Atorvastatin 10 mg provided significant reductions from baseline in total cholesterol (-30%, P < 0.001), LDL cholesterol (-40%, P < 0.001), and apolipoprotein B (-31%, P < 0.001), and significantly increased HDL cholesterol from baseline by 6% (P < 0.005). Atorvastatin 80 mg had a similar effect on HDL cholesterol (+5.2%, P < 0.005) but significantly decreased total cholesterol (-40%, P < 0.001), LDL cholesterol (-52%, P < 0.001), and apolipoprotein B (-40%, P < 0.001) more than atorvastatin 10 mg (P < 0.005). The side effects of atorvastatin 10 and 80 mg were similar and did not differ from the patients receiving placebo. CONCLUSIONS: Administration of 10- and 80-mg doses of atorvastatin provides similar, significant reductions from baseline in triglyceride levels in patients with type 2 diabetes. A higher dose of atorvastatin improves cholesterol-related parameters. Both doses were well tolerated in this patient population.

Anticholesteremic Agents↗
PubMed2005

Addressing the global cardiovascular risk of hypertension, dyslipidemia, diabetes mellitus, and the metabolic syndrome in the southeastern United States, part II: treatment recommendations for management of the global cardiovascular risk of hypertension, dyslipidemia, diabetes mellitus, and the metabolic syndrome.

An aggressive global approach to screening and to the management of the metabolic syndrome is recommended to slow the growth of the syndrome throughout the United States. Prevention should begin in childhood with healthy nutrition, daily physical activity, and annual measurement of weight, height, and blood pressure beginning at 3 years of age. Such screenings will identify cardiovascular risk factors early, allow the health care provider to define global cardiovascular risk with the COSEHC Cardiovascular Risk Assessment Tool, and allow treatment of each risk factor. Lifelong lifestyle modifications and pharmacologic therapy will be required in most patients. Antihypertensive therapy for these patients should begin with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker unless a compelling indication for another drug is present. Metformin should be considered the first drug for glucose control in the patient with type 2 diabetes. A statin should be used initially for hyperlipidemia unless contraindicated. Combinations of antihypertensive, antiglycemic, and lipid-lowering agents will often be required.

Adult↗
PubMed1998

Rationale for and outline of the recommendations of the Working Group on Hypercholesterolemia and Other Dyslipidemias: interim report. Dyslipidemia Working Group of Health Canada.

A panel consisting of lipidologists, epidemiologists, cardiologists, internists, general practitioners, and public health and government representatives used the evidence-based approach to examine the rationale for a draft of recommendations for medical management of lipid disorders. The proposed recommendations deal with assessment of cardiovascular risk based on history, physical examination and laboratory findings; assessment of the fasting lipid profile; diagnosis and treatment of secondary risk factors; calculation of the 10-year risk of a cardiac event; initiation of lifestyle modifications in patients in whom low density lipoprotein cholesterol (LDL-C), total:high density lipoprotein cholesterol (HDL-C) ratio or triglycerides exceeds target values based on a patient's risk category; follow-up; treatment with drugs; and choices of drugs. In contrast to previous recommendations, there are new, considerably lower, cholesterol level targets for secondary prevention, with a less important emphasis on total cholesterol value than on LDL-C or total:HDL-C ratio and triglyceride levels, and an emphasis on determining the likelihood of a cardiac event by evaluating all relevant risk factors and sharpening the focus on nondrug treatment, which should result in treating a greater percentage of at-risk patients.

Anticholesteremic Agents↗
PubMed2003

[Association of herpes simplex virus type2 infection with dyslipidemia in Chinese].

