scholarly journals Evaluation of the Non-HDL Cholesterol to Apolipoprotein B Ratio as a Screening Test for Dysbetalipoproteinemia

2019 ◽  
Vol 65 (2) ◽  
pp. 313-320 ◽  
Author(s):  
Christopher S Boot ◽  
Elizabeth Middling ◽  
Joy Allen ◽  
Robert D G Neely

Abstract BACKGROUND Familial dysbetalipoproteinemia is associated with the accumulation of remnant lipoproteins and premature cardiovascular disease. Identification of dysbetalipoproteinemia is important because family members may be affected. Diagnostic testing involves demonstration of β-lipoprotein in the VLDL fraction or characterization of apo E3. These investigations are complex and relatively expensive. The ratios of apo B to total cholesterol and triglycerides have been proposed as screening tests. However, the ratio of non-HDL cholesterol to apo B (NHDLC/apoB) could offer improved performance as the confounding effect of variations in HDL cholesterol is removed. METHODS We evaluated NHDLC/apoB as a screening test for dysbetalipoproteinemia, using β-quantification analysis as a reference standard. Data from 1637 patients referred over a 16-year period for β quantification were reviewed retrospectively. In 63 patients, diagnostic criteria for dysbetalipoproteinemia (VLDL cholesterol/triglyceride ratio ≥0.69 and presence of β-VLDL) were fulfilled, and 1574 patients had dysbetalipoproteinemia excluded. RESULTS Mean NHDLC/apoB in patients with dysbetalipoproteinemia was 7.3 mmol/g (SD, 1.5 mmol/g) and with dysbetalipoproteinemia excluded was 4.0 mmol/g (SD, 0.5 mmol/g). The optimum cutoff of >4.91 mmol/g achieved a diagnostic sensitivity of 96.8% (95% CI, 89.0–99.6) and specificity of 95.0% (95% CI, 93.8–96.0). NHDLC/apoB offered improved performance compared to total cholesterol/apoB [diagnostic sensitivity 92.1% (95% CI, 82.4–97.4) and specificity 94.5% (95% CI, 93.2–95.6) with a cutoff of >6.55 mmol/g]. NHDL/apoB reference ranges were not sex-dependent, although there was a significant difference between men and women for total cholesterol/apoB. CONCLUSIONS NHDLC/apoB offers a simple first-line test for dysbetalipoproteinemia in selecting patients with mixed hyperlipidemia for more complex investigations.

2005 ◽  
Vol 62 (7-8) ◽  
pp. 529-536 ◽  
Author(s):  
Miroslava Zamaklar ◽  
Katarina Lalic ◽  
Natasa Rajkovic ◽  
Danijela Trifunovic ◽  
Mirjana Dragasevic ◽  
...  

