ObjectiveTo conduct a systematical evaluation and meta-analysis of the relation between serum total cholesterol (TC) level and the risk of gastric cancer. MethodsThe PubMed, Embase, Web of Science, and Cochrane Library databases were searched from inception to March 5, 2023. Two independent reviewers performed the literature search, identification, and screening, as well as performed the quality assessment and data extraction. ResultsA total of 12 studies with 5 143 671 participants and 40 551 patients with gastric cancer were included in the meta-analysis. The results of meta analysis showed that 9 studies reported that the elevated serum TC level decreased the risk of gastric cancer [OR (95%CI) was 0.91 (0.85, 0.98)], and 5 studies reported that the decreased serum TC level increased the risk of gastric cancer [OR (95%CI) was 1.93 (1.17, 3.18)]. Also the results of the subgroup analyses showed that the decreased serum TC level increased the risk of gastric cancer in the studies with cohort study, larger overall sample sizes and gastric cancer sample sizes, with longer duration of follow-up, and in those with habits of alcohol and smoking [0.89 (0.87, 0.92), 0.90 (0.87, 0.94), 0.90 (0.87, 0.93), 0.86 (0.82, 0.90), 0.90 (0.87, 0.93), and 0.90 (0.87, 0.93), respectively] , which was consistent with the overall results. In contrast, there was no statistical difference in the relation between the elevated serum TC level decreased the risk of gastric cancer between male and female patients in the gender subgroup. ConclusionsThe results of this systematical evaluation and meta-analysis suggest that serum TC level [135–294 mg/dL (3.49–7.62 mmol/L)] may be a protective factor for gastric carcinogenesis. The risk of gastric carcinogenesis may be increased when serum TC level decreases, and this change is a long-term and insidious process.
Objective
To investigate the efficacy of LDL-C lowering treatment on NSTE-ACS, and to analyze the target LDL-C level for clinical treatment.
Methods
PubMed, EMbase, the Cochrane Central Register of Controlled Trials, Web of Science databases were searched up to January 2016 for randomized controlled trials assessing the effects of LDL-C lowering therapy on major adverse cardiac events (MACE) in patients with NSTE-ACS. Two reviewers independently screened litertures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by using Stata12.0 and RevMan 5.3 software.
Result
A total of 12 RCT including 4 702 individuals with NATE-ACS were included. The results of meta-analysis showed that, compared with the control group, the statin group could significantly reduced the risk of MACE (RR=0.68, 95% CI 0.549 to 0.834,P=0.000). With 18.68 months of follow-up, patients in target LDL-C level from over 70 mg/dL to less than 100 mg/dL group had lower risk of MACE than other LDL-C level group. When LDL-C lower 20% to 40% than baseline with 28.99 months follow-up, patients in target of LDL-C level from over 70 mg/dL to less than 100 mg/dL group had lowest risk of MACE (RR=20.143, 95% CI 6.946 to 58.414,P=0.000).
Conclusion
LDL-C lower treatment can lower the risk of MACE in patients with NSTE-ACS. Patients in target LDL-C level from over 70 mg/dL to less than 100 mg/dL group have relatively low risk of MACE, in which patients who lower 20% to 40% LDL-C than baseline will get more benefits from LDL-C lowering therapy.