OBJECTIVE: To investigate the relationship between herpes simplex virus type 2 (HSV-2) infection and dyslipidemia. METHODS: ELISA was used to detect the specific IgG to HSV-2 in the samples of peripheral blood collected in succession from 1 244 inpatients, 408 with dyslipidemia and 836 controls without dyslipidemia. Univariate and multivariate analyses were preformed. RESULTS: No significant differences were found in sex and smoking status between the patients with and without dyslipidemia (both P > 0.05). However, the body mass index was significantly higher in the patients with dyslipidemia than in those without dyslipidemia (24.9 +/- 6.6 vs 23.9 +/- 7.6, P = 0.001). Diabetes and hypertension were more frequently found in patients with dyslipidemia in comparison with those without dyslipidemia (both P < 0.05). The prevalence of HSV-2 IgG seropositivity was significantly higher in the patients with dyslipidemia than those without dyslipidemia (38.2% vs 30.6%, P = 0.007). Binary Logistic regression analysis showed an association of HSV-2 IgG seropositivity with dyslipidemia, after adjustment for confoundings, the odds ratio for dyslipidemia was 1.34 (95% confidence interval, 1.04 to 1.72; P = 0.025) for HSV-2 IgG seropositivity. Other traditional risk factors, body mass index [adjusted OR 1.03 (1.01 - 1.05), P = 0.002], hypertension [adjusted OR 1.39 (1.09 - 1.79), P = 0.008] and diabetes [adjusted OR 1.50 (1.05 - 2.15), P = 0.028]. CONCLUSION: HSV-2 infection is an independent risk factor for dyslipidemia, and HSV-2 infection may increase the risk of dyslipidemia.

Adult↗
PubMed2006

Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium.

BACKGROUND: To assess the implementation challenge facing the Third Report of the Adult Treatment Panel (ATP III) of the National Cholesterol Education Program, we determined the prevalence, treatment, and control of dyslipidemia, including ethnic and gender differences, in persons free of known clinical cardiovascular disease (CVD). In addition, this report provides information about the presence of coronary artery calcium (CAC) across groups defined by risk and recommendations for the use of lipid-lowering drugs. METHODS AND RESULTS: The Multi-Ethnic Study of Atherosclerosis (MESA) is a multicenter cohort study of 6814 persons aged 45 to 84 years who were free of clinical CVD at baseline (2000-2002). Participants with complete fasting lipid profiles (n=6704) were evaluated for CVD risk and self-reported use of lipid-lowering therapy. CAC was assessed by CT. Drug treatment thresholds and goals were defined according to ATP III. Models were constructed to adjust for age, clinic site, risk factors, socioeconomic characteristics, and healthcare access variables with the use of Poisson regression. Overall, 29.3% (1964/6704) had dyslipidemia, among whom lipid-lowering drug therapy was reported by 54.0% (1060/1964). Control to ATP III goal was observed in 75.2% (797/1060) of participants with treated dyslipidemia and 40.6% (797/1964) of participants with dyslipidemia. Men were more likely than women to qualify for drug therapy and less likely to be treated and controlled. Relative to non-Hispanic whites, Chinese Americans were less likely to qualify for drug treatment, but no differences in treatment and control rates were observed. Black and Hispanic Americans had prevalence of dyslipidemia that was comparable to that of non-Hispanic whites but were less likely to be treated and controlled. Ethnic disparities were attenuated substantially by adjustment for healthcare access variables; however, the gender disparities persisted despite adjustment for risk factors, socioeconomic characteristics, and healthcare access variables. Control of dyslipidemia was achieved less commonly in the CVD high- and intermediate-risk groups than in the low-risk group. Among high-risk individuals, 19.7% of those who did not qualify for lipid-lowering drug treatment had CAC >400. The proportion of drug treatment-qualifying persons who were not treated differed by presence and severity of CAC, with 48.0%, 46.8%, and 39.6% of eligible persons with no CAC, with CAC >0 and <400, and with CAC >400 not receiving treatment, respectively (P for difference=0.04). CONCLUSIONS: Dyslipidemia is common among persons without CVD. The quality of care for dyslipidemia is suboptimal in general and variable by CVD risk group, ethnicity, and gender. The utility of incorporating CAC screening into the risk stratification and treatment process should be investigated in light of the substantial proportions of persons with CAC who are currently classified as not requiring treatment. Research and quality improvement programs are needed to optimize management of dyslipidemia.

