Hyperlipidemias – ABC CARDIOL

IJCS

Original Article

Agreement Between a Portable Cholesterol Device and Laboratory-Based Testing in Older Adults

Odilon Abrahin et al. Naicha Stefanie Félix Souza Rejane P. Abrahin Alex Harley Crisp

Abstract

Background:

It is crucial to monitor blood lipid levels accurately in older adults to assess cardiovascular risk. Although several portable strip-based devices are commercially available, their accuracy has not been well established.

Objective:

To evaluate the agreement of the Mission Cholesterol device and standard laboratory method results, using samples from older adults.

Methods:

Forty-nine patients (42 females) with an average age of 70 ± 8 years were included. The participants were instructed to fast for 12 hours before undergoing venous and capillary blood sampling for lipid analysis (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglyceride [TG] levels). The agreement between the Mission Cholesterol device and laboratory test results was assessed using the concordance correlation coefficient (CCC) and Bland–Altman plots. The accuracy levels were assessed based on the percentage bias recommended by the National Cholesterol Education Program (NCEP).

Results:

The TC measurement had a better accuracy level (bias = 10.91%; CCC = 0.89) than other lipid measurements. However, none of them met the NCEP’s acceptable standards for bias and concordance (CCC ≥ 0.90). Furthermore, the device demonstrated modest overall agreement in classifying lipid risk according to clinical reference values (agreement rates: TC, 67.3%; HDL-C, 65.3%; LDL-C, 49.0%; and TG, 61.2%).

Conclusion:

The Mission Cholesterol device exhibited insufficient agreement levels for effective lipid profile monitoring and screening in older adults.

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ABC

Editorial

Friedewald, Martin/Hopkins, or Sampson/NIH: Which is the Best Method to Estimate LDL-Cholesterol?

Fernando Cesena

Atherosclerotic cardiovascular disease (ASCVD) is the main cause of death in Brazil and most of the world. Reduction in low-density lipoprotein cholesterol (LDL-c) is the first lipid goal to prevent ASCVD. The decision on the initiation or intensification of LDL-c lowering drug therapy is based on the risk of events and the LDL-c level, so an accurate determination of LDL-c is highly desirable.

The gold standard method to determine the plasma concentration of LDL-c is β-quantification, an expensive, time-consuming procedure based on ultracentrifugation and precipitation. Direct methods that use proprietary chemicals instead of ultracentrifugation are also time-consuming and costly. Moreover, they lack standardization, and the accuracy is not always good.

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IJCS

Original Article

Analysis of the Influence of Abdominal Obesity on Systemic Arterial Hypertension and on the Lipid Profile on Cardiometabolic Risk Stratification in Adult Women

Iury Matheus Lima Cavalcanti et al. Cristian Rodrigues do Nascimento Pedro Pereira Tenório Tiago Ferreira da Silva Araújo

Abstract

Background:

Obesity is a public health problem and has been associated with the development of metabolic disorders that have a strong relationship with the onset of cardiovascular diseases (CVD).

Objective:

The objective was to analyze the influence of abdominal obesity (AO) on systemic arterial hypertension (SAH) and on the lipid profile in cardiovascular risk stratification in adult women.

Methods:

Altogether, 91 women participated in the research. Lifestyle information was collected, in addition to the analysis of clinical measures of cardiovascular risk and biochemical parameters. Unpaired Student’s t-test, logistic regression, and Pearson’s correlation were performed for data analysis, with a value of p <0.05 considered significant.

Results:

The prevalence of AO was 62.6%. Logistic regression showed that AO increased the chance of developing SAH by 2.9-fold. The same behavior was observed in the TG/HDL-c lipid ratio (3.93 ± 0.3 vs. 2.16 ± 0.2), representing an 82% increase in obese women. The present study also demonstrated that the best anthropometric parameter to analyze cardiovascular risk in the studied population was the waist/height ratio (AUC = 0.707).

Conclusions:

It can therefore be concluded that AO plays a significant role in the development of SAH and changes in lipid values that predict increased cardiovascular risk, configuring a strong influence factor for CVD.

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ABC

Research Letter

Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia

Enrico Manfredini et al. Renato Jorge Alves

Introduction

Hyperlipidemia can increase morbidity and mortality. This condition has been classified by Fredrickson into the following phenotypes: I, IIa, IIb, III, IV and V.^– In the mixed ones, the following conditions are present: hypercholesterolemia and hypertriglyceridemia, phenotypes IIb and III, with cholesterolemia and triglyceridemia of 250 to 300 mg/dL in phenotype IIb, and 500 to 600 mg/dL or more, in III, respectively. Pancreatitis is uncommon in both, as well as xanthomatosis in IIb. Xanthomas and cardiovascular complications are more frequent in phenotype III.^,

We present a case of hyperlipidemia with relevant lipid abnormalities, pancreatitis and exuberant xanthomatosis.

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IJCS

Case Report

Acute Coronary Disease in very Young Patient: A Reality!

Erivelton Nascimento et al. Ana Luisa Freitas e Pena Mello Ludmila Souza da Cunha Marcelo Ferreira Villela

Introduction

Acute cardiovascular events such as acute myocardial infarction (AMI) are uncommon in young individuals. Additionally, it is known that different factors may be involved in the occurrence of AMI. Here, we report a case of acute myocardial infarction due to severe coronary lesion in a very young patient.