Background. Abnormal lipid profile is an important risk factor in the development of macrovascular atherosclerotic complications in patients with type 2 diabetes mellitus (T2D). Factors that contribute to endothelial cell dysfunction associated with the initiation of atherosclerosis include oxidative stress. The aim of this study was to investigate the relationship between lipid profile and oxidative stress in type 2 diabetics with and without ischemic heart disease (IHD). Methods. We studied 80 patients with T2D, 40 with IHD (group A1) and 40 without IHD (group A2). We also studied 51 non-diabetics, 31 with IHD (group B1), and 20 without IHD (group B2 - control group). Lipid profile was estimated by the total cholesterol, HDL cholesterol, LDL cholesterol, the level of triglyceride (Tg), lipoproteina a (Lp a), Apo A I, A II, B 100 and E. To evaluate the oxidative status we measured circulating oxidized LDL (ox LDL), erythrocyte antioxidative enzyme activity: superoxide dismutase (E-SOD), glutathione peroxidase (E-GPX), as well as the total antioxidative serum activity (TAS). Inflammatory reaction was estimated by C-reactive protein (CRP) and fibrinogen. Results. No significant difference was found in the lipid profile in groups A1, A2 and B1, but the group B2 had the lowest one. Lp a level was significantly higher in group B1 comparing to other groups (p < 0.05). There was no significant difference in the level of ox LDL between the groups. In diabetics, ox LDL positively correlated with the total cholesterol, LDL cholesterol, non HDL cholesterol, Apo B 100 and the relations between LDL/HDL and Tg/HDL (p < 0.001), as well as with Tg and fibrinogen (p < 0.05). In group B1, ox LDL positively correlated with total cholesterol, Tg (p < 0.01), LDL, and non HDL cholesterol (p < 0.05) and significantly with Apo B 100 (p < 0.001). There was no significant difference in the antioxidant enzyme activities between the groups of diabetics (A1 and A2), but fibrinogen was higher in the group with IHD (group A1, p < 0.05). Group B1 had lower ESOD activity than the groups A1 and A2 (p < 0.05), but CRP was higher (p < 0.05). There were no significant correlations between oxLDL and CRP in groups A1 and A2, but it was statistically significant in the group B1 (p < 0.05). Conclusion. In this study we demonstrated the increased oxidative stress in diabetics compared to non-diabetics regardless of the presence of IHD. Fibrinogen, but not CRP, was higher in diabetics with IHD, compared to diabetics without IHD. The increased oxidative stress, the reduced antioxidative activity E-SOD, and the higher level of CRP were found in non-diabetics with IHD compared to non-diabetics without IHD.


2017 ◽  
Vol 21 (2) ◽  
pp. 73-75
Author(s):  
S Vinod Babu ◽  
Anusha R Jagadeesan ◽  
Jothimalar Ramalingam

ABSTRACT Introduction Obesity is emerging as an epidemic worldwide. Obesity is associated with a number of comorbid conditions, such as diabetes mellitus, hypertension, cancer, dyslipidemia, cardiovascular abnormalities, anemia, obstructive sleep apnea, and psychosocial abnormalities. Aim This study aims at comparing the lipid profile levels of obese and nonobese men. Materials and methods This was a case—control study conducted at a tertiary care center. Totally, 80 men in the age group of 20 to 47 years attending the master health checkup were included in the study, out of which 40 men with normal body mass index (BMI) of 18 to 25 belonged to group I and 40 men with increased BMI of 30 and above belonged to group II. Lipid profile parameters, such as triglycerides (TGLs), total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol were estimated in them. The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software version 15.0. Results Statistically significant difference was found in the total cholesterol levels with a p-value of 0.040 while the difference in LDL cholesterol was statistically highly significant with a p-value of 0.040. Conclusion Among lipid profile parameters, only total cholesterol and LDL cholesterol showed significant difference between the obese and nonobese individuals. However, the other parameters like HDL cholesterol and TGLs did not show any significant difference. How to cite this article Babu SV, Jagadeesan AR, Ramalingam J. A Comparative Study of Lipid Profile in Obese and Nonobese Men attending Master Health Checkup. Indian J Med Biochem 2017;21(2):73-75.


2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Mukhyaprana Prabhu ◽  
Rahul Sai Gangula ◽  
Weena Stanley