Aged↗
PubMed2006

Diabetes, hypertension, and dyslipidemia in Mexican Americans and non-Hispanic whites.

BACKGROUND: Ethnic disparities in healthcare quality have been documented, but knowledge of differences in cardiovascular risk factor prevalence, awareness, treatment, and control between Mexican Americans and non-Hispanic whites remains incomplete. METHODS: Cross-sectional analysis in 2005 of nationally representative data collected from 2256 Mexican-American and 4624 non-Hispanic white adults aged 20 years and over who participated in the 1999-2002 National Health and Nutrition Examination Survey. RESULTS: Type 2 diabetes is significantly more prevalent in Mexican Americans (13% age and gender adjusted) than in non-Hispanic whites (8%); however, Mexican Americans are more likely to be both diagnosed (77% vs 65%) and treated (63% vs 47%). There is no significant difference in the adjusted prevalence of hypertension, at 28% for non-Hispanic whites compared to 26% for Mexican Americans. Mexican Americans have a slightly lower adjusted prevalence of dyslipidemia, at 31% versus 35%. Awareness of hypertension and dyslipidemia are significantly lower in Mexican Americans (57% vs 71% for hypertension, and 33% vs 56% for dyslipidemia). Treatment rates for hypertension and dyslipidemia are also significantly lower in Mexican Americans (42% vs 61% for hypertension; 14% vs 30% for dyslipidemia). Multivariate logistic regression controlling for age, gender, education, and access to care indicate that Mexican Americans are significantly more likely than non-Hispanic whites to be aware and treated for their diabetes, but significantly less likely to be aware and treated for their hypertension or dyslipidemia. CONCLUSIONS: The significantly higher prevalence of diabetes in Mexican Americans, in contrast to hypertension and dyslipidemia, may sensitize healthcare providers to its detection and treatment. Communicating the importance of hypertension and dyslipidemia is essential for eliminating disparities.

Adult↗
PubMed2005

Dyslipidemia and lipid-lowering therapy in the elderly.

According to the current evidence, the fastest growing proportion of patient populations seeking healthcare is those over 65 years of age. Coronary artery disease and subclinical atherosclerosis are highly prevalent in this group of patients and are strongly linked to dyslipidemia, a well-established risk factor for atherosclerosis. Treating dyslipidemia in this group of patients requires specific knowledge and understanding of common dyslipidemias and the relative safety of various pharmacologic agents in the presence of possible multiple comorbidities. Lifestyle modification remains the first step in the treatment of dyslipidemia; however, it can be difficult to sustain and achieve acceptable compliance in the elderly and it is best used in combination with drug therapy. Statins are widely accepted as the first-line therapy. Several recent studies have demonstrated that statins are safe and effective in the elderly. However, it is important to note that there is very limited data regarding the effects of dyslipidemia treatment on morbidity and mortality in patients over 85 years of age. In summary, the clinicians must recognize that the presence of dyslipidemia in the elderly poses substantial risk of coronary events and stroke. The available evidence has demonstrated that in most elderly patients who are at increased risk for cardiovascular morbidity and mortality, treatment of dyslipidemia with appropriate therapy reduces the risk, and when used carefully with close monitoring for safety, the treatment is generally well tolerated. With increasing life expectancy, it is critical for physicians to recognize the importance of detection and treatment of dyslipidemia in the elderly.

Aged↗
PubMed2004

[Chlamydia pneumoniae infection increases the risk of coronary artery disease in the patients with dyslipidemia].