ObjectiveTo understand the current status of low-density lipoprotein cholesterol (LDL-C) control in patients after coronary artery bypass grafting. MethodsClinical data of patients who underwent isolated coronary artery bypass grafting in Beijing Anzhen Hospital in 2023 were collected. All patients returned to our hospital approximately one year after surgery (10-13 months) for a lipid level recheck. We analyzed their LDL-C attainment status and influencing factors. Patients were categorized into two groups based on whether their LDL-C met the target: the LDL-C attainment group and the LDL-C non-attainment group. ResultsThis study included 1456 patients who had undergone coronary artery bypass grafting, including 320 females and 1136 males, with an average age of (61.41±9.12) years. One year post-surgery, 234 patients achieved the LDL-C target, with an attainment rate of 16.07%. The proportion of patients in the LDL-C attainment group who were ultra-high risk (77.35% vs. 92.06%, P＜0.001), female (16.24% vs. 23.08%, P=0.021), and those with comorbid hypertension (55.98% vs. 63.18%, P=0.038) was significantly lower than those in the LDL-C non-attainment group. Additionally, the baseline body mass index (BMI) upon admission in the attainment group [(25.37±3.24) kg/m2 vs. (26.03±3.56) kg/m2, P=0.017], total cholesterol levels [(3.30±0.84) mmol/L vs. (4.01±1.03) mmol/L, P＜0.001], LDL-C [(1.62±0.62) mmol/L vs. (2.25±0.85) mmol/L, P＜0.001], and high-density lipoprotein cholesterol [(0.98±0.26) mmol/L vs. (1.02±0.24) mmol/L, P=0.049] were all lower than in the non-attainment group. Moreover, the lipid-lowering drug usage rate in the attainment group (100.00% vs. 96.24%, P=0.003) and the proportion using two types of drugs together (25.21% vs. 10.72%, P＜0.001) were both higher than in the non-attainment group, while the statin monotherapy rate was lower than in the non-attainment group (74.79% vs. 85.19%, P＜0.001). Logistic regression analysis showed that baseline BMI (OR=0.928, P=0.012) and baseline LDL-C levels (OR=0.207, P<0.001), patient cardiovascular risk stratification (OR=0.155, P<0.001) and lipid-lowering drug treatment regimen (OR=3.758, P<0.001) are significant factors affecting whether LDL-C meets the standard. ConclusionThe LDL-C compliance rate of patients undergoing coronary artery bypass grafting is at a relatively low level 1 year after surgery. Patients with very high risk of atherosclerotic cardiovascular disease, high baseline LDL-C levels, and overweight or obesity should strengthen their lipid management. For these patients, the intensity of lipid-lowering drug use or combination medication should be increased upon discharge.
ObjectiveTo evaluate the relationship between some clinical laboratory tests, such as levels of fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC), and benign prostatic hyperplasia (BPH).
MethodsA total of 146 male patients were included in this study. All the subjects were from the clinic of West China Hospital and Sichuan Cancer Hospital from January 2012 to July 2013. Serum FINS, TG, TC and prostate specific antigen (PSA) were tested, respectively. Prostate volume (PV) was measured by ultrasound.
ResultsFINS, PAS and annual prostate growth rate increased significantly in the large PV group compared with the small PV group (P<0.01). There was no significant association of PV with body mass index and other laboratory tests like serum TC and TG. PV and annual prostate growth rate increased significantly in the group of high FINS level compared with the group of low FINS level (P<0.01). PV was positively correlated with FINS (r=0.159, P<0.05); and annual prostate growth rate was positively correlated with FINS (r=0.201, P<0.05).
ConclusionHyperinsulinism may play an important role in the pathogenesis of BPA.
Objective To investigate the correlation between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and the presence of atherosclerotic stenosis in both intracranial and extracranial arteries among patients who have experienced cerebral infarction. Methods Patients with cerebral infarction admitted to the Department of Neurology of Sichuan Provincial People’s Hospital between January 2021 and June 2024 were retrospective selected. According to the digital subtraction angiography (DSA) performance, patients were divided into cerebral atherosclerotic stenosis group and no cerebral atherosclerotic stenosis group. According to the location of atherosclerotic stenosis, patients were divided into extracranial atherosclerotic stenosis group, intracranial atherosclerotic stenosis group, intracranial and extracranial atherosclerotic stenosis group. According to the severity of atherosclerotic stenosis, patients were divided into mild group, moderate group and severe group. Clinical data and laboratory indicators were collected. Multifactorial regression was used to analyze the risk factors, Spearman correlation analysis was used to evaluate the relationship between UHR and the degree of stenosis, and the predictive value of UHR for intracranial and extracranial atherosclerotic stenosis was analyzed by the receiver operating characteristic curve. Results A total of 388 patients were included. Among them, 291 cases in cerebral atherosclerotic stenosis group and 97 cases in no cerebral atherosclerotic stenosis group; 85 cases in the intracranial atherosclerotic stenosis group, 123 cases in the extracranial atherosclerotic stenosis group, and 83 cases in the intracranial and extracranial atherosclerotic stenosis group; There were 104 cases in the mild group, 81 cases in the moderate group, and 106 cases in the severe group. The results of multiple logistic regression analysis showed that age, hypertension, UHR and uric acid were independent influencing factors associated with atherosclerotic stenosis of intracranial and extracranial arteries. Furthermore, the uric acid and UHR were also risk factors for the degree of stenosis (P<0.05). Spearman correlation analysis results showed that UHR was positively correlated with the degree of stenosis (r=0.516, P < 0.001). Receiver operating characteristic curve showed that the predictive value of UHR (area under the curve was 0.724) was superior to that of uric acid (area under the curve was 0.638) or HDL-C (area under the curve was 0.709). It also showed good predictive value for stenosis in different locations of intracranial and extracranial arteries. Conclusion UHR is an independent risk factor for intracranial and extracranial atherosclerotic stenosis with notabla predictive value
Objective
To explore the characteristics and the related factors of the lipid profiles in patients with ankylosing spondylitis (AS).