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ABC

Editorial

Cardiovascular Risk Factors in Childhood Claim for Public Health Policies

Tania L. R. Martinez et al. Abel Pereira Anita L. R. Saldanha

Obesity is presently a pandemic public health problem not only in developed countries but also in developing ones. As its incidence is increasing in childhood and adolescence as well this issue becomes alarming considering its evolution and associations. The multiple comorbidities such as hypertension, hyperlipidemia and insulin resistance that accompany obesity increase the risk of cardiovascular mortality whilst worsening quality of life in adults. It is always appropriate to reinforce the fact that the atherosclerotic process starts at an early stage in life^– as demonstrated in autopsies of children with strong association between LDL cholesterol levels prior to death and the presence of fatty streaks in the aorta. This observation has been documented in various reports in Brazil demonstrating that public health policies must be reinforced towards this problem.^–

In different approaches in schoolchildren of a city in Sao Paulo for over ten years we have been studying the impact of biochemical, anthropometric, nutritional status, clinical, socio-cultural and economic conditions.

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Original Article

Dyslipidemia in Adolescents Seen in a University Hospital in the city of Rio de Janeiro/Brazil: Prevalence and Association

Nathalia Pereira Vizentin et al. Paula Mendonça Santos Cardoso Camila Aparecida Gomes Maia Isabela Perez Alves … Gabriel Lunardi Aranha Denise Tavares Giannini

Abstract

Background:

Early exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia.

Objectives:

To establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto.

Methods:

This is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used.

Results:

A total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color.

Conclusion:

This study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.

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IJCS

Original Article

Assessment of Bioactive Compounds, Physicochemical Composition, and In Vitro Antioxidant Activity of Eggplant Flour

Mauara Scorsatto et al. Aline de Castro Pimentel Antonio Jorge Ribeiro da Silva Kebba Sabally … Glorimar Rosa Gláucia Maria Moraes de Oliveira

Abstract

Background:

The eggplant (Solanum melongena) is a fruit of world consumption. Its processing in the form of flour is a way to avoid losses and to take advantage of its nutritional characteristics.

Objective:

This study assessed the physicochemical composition (moisture, proteins, lipids, crude fiber, carbohydrates, minerals, niacin, saponins, titratable acidity, dietary fiber, and total phenols) of eggplant flour prepared from the whole fruit dehydrated in an oven.

Methods:

In vitro antioxidant activity was assessed using the following methods: 2.2-diphenyl-1-picrylhydrazyl radical (DPPH); Ferric Reducing/Antioxidant Power (FRAP); and analysis of polyphenols using HPLC (chlorogenic acid, caffeic acid, ferulic acid, and rutin).

Results:

It was possible to observe: 23.09% carbohydrates; 13.34% proteins; 1.85% lipids; 39.19% total fibers; 1,540 mg/100 g total soluble phenolic compounds; 840 mg/100 g saponins; minerals (potassium, magnesium, copper, iron, zinc, manganese); and niacin. In vitro antioxidant activity was observed through DPPH (455.6 mg ascorbic acid/100 g) and FRAP (486.8 mg ascorbic acid/100 g). The HPLC method determined the presence of ascorbic acid, tyrosine, and phenolic acids (chlorogenic acid, caffeic acid, and ferulic acid).

Conclusion:

The eggplant flour had great fiber content in addition to good content of phenolic compounds and saponins with important antioxidant capacity observed through in vitro assays. As a result, eggplant flour is a good addition to the diet of the population, since it can bring potential health benefits.

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Artigo Original

Nutritional and cardiovascular profiles of normotensive and hypertensive rats kept on a high fat diet

Silvio A. Oliveira Júnior et al. Katashi Okoshi Ana Paula Lima-Leopoldo André S. Leopoldo … Dijon H.S. Campos Paula F. Martinez Marina P. Okoshi Carlos R. Padovani Maeli Dal Pai-Silva Antonio C. Cicogna

BACKGROUND: Although a high fat diet (HFD) promotes nutritional and heart disorders, few studies have assessed its influence in normotensive Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). OBJECTIVE: To evaluate and compare the nutritional and cardiovascular profiles of WKY and SHR on a high fat diet. METHODS: 20 WKY and 20 SHR were divided into four groups: Control-WKY (C-WKY), HFD-WKY, Control-SHR (C-SHR) and HFD-SHR. The C and HFD groups received, respectively, a normocaloric diet and a HFD for 20 weeks. The following features were evaluated: body weight (BW), adiposity, blood glucose, serum lipids, with measurements of total cholesterol and triacylglycerol levels, insulin and leptin. The cardiovascular study included the systolic blood pressure (SBP), a cardiopulmonary anatomical evaluation, an echocardiography and heart histology. RESULTS: The SHR had BW, adiposity, glucose, cholesterol, triacylglycerol, leptin and insulin levels lower than the WKY. In SHR, the caloric intake increased with HFD. In WKY, the HFD increased energy efficiency, adiposity and blood leptin, and reduced glucose. In the cardiovascular assessment, the SHR had SBP, pulmonary moisture, myocardial hypertrophy and interstitial fibrosis higher than the WKY (p <0.01); the cardiac function was similar in both strains. The HFD reduced the ventricular systolic diameter in the WKY and increased the mitral E/A ratio, the diastolic thickness of the interventricular septum and the posterior wall, as well as the interstitial fibrosis of the left ventricle. (Arq Bras Cardiol 2009; 93(5) : 487-494) CONCLUSION: Although it had not significantly affected the nutritional profile of the SHR, the treatment increased cardiac remodeling and precipitated the emergence of ventricular diastolic dysfunction. In WKY, the diet increased adiposity and leptinemia, and promoted non-significant cardiovascular changes.

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