OBJECTIVE: To investigates the role of chlamydia pneumoniae (CP) infection in the development of coronary artery disease (CAD) in the patients with dyslipidemia, and to examine the gender related differences in this role. METHODS: 523 inpatients with dyslipidemia and 1196 inpatients without dyslipidemia tested for specific CP IgG by enzyme-linked immunoassay. Multivariate analyses were performed in the patients with and without dyslipidemia, and in the subgroups of male and female dyslipidemic patients to get the adjusted odds ratio (OR) (95% confidence intervals) of CAD for a given risk factor. RESULTS: After adjusting for age over 55 years, male sex, smoking, hypertension and diabetes, the OR of CAD associated with CP infection was 2.5 (1.4 to 4.6, P = 0.002) in the patients with dyslipidemia, and was 0.967 (0.7 - 1.4, P = 0.851) in those without dyslipidemia. In comparison with the male patients with dyslipidemia, the adjusted OR of CAD was 2.1 (1.1 to 4.1) for CP infection and 3.3 (1.9 - 5.9) for smoking; only CP infection was significantly contributed to CAD in female dylipidemic patients, with an adjusted OR of 4.4 (1.4 to 14.6). CONCLUSION: CP infection increases the risk of CAD only in patients with dyslipidemia, and this increase was greater in women than in men.

Aged↗
PubMed1996

A practical approach to the laboratory diagnosis of dyslipidemia.

Disorders in lipoprotein metabolism (dyslipidemia) can result in premature atherosclerosis or pancreatitis. Dyslipidemias can be classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low density lipoprotein cholesterol and decreased levels of HDL cholesterol predispose to premature atherosclerosis. Triglyceride levels greater than 1,000 mg/dL increase the risk for pancreatitis. In the appraisal of the dyslipidemias, measurement of serum cholesterol, triglycerides, HDL-cholesterol and obtaining the LDL cholesterol by Friedewald equation is usually sufficient in the majority of patients. However, in some cases, such as the diagnosis of the Type III dyslipidemia and when triglycerides are > or = 400 mg/dL, ultracentrifugation is required to determine the VLDL or LDL cholesterol. Lipoprotein electrophoresis can be useful in the diagnosis of Type III dyslipidemia (broad beta band) and also to detect chylomicrons. In young subjects with coronary artery disease with a normal LDL cholesterol an apolipoprotein B-100 level may be a useful test. In children and young adults with severe hypertriglyceridemia, measurement of lipoprotein lipase activity or assaying apolipoprotein C-II levels can be useful in elucidating the cause. Also, laboratory tests are useful in excluding a secondary cause of dyslipidemia (urinalysis, plasma creatinine, TSH, glucose, protein electrophoresis, alkaline phosphatase and transaminases). Thus, laboratory investigations play an important role in the management of dyslipidemia.

Chemistry, Clinical↗
PubMed2026

Source- and Solubility-specific Choline, Gut Microbiota, and Dyslipidemia Risk: Trimethylamine N-oxide-associated and Non-trimethylamine N-oxide-Associated Patterns in a Prospective Cohort Study.

BACKGROUND: Dietary choline, a major precursor of the gut microbial metabolite trimethylamine N-oxide (TMAO), is implicated in dyslipidemia risk; however, source- and form-specific associations and interactions with gut microbiota remain unclear. OBJECTIVES: The aim of this study was to examine longitudinal associations of source- and form-specific dietary choline with plasma TMAO and dyslipidemia and to identify gut microbiota interactions. METHODS: Using data from the China Health and Nutrition Survey (2018-2023), dietary intake was assessed via 3 consecutive 24-h recalls in this prospective cohort study. Two-level generalized linear mixed-effects models were applied in 4828 adults (mean age: 55.9 &#xb1; 12.6 y, 56.6% females) to assess choline-dyslipidemia associations. Choline-TMAO and TMAO-dyslipidemia analyses were conducted in 1091 participants free of dyslipidemia at baseline. Among 7169 adults with gut microbiome data, Least Absolute Selection and Shrinkage Operator and logistic regression identified lipid-associated gut genera; TMAO relationships were examined in a subset of 693 participants. RESULTS: Higher intakes of total [Q4 compared with Q1: odds ratio (OR) = 1.261; 95% confidence interval (CI): 1.007, 1.580], red meat-derived (OR: 1.753; 95% CI: 1.196, 2.568), and lipid-soluble choline (OR: 1.304; 95% CI: 1.047, 1.624) were associated with higher risk of elevated low-density lipoprotein cholesterol (LDL cholesterol), whereas vegetable-derived choline was inversely associated. Egg-derived and lipid-soluble choline were positively associated with plasma TMAO, which was prospectively associated with 5-y incident dyslipidemia (Q4 compared with Q1-OR: 1.620; 95% CI: 1.047, 2.509), elevated LDL cholesterol (Q3 compared with Q1-OR: 2.478; 95% CI: 1.187, 5.174), and hypertriglyceridemia (Q4 compared with Q1-OR: 1.829; 95% CI: 1.028, 3.225). Three TMAO-associated genera were identified: Lachnospiraceae and Phascolarctobacterium as pro-risk taxa and Turicibacter as protective. The adverse LDLcholesterol association of egg-derived choline was observed exclusively in Phascolarctobacterium-enriched individuals. CONCLUSIONS: Dietary choline source and solubility differentially associated with dyslipidemia risk through TMAO-associated and non-TMAO-associated patterns, with gut microbiota as key modulators.

