2.Associations between various lipid components and premature myocardial infarction: a cross-sectional study.
Jing SHI ; Hai Yu ZHANG ; Ding Yu WANG ; Qiang GAO ; Li SHENG ; Peng Wei SONG ; Yu ZHANG ; Yue LI
Chinese Journal of Cardiology 2023;51(3):278-287
Objective: Hyperlipidemia is closely related to premature acute myocardial infarction (AMI). The present study was performed to explore the correlation between various blood lipid components and the risk of premature AMI. Methods: This is a cross-sectional retrospective study. Consecutive patients with acute ST-segment elevation myocardial infarction (STEMI), who completed coronary angiography from October 1, 2020 to September 30, 2022 in our hospital, were enrolled and divided into premature AMI group (male<55 years old, female<65 years old) and late-onset AMI group. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, lipoprotein (a) (Lp (a)), apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA-1), non-HDL-C/HDL-C and ApoB/ApoA-1 were analyzed. The correlation between the above blood lipid indexes and premature AMI was analyzed and compared by logistic regression, restricted cubic spline and receiver operating characteristic curve (ROC). Results: A total of 1 626 patients with STEMI were enrolled in this study, including 409 patients with premature AMI and 1 217 patients with late-onset AMI. Logistic regression analysis showed that the risk of premature AMI increased significantly with the increase of TG, non-HDL-C/HDL-C, non-HDL-C, ApoB/ApoA-1, TC and ApoB quintiles; while LDL-C, ApoA-1 and Lp (a) had no significant correlation with premature AMI. The restricted cubic spline graph showed that except Lp (a), LDL-C, ApoA-1 and ApoB/ApoA-1, other blood lipid indicators were significantly correlated with premature AMI. The ROC curve showed that TG and non-HDL-C/HDL-C had better predictive value for premature AMI. Inconsistency analysis found that the incidence and risk of premature AMI were the highest in patients with high TG and high non-HDL-C/HDL-C. Conclusion: TG, non-HDL-C/HDL-C and other blood lipid indexes are significantly increased in patients with premature AMI, among which TG is the parameter, most closely related to premature AMI, and future studies are needed to explore the impact of controlling TG on incidence of premature AMI.
Humans
;
Male
;
Female
;
Middle Aged
;
Aged
;
Cross-Sectional Studies
;
Cholesterol, LDL
;
Retrospective Studies
;
ST Elevation Myocardial Infarction
;
Apolipoprotein A-I
;
Myocardial Infarction
;
Cholesterol
;
Apolipoproteins B
;
Triglycerides
;
Cholesterol, HDL
;
Lipids
;
Lipoproteins
3.Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly.
Yu Jia WANG ; Zheng Hui GU ; Xue Ping WU ; Zhi Yi FANG ; Tian Hu WANG ; Shan GAO ; Xue YANG ; Xiao Ying SHEN ; Ting Yu ZHOU ; Qi ZHANG ; Jun Xia LI ; Feng CAO
Chinese Journal of Cardiology 2023;51(10):1069-1074
Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.
Aged, 80 and over
;
Humans
;
Male
;
Aged
;
Female
;
Ankle Brachial Index
;
Vascular Stiffness/physiology*
;
Octogenarians
;
Retrospective Studies
;
Cross-Sectional Studies
;
Alanine Transaminase
;
Alkaline Phosphatase
;
Creatinine
;
Sclerosis
;
Pulse Wave Analysis
;
Risk Factors
;
Amylases
;
Lipoproteins, HDL
;
Cholesterol
4.Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly.
Yu Jia WANG ; Zheng Hui GU ; Xue Ping WU ; Zhi Yi FANG ; Tian Hu WANG ; Shan GAO ; Xue YANG ; Xiao Ying SHEN ; Ting Yu ZHOU ; Qi ZHANG ; Jun Xia LI ; Feng CAO
Chinese Journal of Cardiology 2023;51(10):1069-1074
Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.