Context. Ability of SAAG to differentiate malignant ascites from other aetiologies like tubercular peritonitis is a major problem. Alternate screening test is needed for differentiating ascites due to malignancy from those due to tubercular peritonitis. Aims. To study the diagnostic utility of serum ascites lipid gradients and serum ascites protein gradients in pathophysiological differentiation of ascites. Settings and Design. The present study is a prospective, descriptive, hospital-based, cross-sectional study. Methods and Material. The study was conducted on patients with ascites who were admitted to General Medicine Department, Kasturba Hospital, Manipal. The study included 60 patients with ascites of different etiologies (liver cirrhosis, tubercular peritonitis, and malignant ascites). All of them had undergone clinical, laboratory, and imaging investigations and were treated as per standard of care. All patients underwent abdominal paracentesis, and fluid samples were sent for analysis. Statistical Analysis Used. ANOVA, Kruskal-Wallis H test, and ROC curve analysis. Results. Among the gradients, only SAPG and SAAG had over all statistical significance (<0.005) among the groups, but no significance between malignancy and tubercular peritonitis had been observed. Similarly all the ascitic fluid parameters measured had an overall statistical significance (<0.005), but there was no significant difference observed between malignancy and tubercular peritonitis groups. However, ascitic fluid and serum HDL cholesterol had a statistical significance (<0.05) between malignancy and tubercular peritonitis. Conclusions. With a cut-off value of 4, SAPG is one of best screening tests in differentiation of cirrhotic with noncirrhotic ascites when compared with SAAG, whereas it is a poor parameter with high sensitivity and very low specificity in differentiation of malignant with nonmalignant ascites. Also the present study reveals HDL cholesterol levels in ascitic fluid to be a valuable marker with higher sensitivity and specificity in differentiation of malignancy and tuberculosis peritonitis (i.e., differentiation of low SAAG ascites).


2011 ◽  
Vol 8 (1) ◽  
pp. 23
Author(s):  
Siti Fatimah ◽  
Apoina Kartini

Background: Hypercholesterolemia is a condition in which levels of cholesterol in the blood above normal levels (≥ 240 mg/dl). Physical exercises done regularly useful in the regulation of cholesterol, is total cholesterol, LDL cholesterol and triglycerides in the blood decreased, while HDL cholesterol increased. Food has an important role in association with the incident hypercholesterolemia.Objective: The purpose of this study was to determine the effect of aerobic exercise on blood total cholesterol level of adult women in the city of Semarang.Method: This research was explanatory research with cross sectional study. Subject was women aged 20-49 years gymnastic participants, as a comparison group was a housewife who was not doing gymnastics. Twenty three samples for group2 by matching on nutritional status and age and with the sampling purposive sampling. Adequacy levels of carbohydrates, proteins, fats, and also vitamins A and C were obtained through 2x24-hour recall was not a sequence, and processed using NutriSurvey. Results of independent t-test used to determine the effect of cholesterol levels between groups, and chi square test was used to determine association with nutrient adequacy levels of total cholesterol.Results: The results showed no significant difference in mean total cholesterol level between groups of gymnastic participants (201.2 g/dl) with housewife group (208.3 g/dl). Housewife group was belonging to hypercholesterolemia by 52.2%, while in group of exercise participants at 43.5%. Sufficiency level of protein showed a role in the total cholesterol level of adult women.Conclusion: The aerobic gymnastics did not affect total cholesterol. Moderate level of protein adequacy contributes to the total cholesterol level of adult women.


2020 ◽  
Author(s):  
Ali M. El Shafie ◽  
Zein A.L. Omar ◽  
Mai M. Bashir ◽  
sorour fayez mahmoud ◽  
El-sayedamr M. Basma ◽  
...  

Abstract Background: Detecting developmental delays in infants is an ongoing world commitment, especially for those below three years old. it provides appropriate services to them, early inspection enhances the communal quality of resolving difficult issues of this critical period of age. Thus, our main objective lies in developing a sufficient screening test for early evaluation of mental and motor development for infants.Methods: 54 items of motor and mental developmental milestones were adopted from the Baroda Screening Test. Then, researchers enrolled 1600 subjects based on certain inclusion and exclusion criteria. 97 pass level of developmental achievements resembles the threshold of which infants below which, infants are considered delayed.Results: The designed Egyptian Developmental Screening Tool (“EDST”) from birth up to 30 monthswith 50% and 97% pass level curves proves efficacy, reliability, cultural adaptability, and simplicity to use when compared with other peer screening tools. Results revealed a statistically significant difference between Egyptian and Baroda chart at 50% and 97% pass level. A z-score chart for motor and mental development follow up designed by calculating each age group.Conclusions: Developmental screening tests from birth up to 30 months proved consistent reliability and versatility to use in Egypt for early development delay detection. The wide variation of Egyptian infants 'developmental ages on both Egyptian and Baroda charts underpins the Egyptian chart to the Egyptian public. The z-score chart is a rapid and easy follow-up chart for Egyptian infants' development.