Humans↗
PubMed2006

Analysis of dyslipidemia in patients on chronic hemodialysis in Catalonia.

Chronic hemodialysis patients show a high incidence and prevalence of cardiovascular disease of multifactorial etiology and an association between dyslipidemia and accelerated atherosclerosis. We analyzed characteristics of dyslipidemia in 1824 hemodialysis patients (59% men; mean age 65 +/- 15 years) in Catalonia and identified risk factors by logistic regression. Prevalence of dyslipidemia was high (63%). Most frequent lipid alterations were decreased HDL cholesterol (40%), hypertriglyceridemia (31%) and hypercholesterolemia (19%). Total cholesterol/HDL ratio was elevated in 23%. Body mass index (OR 1.08; 95% CI 1.05-1.11), diabetes mellitus (1.4; 1.09-1.79), ischemic heart disease (1.38, 1.08-1.75) and stroke (1.30; 1.0-1.69) were independent factors associated with dyslipidemia. Lengthy time (> 7 years) on dialysis (0.77; 0.59-0.99) and female sex (0.78; 0.64-0.96) were independent protective factors. A significant reduction in the risk of developing dyslipidemia was observed after the age of 50. Lipid-lowering drug use was low (19%), with statins being the most frequent (83%). The percentage of patients reaching target LDL levels according to individual cardiovascular risk (ATPIII) was unsatisfactory, particularly in high risk patients (52%). In light of the high prevalence of dyslipidemia and low adherence to target LDL goals, we conclude that strict control of dyslipidemia should be included in cardiovascular risk prevention strategies for chronic hemodialysis patients.

Adolescent↗
PubMed2005

The metabolic basis of atherogenic dyslipidemia.

Atherogenic dyslipidemia is one of the major components of the metabolic syndrome, a complex cluster of several risk factors within a single patient that according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III includes at least 3 of the following: large waist circumference, elevated triglyceride levels, low levels of high-density lipoprotein cholesterol (HDL-C), hypertension, and elevated fasting glucose levels, which are directly related to the incidence of coronary heart disease. Atherogenic dyslipidemia clinically presents as elevated serum triglyceride levels, increased levels of small dense low-density lipoprotein (sdLDL) particles, and decreased levels of HDL-C. An important component of atherogenic dyslipidemia is central obesity, which is defined as increased waist circumference and has recently been identified as a chief predictor of the metabolic syndrome in certain patients. Another recent study found that both body mass index and waist circumference were highly predictive of eventual development of the metabolic syndrome. Because atherogenic dyslipidemia usually precedes the clinical manifestation of the metabolic syndrome, strategies to treat it are the focus of pharmacologic intervention. For example, the 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors, commonly known as statins, benefit hypercholesterolemic patients who have atherogenic dyslipidemia that is associated with the metabolic syndrome. Pioglitazone, an antidiabetic agent that acts primarily by decreasing insulin resistance, improves sensitivity to insulin in muscle and adipose tissue and inhibits hepatic gluconeogenesis. Pioglitazone improves glycemic control while reducing circulating insulin levels. The investigational agent, rimonabant--a centrally and peripherally acting, selective cannabinoid type-1 receptor blocker--is the first therapy developed for managing several cardiovascular risk factors at one time. Rimonabant has shown promise in attacking atherogenic dyslipidemia from several vantage points by affecting glucose, HDL-C, triglycerides, and waist circumference in patients who are prone to atherogenic dyslipidemia.