Aged, 80 and over
;
Humans
;
Male
;
Aged
;
Female
;
Ankle Brachial Index
;
Vascular Stiffness/physiology*
;
Octogenarians
;
Retrospective Studies
;
Cross-Sectional Studies
;
Alanine Transaminase
;
Alkaline Phosphatase
;
Creatinine
;
Sclerosis
;
Pulse Wave Analysis
;
Risk Factors
;
Amylases
;
Lipoproteins, HDL
;
Cholesterol
5.Advances in clinical significance and detection methods research of high density lipoprotein subfractions.
Chao Juan WEN ; Min Hong WANG ; Pei YU ; Qiang ZHOU
Chinese Journal of Preventive Medicine 2023;57(11):1901-1907
High density lipoprotein (HDL) is an important biochemical index of clinical cardiovascular disease. Many new studies have demonstrated abnormalities of plasma HDL subfractions in patients with this disease,and their clinical significance is greater than the overall abnormalities of HDL. Therefore,the HDL subfraction as an important factor in cardiovascular disease has attracted extensive research and attention. This article summarizes current research on HDL subfractions,their measurements and their relationships with atherosclerosis and coronary artery disease.
Humans
;
Cardiovascular Diseases
;
Clinical Relevance
;
Cholesterol, HDL
;
Lipoproteins, HDL
;
Coronary Artery Disease
6.Advances in clinical significance and detection methods research of high density lipoprotein subfractions.
Chao Juan WEN ; Min Hong WANG ; Pei YU ; Qiang ZHOU
Chinese Journal of Preventive Medicine 2023;57(11):1901-1907
High density lipoprotein (HDL) is an important biochemical index of clinical cardiovascular disease. Many new studies have demonstrated abnormalities of plasma HDL subfractions in patients with this disease,and their clinical significance is greater than the overall abnormalities of HDL. Therefore,the HDL subfraction as an important factor in cardiovascular disease has attracted extensive research and attention. This article summarizes current research on HDL subfractions,their measurements and their relationships with atherosclerosis and coronary artery disease.
Humans
;
Cardiovascular Diseases
;
Clinical Relevance
;
Cholesterol, HDL
;
Lipoproteins, HDL
;
Coronary Artery Disease
7.Components and lipid-lowering effect of total saponins from underground part of Gynostemma pentaphyllum.
Fei TENG ; Xiang-Wei LI ; Min LI ; Dong-Dong FAN ; Jing-Jing ZHU ; Hui-Min GAO ; Zhi-Min WANG
China Journal of Chinese Materia Medica 2022;47(18):5022-5031
The saponins in different parts of Gynostemma pentaphyllum were analyzed via UPLC-Q-TOF-MS~E. A total of 46 saponins were identified, and the underground part had 26 saponins more than the aboveground part, most of which were trisaccharide saponins. The rat model of hyperlipidemia was established with high-fat diet. This study explored the lipid-lowering activity of total saponins in the underground part of G. pentaphyllum, so as to provide a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum. A total of 99 healthy SD rats were randomly assigned into a blank group, a model group, a positive drug group, an aboveground total saponins group, and low-, medium-, and high-dose underground total saponins groups. Except the blank group, the other groups were fed with high-fat diet for 6 weeks. Then, the blood was collected from the orbital cavity to determine whether the modeling was successful according to the serum levels of total cholesterol(TC) and triglyceride(TG). After intragastric administration of the corresponding agents for 30 continuous days, the physical state of the rats were observed, and the body weight and liver specific gravity were measured. Furthermore, the levels of TC, TG, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), alanine transaminase(ALT), aspartate transaminase(AST), bilirubin, and total bile acids in serum, as well as the levels of superoxide dismutase(SOD), malondialdehyde(MDA), peroxidase proliferator-activated receptor(PPAR-γ) in the liver tissue, were determined. The pathological changes of liver was observed via HE staining. The results showed that the aboveground total saponins and medium-and high-dose underground total saponins can treat hepatocyte steatosis, lower TC, TG, LDL-C, ALT, AST, total bilirubin, MDA, and PPAR-γ levels, and increase HDL-C and SOD levels in the model rats. The effect tended to be more obvious with the increase in dosage. Therefore, the total saponins in the underground part of G. pentaphyllum have good pharmacological effect of reducing blood lipid, which provides a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum.
