Lipid Profile Abnormalities and Their Association with Covid-19 Severity among Patients Admitted at Covid-19 Center in Ethiopia

Background: Current studies have presented and analyzed epidemiological, clinical and clinical laboratory features COVID-19 Patients. Studies suggests that patients with severe COVID-19 shows unregulated lipid metabolism and profile but adequate information is not available concerning the association of lipid parameter features with severity of disease its outcome in Ethiopia. Objective: This study aims to determine the magnitude of lipid profile abnormalities and association of COVID-19 outcome among admitted patients at Millennium COVID-19 care center in Ethiopia. Methods: A prospective observational cohort study was conducted among COVID-19 admitted patients to investigate lipid profile parameters from January 2021- June 2021. A total of 500 patients confirmed with COVID-19 infection by RT-PCR were included. Dynamic alteration in lipid profiles were recorded and tracked. Data were analyzed using SPSS version 25. P value <0.05 was considered significantly associated. Result: The median age of the 500 study participants was 55.58+7.707 years, and from these 71.3% of patients were males. This study found that high-density Lipoprotein cholesterol (HDL-C) and Total Cholesterol levels were significantly higher in the severe and Critical disease category. The total cholesterol results showed that significantly higher 25 (5.38%) in severe infection cases than that, (17 (3.4%), 12(2.4%) and 5 (1%) in moderate, mild and critical cases consecutively (P<0.000). Whereas, patients with severe infection had slightly lower of HDL than Mild and moderate infection cases (P=0.000 and P=0.000) respectively. Moreover, a significant decrement in the level of TG was detected in severe infection cases compared to mild and moderate cases (P=0.0001). Hence, the higher TG/HDL-C ratio (3.754) was found in severe infection cases, compared with mild and moderate infection (P=0.001 and P=0.002) respectively. Conclusion: Lipid function biomarkers like CHO, TG and LDL serum value was found elevated among severe than other patients. Lipid Metabolism biomarkers are a candidate for predicting COVID-19 disease severity in order to guide clinical care and general Public

Two-Year Change in Serum Total Cholesterol Is Associated With Incident Ischemic Stroke: Results From the Kailuan Study

Background and Purpose: Compared with one single measurement, dynamic change of lipid parameter calculated by repeated measurements has been recognized as a potential biometric to make stroke risk assessments. Total cholesterol (TC) is an important risk factor for stroke, but the relationship between TC change and incident stroke has not been investigated thoroughly. We thus aimed to explore the association between 2-year TC change and the risk of incident stroke, both ischemic and hemorrhagic, in the general population.Methods: From June 2006 to October 2007, a total of 70,999 participants with complete TC value at baseline (2006–2007) and the second examination (2008–2009) were included in our study. The change of TC was calculated as the 2-year follow-up TC subtracting baseline TC. Cox proportional hazards regression analysis was used to evaluate the association between the tertile of TC change and risk of incident stroke and stroke subtypes.Results: A total of 2,815 cases of stroke events were identified with a median follow-up period of 9.0 years. After adjusting for baseline TC and confounding factors, 2-year TC change was independently associated with increased risk of total stroke (HR 1.07, 95% CI 1.02–1.12) and ischemic stroke (HR 1.08, 95% CI 1.03–1.13) per SD (1.04 mmol/L) increase, while no significant association was obtained between TC change and intracerebral hemorrhage (p = 0.659).Conclusions: Increased 2-year TC change is associated with an elevated risk of incident total stroke and ischemic stroke, irrespective of the baseline TC value. Maintaining a sustained ideal level of TC is important for stroke prevention.

The Fatty Acid-Based Erythrocyte Membrane Lipidome in Dogs with Chronic Enteropathy