Arteriosclerosis↗
PubMed2005

[The association of S447X and Hind III polymorphism in the lipoprotein lipase gene with dyslipidemia of the metabolic syndrome in patients with essential hypertension].

OBJECTIVE: To assess the association of S447X mutation and Hind III polymorphism in the lipoprotein lipase gene with dyslipidemia of the metabolic syndrome in patients with essential hypertension. METHODS: A total of 983 patients were randomly selected from those with hypertension (diagnosed in the Community-based Comprehensive Studies on Prevention and Control of Hypertension Project in China) and those not treated with anti-hypertensive medications for at least in 2 weeks immediately before blood collection. Among them were 389 subjects with dyslipidemia and 594 subjects without dyslipidemia. The definition of dyslipidemia in patients with hypertension was used only when triglyceride or HDL-cholesterol was at abnormal level. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine Ser447stop mutation and Hind III polymorphism in LPL gene. RESULTS: Linkage disequilibrium between the two sites was observed, with three major haplotypes identified: H+S, H-S, and H-X. The LPL gene S447X mutation and H-X haplotype were significantly associated with dyslipidemia (OR=0.547, 95%CI: 0.348-0.859 for S447X mutation; OR=0.537, 95%CI: 0.328-0.880 for H-X haplotype) in male, both by themselves and after adjustment for age, body mass index, smoking, alcohol intake, systolic blood pressure, diastolic blood pressure, education and serum glucose. The LPL H- carriers and H-S haplotype were significantly associated with dyslipidemia (OR=0.575, 95%CI: 0.358-0.923) in female after multivariate adjustment. Moreover, compared with the H+S haplotype, the H-X haplotypes were associated with significantly lower TG and Log (TG/HDL-C) levels in both men and women, and with higher HDL-C levels in women; whereas no significant difference was observed between the H-S and H+S haplotype. Compared with the H-S haplotype, the H-X haplotypes had significant effect on the HDL-C levels in women. CONCLUSION: The LPL H-X haplotype was one of the protective factors of dyslipidemia of metabolic syndrome in hypertensive patients. It is significantly associated with low triglyceride, log triglyceride-to-HDL-cholesterol ratio and high HDL-cholesterol levels. S447X mutation does not explain all the effect associated with the Hind III polymorphism, although the effect on serum lipids associated with the H-X haplotype appeared to be mainly mediated by the S447X mutation. It is possible that some functional mutations in the LPL gene besides the S447X mutation are in linkage disequilibrium with the Hind III polymorphism.

Aged↗
PubMed2000

The Pro12A1a substitution in the peroxisome proliferator activated receptor gamma 2 is associated with an insulin-sensitive phenotype in families with familial combined hyperlipidemia and in nondiabetic elderly subjects with dyslipidemia.

Dyslipidemias and insulin resistance often present simultaneously, as in familial combined hyperlipidemia (FCHL), and therefore may have a common genetic background. In our previous study the Pro12A1a substitution of peroxisome proliferator receptor gamma 2 (PPARgamma2) associated with insulin sensitivity, low body mass index (BMI) and high-density lipoprotein (HDL) cholesterol levels. In this study, we investigated the role of this substitution in dyslipidemias. Therefore, 228 nondiabetic members of FCHL families and 866 nondiabetic elderly subjects with (n=217) and without dyslipidemia (n=649) were genotyped. The allele frequencies of the Pro12A1a substitution did not differ between elderly subjects with or without dyslipidemia or 27 probands with FCHL. However, this substitution was associated with low fasting insulin levels both in FCHL family members (P = 0.036 adjusted for gender and age) and elderly subjects with dyslipidemia (P=0.050) but not in elderly subjects without dyslipidemia (P=0.080). In addition, the Ala12 allele of PPARgamma2 was associated with low BMI (P= 0.034) and low total triglycerides (P=0.027), and increased HDL-cholesterol (P < 0.001) in elderly subjects with dyslipidemia (n=299) but not among any other study groups. We conclude that the Ala12 isoform of PPARgamma2 ameliorates the insulin resistance and unfavorable lipid and lipoprotein profiles in FCHL and hyperlipidemic elderly subjects.