Alanine Transaminase/analysis*
;
Animals
;
Aspartate Aminotransferases/analysis*
;
Bile Acids and Salts/blood*
;
Bilirubin/blood*
;
Cholesterol, LDL/blood*
;
Diet, High-Fat/adverse effects*
;
Gynostemma/chemistry*
;
Hypolipidemic Agents/therapeutic use*
;
Lipoproteins, HDL/blood*
;
Liver/metabolism*
;
Malondialdehyde/analysis*
;
Peroxisome Proliferator-Activated Receptors/analysis*
;
Rats
;
Rats, Sprague-Dawley
;
Saponins/therapeutic use*
;
Superoxide Dismutase
;
Triglycerides/blood*
;
Trisaccharides/therapeutic use*
8.Analysis of clinical features and the outcome of in-hospital mortality of myocardial infarction with non-obstructive coronary arteries.
Song ZHANG ; Xiao ZHANG ; Shuo WU ; Tao ZHANG ; Hong Mei JI ; Qi ZHANG ; Jie GAO ; Chang PAN ; Jiao Jiao PANG ; Feng XU ; Jia Li WANG ; Yuguo CHEN
Chinese Journal of Cardiology 2022;50(9):873-880
Objective: To compare the clinical features and the outcome of in-hospital mortality between patients with myocardial infarction with non-obstructive coronary arteries(MINOCA)and myocardial infarction with obstructive coronary artery disease (MI-CAD). Methods: This is a retrospective study. The clinical data of acute myocardial infarction (AMI) patients admitted to Qilu Hospital of Shandong University from January 2017 to May 2021, who underwent coronary angiography, were collected. Patients were divided into MINOCA group and MI-CAD group according to the degree of coronary stenosis (<50% or ≥50%). Baseline clinical characteristics, electrocardiograph during hospitalization, myocardial bridge, length of stay in hospital, discharge medication and the outcome of in-hospital mortality were collected and compared between the two groups. Univariate and multivariate logistic regression analysis was used to screen the related factors of MINOCA and the factors predicting the nosocomial death outcome of patients with AMI. Results: A total of 3 048 AMI patients were enrolled, age was 62 (54, 69) years, 741 (24.3%) patients were women including 165 patients (5.4%) in the MINOCA group and 2 883 patients (94.6%) in the MI-CAD group. Compared with MI-CAD patients, MINOCA patients were younger, had a higher proportion of females and a higher incidence of NSTEMI, and had a lower history of smoking, diabetes, coronary heart disease and myocardial infarction. Baseline inflammatory markers such as neutrophil count, monocyte count, neutrophil count/lymphocyte count (NLR), and monocyte count/high-density lipoprotein count (MHR) were lower, creatinine, N-terminal pro-brain B-type Natriuretic peptides (NT-proBNP), creatine kinase-MB, hypersensitive troponin I, fibrinogen, baseline blood glucose levels were lower, high-density lipoprotein cholesterol was higher, and the incidence of myocardial bridge, arrhythmia, tachycardia and atrial fibrillation was higher (P<0.05). The application rates of calcium antagonists and non-vitamin K antagonists oral anticoagulants were higher in MINOCA group (P<0.05), and there was no statistical difference in hospitalization days and in-hospital death between the two groups (P>0.05). Multiple logistic regression analysis showed that young age, female, non-smoker, no history of coronary heart disease and low MHR were risk factors of MINOCA (P<0.05). MINCOA was not associated with higher in-hospital death (P>0.05). Patients with AMI and a history of coronary heart disease, chronic renal failure, higher baseline blood glucose, higher NLR, and higher D-dimer were risk factors of in-hospital death (P<0.05). Conclusions: Compared with MI-CAD patients, MINOCA patients are younger, more likely to be female and non-smokers and on history of coronary heart disease, and have lower baseline MHR. MINOCA is often associated with myocardial bridge and atrial fibrillation. The incidence of in-hospital death in MINCOA patients is similar as in MI-CAD patients.