Canine chronic enteropathies (CEs) are inflammatory processes resulting from complex interplay between the mucosal immune system, intestinal microbiome, and dietary components in susceptible dogs. Fatty acids (FAs) play important roles in the regulation of physiologic and metabolic pathways and their role in inflammation seems to be dual, as they exhibit pro–inflammatory and anti–inflammatory functions. Analysis of red blood cell (RBC) membrane fatty acid profile represents a tool for assessing the quantity and quality of structural and functional molecular components. This study was aimed at comparing the FA membrane profile, determined by Gas Chromatography and relevant lipid parameter of 48 CE dogs compared with 68 healthy dogs. In CE patients, the levels of stearic (p < 0.0001), dihomo–gamma–linolenic, eicosapentaenoic (p = 0.02), and docosahexaenoic (p = 0.02) acids were significantly higher, and those of palmitic (p < 0.0001) and linoleic (p = 0.0006) acids were significantly lower. Non-responder dogs presented higher percentages of vaccenic acid (p = 0.007), compared to those of dogs that responded to diagnostic trials. These results suggest that lipidomic status may reflect the “gut health”, and the non–invasive analysis of RBC membrane might have the potential to become a candidate biomarker in the evaluation of dogs affected by CE.

A real-world clinical experience on the effectiveness of remogliflozin etabonate in management of Indian patients with type II diabetes mellitus

Background: The aim of the study was to evaluate effectiveness and safety of remogliflozin etabonate in a real-world outpatient setting in type 2 diabetes mellitus (T2DM) patients in India.Methods: A retrospective, observational, single-center study wherein medical records of adult patients (≥18 years old) with T2DM managed with remogliflozin 100 mg for at least three months at the diabetes care center in Jharkhand were retrieved. The effectiveness was assessed in terms of change from baseline in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), total body weight, blood pressure (BP, systolic and diastolic), kidney function tests, and lipid parameters after three months of treatment. Safety was assessed by adverse events (AEs) and serious AEs.Results: Half of the patients received ≥3 concomitant antidiabetic drugs, common being sulphonylureas (92%), and metformin (91%). Remogliflozin treatment resulted in a significant mean reduction from baseline in HbA1c [-1.99 (0.12%); p<0.001], FPG [-52.3 (4.31) mg/dl; p<0.001] and PPG [-103.6 (7.10) mg/dl; p<0.001). Bodyweight reduction was not statistically significant [-0.1 (10.12) kg]. A significant reduction was observed in the systolic BP [-15.9 (2.21) mmHg; p<0.001] and diastolic BP [-3.3 (0.95) mmHg; p=0.001]. Commonly reported AE was heartburn (51.4%) and urinary tract infections (34.2%). No serious AEs were reported. The mean estimated glomerular filtration rate showed a statistically significant reduction of -1.55 (0.61) ml/min. The lipid parameter findings were non-significant.Conclusions: The real-world experience of remogliflozin administered concomitantly with other antidiabetic drugs was effective and well-tolerated in Indian patients with T2DM.

Association between lipid indices and 10-year cardiovascular risk of a cohort of black Africans living with type 2 diabetes mellitus

Introduction Diabetes mellitus is an established cardiovascular risk factor. Diabetes mellitus impairs lipid metabolism and enhances atherosclerosis development. Absolute lipid parameter are inadequate in predicting cardiovascular risk and some lipid indices have been reported to circumvent this deficiency. The objective of the study was to determine the association between these lipid indices and 10-year cardiovascular risk among black Africans with diabetes. Methods Seventy individuals (35 males and 35 females) living with diabetes who attended the diabetes clinic of a referral hospital in South-western Nigeria were recruited to the study. Ethical approval and participants’ informed consent were duly obtained. Fasting plasma glucose, fasting lipid profile and glycated haemoglobin were done using appropriate laboratory techniques. Atherogenic index of plasma, atherogenic coefficient, Castelli’s risk index I, Castelli’s risk index II and CHOLindex were calculated using appropriate formulae. QRISK 3 score was obtained using a validated calculator. The association between QRISK 3 and the lipid indices was determined using Pearson’s correlation. Results The mean age of the participants was 53.34 ± 9.57 years. The mean duration of diabetes mellitus among the participants was 6.29 ± 2.78 years. The mean HbA1c and FPG were 6.98±0.72% and 6.32±0.87 mmol/L respectively. The mean QRISK 3 score was 7.58±4.80. There was a statistically significant and positive correlation between QRISK 3 score and AIP, AC, CR I and CR II. CHOLindex did not significantly correlate with QRISK 3 score. Conclusion Among black Africans with diabetes, lipid indices (AIP, AC, CR I and CR II) significantly correlated with QRISK 3 score and therefore may be used as cheap markers of 10-year cardiovascular risk in these individuals.