2001 ◽  
Vol 47 (3) ◽  
pp. 532-539 ◽  
Author(s):  
Maureen L Sampson ◽  
Andrea Aubry ◽  
Gyorgy Csako ◽  
Alan T Remaley

Abstract Background: The analysis of lipids in serum lipoprotein fractions is useful in assessing the risk for coronary artery disease, but it typically involves performing multiple tests. An automated single-tube assay, referred to as the triple lipid screening (TLS) test, can be used for measuring HDL-cholesterol (HDL-C), total cholesterol, and triglycerides (TGs) with no specimen pretreatment. Methods: The first part of the assay is based on a homogeneous assay for HDL-C that uses either an anti-apolipoprotein B antibody (TLS-A test) or a polyanion (TLS-B test) that blocks the enzymatic measurement of cholesterol on the non-HDL fraction. After the addition of deoxycholate, which solubilizes the unreacted cholesterol from the non-HDL fraction, the remaining cholesterol in the sample is subsequently measured enzymatically. Using the same enzyme detection system as the cholesterol assay, TGs are measured in the last step, after the addition of the enzymes for the TG assay. Results: The TLS assay (y) had acceptable analytic performance and compared favorably with standard tests (x) for each analyte: for HDL-C, TLS-A = 0.99x + 0.19 (R = 0.980); TLS-B = 1.00x − 0.15 (R = 0.974); for total cholesterol, TLS-A = 1.03x + 0.12 (R = 0.997); TLS-B = 1.07x − 0.30 (R = 0.965); and for TGs, TLS-A = 1.02x + 0.02 (R = 0.988); TLS-B = 1.04x − 0.28 (R = 0.980). Conclusions: The TLS test is a single-tube homogeneous assay for the analysis of all of the major serum lipoprotein fractions and can be used as a simple screening test for the detection of hyperlipidemia.


2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Kerim GUZEL ◽  
Mustafa IKIZEK

Background & Objective: Obesity has become a serious health problem that has become increasingly important in recent years. Since patients with high levels of obesity have dyslipidemia and an unbalanced lipid profile, they have a high risk of both diabetes mellitus and cardiovascular disease. This study aimed to evaluate the short (3 months) and long term (12 months) effects of mini-gastric bypass surgery from the current bariatric surgical techniques on the lipid profile. Methods: Of the patients undergoing Mini-gastric bypass operation between January 2016 to December 2018 at the General Surgery Clinic of Private Samsun Büyük Anadolu Hospital, demographic data and changes in lipid concentrations at 3 and 12 months were analyzed. Patients were grouped according to age, sex, body mass index (BMI), cardiologic risk groups, bypass lengths, and obesity classes. Total cholesterol, triglyceride, LDL-cholesterol, and HDL cholesterol values of the patients were examined at the time of admission to the outpatient clinic before the operation, at the postoperative third month and at the post-operative twelfth-month. Patients who did not go for a checkup during the one-year follow-up and whose data could not be reached or missing were excluded from the study. Results: There was no significant difference in terms of age, sex, and cardiovascular risk (p>0.05). Although the HDL-C level was initially low (p<0.001), it significantly increased 12 months after surgical treatment (p<0.001). While serum concentrations of LDL cholesterol, total cholesterol, and triglycerides were high preoperatively, they significantly decreased at 12 months postoperatively (p<0.001). When compared with values in the 3rd- and 12th-month, there was a significant decrease in the class-3 obesity group but not in the class-2 obesity group. When serum HDL cholesterol concentrations were compared with preoperative baseline and postoperative 12th-month those, no statistically-significant difference was found in serum concentrations in the 3rd month, although there was a significant increase in both class 2 and 3 obesity groups. Conclusion: In patients undergoing mini-gastric bypass surgery, serum LDL cholesterol, total cholesterol, and triglyceride concentrations decreased in the 12th postoperative month, but serum HDL cholesterol concentrations increased. doi: https://doi.org/10.12669/pjms.37.7.4123 How to cite this:Guzel K, Ikizek M. Comparison of preoperative and postoperative Lipid Profile changes in obese and morbidly obese patients after mini gastric bypass surgery. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4123 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2006 ◽  
Vol 95 (2) ◽  
pp. 366-371 ◽  
Author(s):  
Shu-Tzu Chen ◽  
Jiun-Rong Chen ◽  
Chwei-Shiun Yang ◽  
Sheng-Jeng Peng ◽  
Shyang-Hwa Ferng