Methods
Sixty AS patients and 60 healthy controls were included retrospectively from January 2005 to January 2015. Information including general data, physical examination, and blood sample were collected; triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), and C-reactive protein (CRP) were assessed.
Results
TG increased in 46.7% (28/60) patients, and HDL-C decreased in 50.0% (30/60). Compared with the control group, AS patients had lower levels of HDL-C, TC and LDL-C, and higher levels of TG, VLDL-C, VLDL-C/LDL-C ratio, LDL-C/HDL-C ratio, and TC/HDL-C ratio; the differences above were all statistically significant (P<0.01). Spearman correlation test demonstrated that HDL-C level was correlated negatively with serum CRP (rs=–0.359, P=0.005). Multiple linear regression model demonstrated that CRP was associated with HDL-C in AS patients (P=0.019).
Conclusions
Dyslipoproteinemia is a common feature in AS patients. The main characteristic is the increase of TG and decrease of HDL-C, related with inflammation. It suggests a high risk of atherosclerosis.
ObjectiveTo summarize the remodeling of cholesterol metabolism in the occurrence and progression of pancreatic ductal adenocarcinoma (PDAC), and to review the research progress on targeted cholesterol metabolism in the treatment of PDAC. MethodRelevant literatures on cholesterol metabolism in the occurrence, development, and diagnosis and treatment of PDAC in recent years were searched and reviewed. ResultsMetabolites of PDAC tumor cells affected the expression of oncogenes or tumor suppressor genes. Signaling regulation within tumor cells affects cholesterol metabolism, characterized by increased de novo cholesterol synthesis and esterification, and reduced efflux. Tumor cells also regulated tumor immune microenvironment or tumor stroma formation through cholesterol metabolism. Inhibiting cholesterol metabolism could suppress the proliferation, invasion and migration of PDAC tumor cells, and combination therapy targeting cholesterol metabolism had a synergistic anti-PDAC effect. ConclusionsRemodeling of cholesterol metabolism occurs in both PDAC tumor cells and the tumor microenvironment, and is closely related to the occurrence, development, invasion, metastasis, and treatment response of PDAC. Targeting cholesterol metabolism or combined application with chemotherapy drugs can have anticancer effects. However, more research is needed to support the translation of cholesterol metabolism regulation into clinical treatment applications.
Objective To identify independent risk factors for in-hospital all-cause mortality in patients with sepsis and to integrate them into the quick Sequential Organ Failure Assessment (qSOFA) score to construct modified models, thereby improving the ability of the original qSOFA to predict mortality risk. Methods This retrospective study included adult patients who met the Sepsis-3 criteria for sepsis and were admitted to the Intensive Care Unit or Emergency Intensive Care Unit of Zigong Fourth People’ s Hospital between January 2018 and December 2023. Demographic characteristics, vital signs, comorbidities, and laboratory parameters were collected, and the Sequential Organ Failure Assessment (SOFA) and qSOFA scores were calculated. Multivariable logistic regression analysis was used to identify independent predictors of in-hospital mortality. Independent predictors were dichotomized according to cut-off values derived from receiver operating characteristic (ROC) curves and combined with qSOFA to construct new models. The ROC analysis with bootstrap validation was used to assess predictive performance, and comparative performance was further evaluated using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results A total of 218 patients were included. Multivariable logistic regression analysis identified blood urea nitrogen (BUN) [odds ratio (OR)=1.100, 95% confidence interval (CI) (1.040, 1.170)] and qSOFA [OR=2.610, 95%CI (1.450, 4.920)] as independent risk factors for in-hospital mortality, whereas high-density lipoprotein cholesterol (HDL-C) was an independent protective factor [OR=0.250, 95%CI (0.065, 0.841)]. After dichotomization by ROC-derived cut-off values, BUN and HDL-C were incorporated into qSOFA to generate B-qSOFA, H-qSOFA, and BH-qSOFA. Bootstrap ROC analysis showed that BH-qSOFA exhibited the highest discriminatory ability compared with all combined models as well as the conventional SOFA and qSOFA scores [area under the curve=0.803, 95%CI (0.735, 0.863)]. NRI and IDI analyses demonstrated that BH-qSOFA provided incremental prognostic improvement over qSOFA (NRI=0.969, IDI=0.165), B-qSOFA (NRI=0.644, IDI=0.054), and H-qSOFA (NRI=0.804, IDI=0.091) (all P<0.05). Conclusions Elevated BUN and qSOFA and decreased HDL-C are independent predictors of in-hospital mortality in sepsis. The BH-qSOFA model is simple and clinically practical, exhibits superior predictive performance over the original qSOFA. It may serve as a useful early instrument for prognostic risk stratification in patients with sepsis.