Atrial Fibrillation/complications*
;
Blood Glucose
;
Coronary Artery Disease/complications*
;
Female
;
Hospital Mortality
;
Humans
;
Lipoproteins, HDL
;
MINOCA
;
Male
;
Myocardial Infarction/complications*
;
Retrospective Studies
9.Correlation between GPR, MHR and elderly essential hypertension with unstable angina pectoris.
Xiaoteng LIU ; Ying ZHANG ; Fengbiao JIN ; Huiqing LIU ; Qinglian LI ; Yu GAO ; Ruitian HOU ; Zhimin ZHANG
Journal of Central South University(Medical Sciences) 2021;46(4):373-378
OBJECTIVES:
To investigate the level and significance of serum γ-glutamyl transferase-to-platelet ratio (GPR) and monocyte count to high-density lipoprotein ratio (MHR) in patients with essential hypertension (EH) and unstable angina (UA).
METHODS:
A total of 218 patients with coronary angiography aged ≥60 years, who were admitted to the EH hospital of the Department of Cardiac Medicine, Affiliated Hospital of Chengde Medical College, were selected from September 2018 to September 2019. They were divided into an EH+UA group (
RESULTS:
Compared with the control group, patients in the EH+UA group and the EH group had higher body mass index (BMI), tyiglyceride (TG), GPR, and MHR, and lower high-density lipoprotein-cholesterol (HDL-C) (all
CONCLUSIONS
There is a correlation between GPR, MHR and EH combined with UA pectoris, and the combined detection of the two indicators has adjuvant diagnostic value for elderly EH combined with UA.
Aged
;
Angina, Unstable
;
Cholesterol, HDL
;
Coronary Angiography
;
Essential Hypertension
;
Humans
;
Lipoproteins, HDL
;
Monocytes
10.Fibroblast Growth Factor-23 is associated with High-density lipoprotein in Systemic sclerosis Female patients
Antonio Alvarez-Cienfuegos ; Lucia Cantero-Nieto ; Jose Alberto Garcí ; a-Gomez ; Jose Luis Callejas-Rubio ; Javier Martin ; Norberto Ortego-Centeno
Philippine Journal of Internal Medicine 2020;59(1):9-13
INTRODUCTION: Fibroblast growth factor-23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and has been implicated as a putative pathogenic factor in cardiovascular disease. The objectives of this study were: to compare serum FGF23 levels between systemic sclerosis (SSc) patients and healthy controls and to investigate possible associations between FGF23 and serum lipid profile in SSc patients.
METHODS: This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. We enrolled 62 consecutive female patients affected by SSc and 62 healthy women who served as controls. Cardiovascular risk factors and related biochemical parameters were collected. Serum FGF23 was analyzed using enzyme- linked immunosorbent assay (ELISA). Linear regression was used to examine the cross-sectional associations of serum FGF23 concentrations with high density lipoprotein-cholesterol (HDL-c).
RESULTS: There was no significant differences in FGF23 levels between the patients and controls (78.2 ± 60.5 vs. 80.3 ± 56.3 pg/mL, p= 0.662), but we found a statistically significant inverse relationship between FGF23 and HDL-c measurements (r= -0.27; p= 0.03) in women with SSc. In addition, in the linear regression model, higher FGF23 concentrations were associated with lower HDL-c [β = -1.45 95% CI (-2.81, -0.08); p < 0.05].
CONCLUSIONS: We report an association between circulating FGF23 and HDL-c in SSc female patients, representing a novel pathway linking high FGF23 to an increased cardiovascular risk.
Lipoproteins, HDL
;
fibroblast growth factor 23
;
Scleroderma, Systemic
;
Fibroblast Growth Factors


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