Clinical trials have shown that soya protein reduces the concentrations of some atherogenic lipids in subjects with normal renal function. The present study examined the effects of soya protein on serum lipid concentrations and lipoprotein metabolism in patients on hypercholesterolaemic haemodialysis. Twenty-six hypercholesterolaemic (total cholesterol ≥6·21mmol/l) patients on haemodialysis were studied in a randomized, double-blind, placebo-controlled clinical trial. After a 4-week run-in phase, the subjects were randomly assigned to two groups. Isolated soya protein or milk protein 30g was consumed daily as a beverage at breakfast or post-dialysis for 12 weeks. Soya protein substitution resulted in significant reductions in total cholesterol (17·2 (sd8·9)%), LDL-cholesterol (15·3 (sd12·5)), apo B (14·6 (sd12·1)%) and insulin (23·8 (sd18·7)%) concentrations. There were no significant changes in HDL-cholesterol or apo A-I. These results indicate that replacing part of the daily protein intake with soya protein has a beneficial effect on atherogenic lipids and favourably affects lipoprotein metabolism in hypercholesterolaemic patients undergoing haemodialysis.


2008 ◽  
Vol 61 (3-4) ◽  
pp. 164-168 ◽  
Author(s):  
Bosa Mirjanic-Azaric ◽  
Mirjana Djeric ◽  
Maja Vrhovac ◽  
Ljiljana Males-Bilic

Introduction The aim of this study was to estimate the correlation between C-reactive protein levels and leading risk factors for cardiovascular disease in men. Material and methods The study included 183 working capable men chosen randomly from the regular systematical check-up in Health Centre Banja Luka in 2006. Standard laboratory methods were used to establish the following: total cholesterol, triglyceride and HDL-cholesterol level and LDL-cholesterol level was calculated. . High sensitive C-reactive protein level was measured by immunuturbidimetric method CRP (Latex) HS Roche Diagnostic. Results Average values of high sensitive C-reactive protein for the whole group was 1.69 mg/L, total cholesterol 5.73 mmol/L, HDL-cholesterol 1.38 mmol/L, LDL-cholesterol 3.40 mmol/L. The average value for the systolic blood pressure was 132.9 mmHg, dyastolic blood pressure 85.4 mmHg, and body mass index 28.47 kg/m2. Out of the overall number of examinees, 74 were smokers (40.4%) and 109 (59.6%) nonsmokers. The statistical analysis showed that there was a statistically significant difference between C-reactive protein level in the group with dyastolic blood pressure below 90 mmHg and above (p<0.05); as well as statistically significant difference between the group with desirable body mass index and the group with increased BMI(p<0.05). Discussion The results of our study show that there is a significant correlation between CRP levels and high blood pressure, and in persons with increased body mass index. However, there was no correlation between CRP levels and total cholesterol HDL and LDL cholesterol levels. Conclusion High sensitive CRP screening is useful in early detection and prevention of cardiovascular diseases.


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