Adult↗
PubMed2004

Health-related quality of life in cardiac patients with dyslipidemia and hypertension.

BACKGROUND: Hypertension is associated with lower health-related quality of life (HRQOL). Similar association may be found for dyslipidemia. However, controversies exist regarding the HRQOL with dyslipidemia. We evaluated the HRQOL of cardiac patients with and without dyslipidemia and hypertension. METHODS: In a cross-sectional study, 284 cardiac patients rated their HRQOL using SF-36 Health Survey (SF-36), and three preference-based measures (Rating Scale, Time Trade-off and Standard Gamble). RESULTS: Compared to those without dyslipidemia, those with dyslipidemia reported better HRQOL on all preference-based measures and most SF-36 scales particularly on the physical health scales. Adjusted mean differences and 95% confidence interval (95% CI) were equal to 4.5 (0.5, 8.5), 10.8 (2.8, 18.8), and 2.2 (0.2, 4.2) on the Physical Functioning, the Role-Physical and the Physical Component Summary scales, respectively. Exactly the opposite trends were observed among patients with hypertension. The adjusted mean differences (95% CI) were equal to -2.7 (-6.7, 1.4), -10.9 (-19.1, -2.8), and -2.9 (-4.9, -0.9) on the Physical Functioning, the Role-Physical and the Physical Component Summary scales, respectively. CONCLUSION: Cardiac patients with hypertension reported lower physical health than those without hypertension while cardiac patients with dyslipidemia reported better physical health than those without dyslipidemia. The reason for these different trends is not known. Possible explanations are discussed.

Adult↗
PubMed1992

Does glycemic control of type II diabetes suffice to control diabetic dyslipidemia? A community perspective.

OBJECTIVE: To assess the extent to which glycemic control by itself results in satisfactory control of diabetic dyslipidemia. RESEARCH DESIGN AND METHODS: A population-based case series consisting of 386 Mexican Americans and 94 non-Hispanic whites with non-insulin-dependent (type II) diabetes was studied. All subjects answered questions about their medical history and care received and underwent a standardized oral glucose tolerance test and measurements of fasting serum lipid and lipoprotein concentrations. Three definitions of dyslipidemia were used: total cholesterol greater than 6.20 mM (240 mg/dl), triglyceride greater than 2.82 mM (250 mg/dl), and high-density lipoprotein cholesterol less than 0.90 mM (35 mg/dl). RESULTS: Despite having removed subjects receiving lipid-lowering drugs, diabetic subjects who had been previously diagnosed and were under medical care exhibited a lower prevalence of hypertriglyceridemia than those who were newly diagnosed at the time of their survey visit, suggesting that conventional management was associated with a reduced frequency of this dyslipidemia. Among previously diagnosed cases, the prevalence of dyslipidemia rose with worsening glycemic control but there was little association with type of therapy (diet only, oral agents, or insulin) or frequency of physician visits. In general, the prevalence of dyslipidemia in diabetic subjects remained higher than in nondiabetic subjects, despite hypoglycemic therapy. CONCLUSIONS: The results suggest that glycemic control by itself does not suffice to control diabetic dyslipidemia and that significant numbers of diabetic subjects will need direct lipid management. Clinical trials are urgently needed to define the optimum management strategy for diabetic dyslipidemia.

Adult↗