Different Lipid Parameters in Predicting Clinical Outcomes in Chinese Statin-Naïve Patients After Coronary Stent Implantation

Background: Low-density lipoprotein cholesterol (LDL-C) is a critical surrogate outcome for cardiovascular disease (CVD). Recent observational studies identified different predictive lipid parameters, but these have not been fully validated in the Chinese population. This study aimed to compare the predictive value of lipid parameters for cardiovascular outcomes in Chinese statin-naïve patients who underwent percutaneous coronary intervention (PCI).Methods: We retrospectively recruited statin-naïve patients who underwent PCI for stable angina and acute coronary syndrome at Sichuan Provincial People's Hospital between 1 January 2016 and 31 December 2017. A follow-up was conducted via outpatient visits or telephone. We divided patients into three groups based on lipid parameter tertiles. We calculated the hazard ratios (HRs) of the highest and lowest tertiles for major adverse cardiovascular events (MACEs) using multivariate Cox proportional hazards regression. We compared the association strength of lipid parameters with MACEs using the HR of non-LDL-C lipid parameters relative to LDL-C.Results: Among 445 included patients, the highest LDL-C, LDL-C/high-density lipoprotein cholesterol (HDL-C), atherosclerosis index, and non-HDL-C level tertiles were associated with an average increase of 165% (HR 2.65, confidence interval [CI] 1.26 to 5.61; P = 0.01), 324% (HR 4.24, CI 1.89 to 9.52; P &lt; 0.001), 152% (HR 2.52, CI 1.22 to 5.22; P = 0.01), and 125% (HR 2.25, CI 1.09 to 4.64; P = 0.01) in the hazard of composite CVD, respectively. Lipoprotein (a) levels did not show a significant association with the endpoints. Except for LDL-C/HDL-C, different lipid parameter HR ratios were &lt;1.0; none were statistically significant.Conclusion: Compared with non-LDL-C lipid parameters, LDL-C acts better predictive value for cardiovascular outcomes in general Chinese statin-naïve post-PCI patients.

Benefits of Anthocyanin-Rich Black Rice Fraction and Wood Sterols to Control Plasma and Tissue Lipid Concentrations in Wistar Kyoto Rats Fed an Atherogenic Diet

Background: This study reports on the relative effects of administrating a cyanidin-3-O-glucoside-rich black rice fraction (BRF), a standardized wood sterol mixture (WS), and a combination of both to lower plasma and target tissue lipid concentrations in Wistar Kyoto (WKY) rats fed atherogenic diets. Methods: Male WKY (n = 40) rats were randomly divided into five groups, which included a nonatherogenic control diet and atherogenic diets that included a positive control and atherogenic diets supplemented with BRF or WS, respectively, and a combination of both BRF + WS. Plasma and target tissue liver, heart and aorta cholesterol, and triacylglycerides (TAG) content were also measured. Results: Rats fed atherogenic diets exhibited elevated hyperlipidemia compared to counterparts fed nonatherogenic diets (p < 0.001); this effect was mitigated by supplementing the atherogenic diets with BRF and WS, respectively (p < 0.05). Combining BRF with WS to enrich the supplement lowered cholesterol similar to the WS effect (p < 0.05) and lowered TAG characteristic to the BRF effect (p < 0.05). Conclusions: Rats fed diets containing BRF or WS effectively mitigate the hypercholesterolemia and elevated TAG induced by feeding an atherogenic diet. The benefit of adding BRF + WS together is relevant to the lipid parameter measured and is target tissue-specific.

Long-term Exposure to Air Pollution and Lipometabolic Disturbance: A Systematic Review and Meta-Analysis