Objective To investigate the characteristics of dyslipidemia in patients with immunoglobulin G4-related disease (IgG4-RD) and its correlation with clinical indicators and organ involvement. Methods Patients diagnosed with IgG4-RD at West China Hospital of Sichuan University between September 2020 and October 2024 were retrospectively selected. Based on lipid levels, patients were divided into a high-TG group and a normal-TG group, as well as a high-TC group and a normal-TC group. The demographic characteristics, serological indicators (lipids, IgG4, IgE), and organ involvement of the two groups were analyzed, and the correlation between the indicators was evaluated. Results A total of 125 IgG4 RD patients were included. Among them, there were 89 males (71.2%) and 36 females (28.8%); 21 cases of high TG and 29 cases of high TC. The high-density lipoprotein cholesterol level was lower in the high TG group [(1.16±0.33) vs. (1.41±0.50) mmol/L, P=0.032], and the proportion of retroperitoneal fibrosis involvement was higher (23.8% vs. 9.6%). The low-density lipoprotein cholesterol level in the high TC group was higher than that in the normal TC group [(3.09±0.95) vs. (2.39±0.93) mmol/L, P<0.001]. Correlation analysis showed that TG was positively correlated with TC (r=0.37, P<0.05), IgG4 levels were positively correlated with the number of affected organs (r=0.24, P<0.05), while lipid parameters were not correlated with IgG4, IgE, and the number of affected organs. Conclusions Dyslipidemia is common in IgG4-RD patients. High TG is associated with low high-density lipoprotein and a tendency for retroperitoneal fibrosis involvement, while high TC is associated with elevated low-density lipoprotein. Serum IgG4 levels can reflect the extent of organ involvement, but lipid indicators show no significant correlation with disease-specific immune markers. It is recommended to emphasize lipid monitoring in clinical management, particularly for patients with retroperitoneal fibrosis or those on long-term glucocorti coid therapy.
ObjectiveTo investigate the predictive value of a new nutritional index, triglycerides-total cholesterol-body mass index (TCBI), for prolonged postoperative hospital stay in patients undergoing coronary artery bypass grafting surgery (CABG). MethodsA retrospective analysis was conducted on the clinical data of CABG patients admitted to Wuhan Asian Heart Hospital, Wuhan University of Science and Technology from January 2022 to March 2024. Based on the postoperative hospital stay duration of CABG patients, they were divided into two groups: normal hospital stay group (≤14 days) and prolonged hospital stay group (>14 days). Univariate and multivariate logistic regression analyses were used to identify independent factors associated with prolonged postoperative hospital stay in CABG patients. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of TCBI for prolonged postoperative hospital stay. ResultsA total of 460 patients were included, with 289 males (62.8%) and 171 females (37.2%), with an average age of 67 years (range 35-83 years). The TCBI level in the prolonged hospital stay group was significantly lower than that in the normal hospital stay group [1161.71 (825.36, 1511.78) vs. 1777.60 (1354.53, 2448.60), P<0.001]. Multivariate logistic regression analysis revealed that drinking history (OR=2.222, P=0.022), low absolute lymphocyte count (OR=0.169, P<0.001), low serum albumin (OR=0.624, P<0.001), and low TCBI (OR=0.816, P<0.001) were independent risk factors for prolonged postoperative hospital stay in CABG patients. ROC curve results showed that the area under the curve for TCBI to predict prolonged hospital stay was 0.808, with a sensitivity of 72.8% and specificity of 70.9% at a cutoff value of 1446.11. ConclusionTCBI is an effective predictive indicator for prolonged postoperative hospital stay in CABG patients, and the risk of prolonged postoperative hospital stay is higher in CABG patients with TCBI ≤1446.11.