Background: Growing evidence suggests that long-term exposure to air pollutants is associated with cardiovascular morbidity, including lipometabolic disturbance. Objectives: To explore the chronic effects of air pollutants on lipometabolic disturbance via detectable lipoprotein parameters. Methods: Seven online databases were searched to conduct a meta-analysis of epidemiological studies examining the relationship between air pollution and lipid parameter levels. Subgroup analysis was additionally carried out for each air pollutant studied. Results: A total of 2,274 records were retrieved, resulting in 10 studies included in the final quantitative meta-analysis, comprising seven studies in Europe and the United States and three studies in mainland China. Using a random-effect model, the results showed that for each 10 μg/m3 increase in PM2.5, TC, LDL-C, and HDL-C levels and metabolic syndrome (MetS) incidence increased by 3.31% (95% CI: 2.29%, 8.91%), 2.34% (95% CI: 1.30%, 3.39%), -1.57% (95% CI: -1.85%, -1.28%), and 4.33% (95% CI: 2.69%, 5.98%), respectively; for each 10 μg/m3 increase in PM10, TG, HDL-C, and LDL-C levels increased by 5.27% (95% CI: 2.03%, 8.50%), -0.24% (95% CI: -0.95%, -0.47%), and 0.45% (95% CI: -0.57%, 1.47%), respectively; for each 10 μg/m3 increase in NO2, TG and HDL-C levels increased by 4.18% (95% CI: 1.12%, 7.23%) and -0.51% (95% CI: -2.61%, 1.58%), respectively. No significant associations were detected for combinations of air pollutants on lipometabolic disturbance. Conclusion: Increased air pollutant exposure was significantly associated with changes in blood lipid parameter levels, which can be an indicator of the body's lipometabolic disturbance.

Abstract WP219: Lipoprotein Subfractions Are Associated With Stroke Among 9,795 Patients in the Field Trial

Background: In the FIELD trial, a 5-year randomized double-blind placebo-controlled trial of fenofibrate vs. placebo in 9,795 adults with type 2 diabetes (T2D), the only standard lipid parameter correlating with microvascular (renal) events was triglycerides. Given the high prevalence of stroke among diabetic patients, we explored associations between lipoprotein subfractions and risk for stroke in the FIELD trial. Methods: We performed ultracentrifugation using the vertical auto profile (VAP, Atherotech) on plasma (baseline and after 6 weeks of fenofibrate). Analyses were performed using Cox proportional hazards and logistic regression for new on-study events. Results were adjusted for gender and fenofibrate or placebo allocation. Results: HDL related analytes (HDL-C, HDL3-C, apo A1, apoA2) correlated with reduced risk for all stroke. LDL and its subfractions and Lp(a)-C did not. VLDL and its subfractions, non-HDL-C, triglycerides, apo B, apo En, various ratios incorporating apo C3, and the ratios of apoB/A1 and apoB/apoA2 all correlated with increased risk for stroke. Conclusions: VAP identifies multiple lipoprotein subclasses, apoproteins, and VAP subclass/apoprotein ratios associated with stroke. Many of these measures improved with fenofibrate therapy.

P1884Low lipid levels and high variability correlate with the risk of new-onset atrial fibrillation

Background High levels of lipids and lipid variability are established risk factors for atherosclerotic cardiovascular disease. We investigated their roles in the development of atrial fibrillation (AF). This is the largest cohort study yet on the association between lipid levels and AF, and the first study on the association between lipid variability and AF. Methods A nationwide population-based cohort of 3,828,652 adults (mean age 43.9 years) from the Korean National Health Insurance Service database without prevalent AF, not on lipid-lowering medication, and with at least 3 measurements of each lipid parameter at 1–2 year intervals over a 4-year period were included. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured, and lipid variability was calculated using variability independent of mean. The cohort was divided into quartiles by baseline lipid levels and lipid variability, and followed up for incident AF. Results During median 3.4 years of follow-up, AF was newly diagnosed in 13,240 (0.35%). AF development was inversely associated with TC and LDL-C levels (for top vs. bottom quartile; TC, hazard ratio [HR] 0.76, 95% confidence interval [95% CI] 0.72–0.80); LDL-C, HR 0.78, 95% CI 0.74–0.82) in both sexes, and with TG levels in men (HR 0.85, 95% CI 0.80–0.90). Meanwhile, AF development was associated with higher LDL-C and HDL-C variability (for top vs. bottom quartile; LDL-C, HR 1.16, 95% CI 1.10–1.22; HDL-C, HR 1.08, 95% CI 1.03–1.14) in both sexes, and with TC variability in men (HR 1.16, 95% CI 1.10–1.22). Conclusions Lower cholesterol levels (TC, LDL-C) and higher cholesterol variability (LDL-C, HDL-C) were associated with higher risk for AF. Low TG levels and high TC variability were also associated with AF incidence in men. These findings support the “cholesterol paradox” in AF, and suggest that cholesterol variability is also a risk factor for AF development.