Journal of clinical lipidology最新文献

{"title":"Joint association of plasma ceramide and renal function with coronary artery lesion severity: The CRUISE-MET study.","authors":"Qiang Chen, Yike Li, Haoming He, Yingying Xie, Dongliang Fu, Ruilong Gao, Nan Li, Sunjin Fu, Yakun Mu, Yuxuan Sun, Zixuan Yang, Jiahui Zhou, Xu Li, Yanxiang Gao, Jingang Zheng","doi":"10.1016/j.jacl.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Ceramides and chronic kidney disease (CKD) independently promote atherosclerosis, yet their synergistic effect remains underexplored. This study systematically investigates their combined impact on coronary lesion severity.</p><p><strong>Method: </strong>This cross-sectional analysis included coronary artery disease (CAD) patients from the CRUISE-MET trial (NCT06383208). Six ceramide species: Cer (18:1/16:0), Cer (18:1/18:0), Cer (18:1/20:0), Cer (18:1/22:0), Cer (18:1/24:0), and Cer (18:1/24:1), were quantified via ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry. Baseline SYNTAX score (bSS) > 22 defined complex CAD. CKD was classified based on both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). The combined and mediating effects of ceramides and renal dysfunction on coronary lesion complexity were further evaluated.</p><p><strong>Result: </strong>Among 691 CAD patients, those with complex lesions exhibited elevated UACR, Cer (18:1/16:0), Cer (18:1/18:0), Cer (18:1/24:1), and decreased eGFR (all P < .05). Cer (18:1/16:0) demonstrated the strongest correlation with bSS (r = 0.186, P < .001) and highest predictive accuracy (area under the curve = 0.616). Multivariable-adjusted logistic regression revealed that per-SD increase in Cer (18:1/16:0) conferred 31% higher odds of complex CAD (odds ratio [OR] = 1.31, 95% CI: 1.08-1.59; P = .006), with the highest tertile showing 88% elevated risk (OR = 1.88, 95% CI: 1.18-3.01; P = .008). Synergistic effects were observed between CKD and elevated Cer (18:1/16:0) (> median), with combined exposure increasing complex CAD risk 4.4-fold (OR = 4.40, 95% CI: 2.74-7.07; P < .001). Mediation analysis implicated renal impairment in 28.1% (UACR) and 13.9% (eGFR) of ceramide's atherogenic effects. Sensitivity analyses confirmed robustness in diabetic and hypertensive subgroups.</p><p><strong>Conclusion: </strong>The study highlights ceramide-renal synergy in exacerbating coronary atherosclerosis, advocating integrated biomarker profiling for risk stratification and dual-targeted therapies.</p>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early triglyceride-lowering therapy in acute pancreatitis with extremely high triglyceride levels.","authors":"Lanting Wang, Qiong Wu, Enrique de-Madaria, Yuan Yuan, Pinjie Zhang, Longxiang Cao, Jing Zhou, Yuxiu Liu, Zhihui Tong, Weiqin Li, Lu Ke","doi":"10.1016/j.jacl.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.09.003","url":null,"abstract":"<p><strong>Background: </strong>Initial triglyceride levels are likely to influence the effect of triglyceride-lowering therapy in hypertriglyceridemia-associated acute pancreatitis (HTG-AP).</p><p><strong>Objective: </strong>This study aimed to evaluate whether timely triglyceride decline and different triglyceride-lowering therapies were associated with disease severity in HTG-AP patients with extremely high triglycerides.</p><p><strong>Methods: </strong>In this registry-based cohort study, patients with on-admission triglyceride levels of 45.2 mmol/L or more were included. We grouped patients according to their post-treatment triglycerides on day 3 (target reaching, <5.65 mmol/L vs non target-reaching, ≥5.65 mmol/L) and triglyceride-lowering modality (plasmapheresis vs medical). The primary outcome was the development of severe acute pancreatitis (SAP). Multivariable logistic regression models were used to analyze the association between exposure variables and SAP. Generalized estimating equation models were used to examine repeated measures.</p><p><strong>Results: </strong>Overall, 90 patients were included for analysis (median [IQR] initial triglycerides, 65.1 [53.8-77.5] mmol/L). Among the 80 patients with available triglycerides on day 3, 27 (33.8%) reached the target. After controlling for potential confounders, target reaching was significantly associated with decreased risk of SAP (odds ratio [OR], 0.12; 95% CI 0.02 to 0.59; P = .009). Compared to exclusive medical treatment, the use of plasmapheresis was not associated with the development of SAP (OR, 1.98; 95% CI 0.56 to 6.99; P = .291), nor with more rapid decline of triglyceride levels (mean difference 2.76 mmol/L; 95% CI -3.87 to 6.94; P = .577).</p><p><strong>Conclusions: </strong>In HTG-AP patients with extremely high triglycerides, timely triglyceride decline was associated with reduced risk of SAP. Concerning treatment modality, plasmapheresis was not associated with fewer SAP, and the rapidity of triglyceride decline.</p>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth-onset type 2 diabetes: Advances, treatments, and challenges in prevention","authors":"David P. Sparling MD, PhD,&nbsp;Jeanie B. Tryggestad MD","doi":"10.1016/j.jacl.2025.05.020","DOIUrl":"10.1016/j.jacl.2025.05.020","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Youth-onset type 2 diabetes (YOT2D) rates have increased dramatically in the last 20 years paralleling the increase in obesity. The primary pathophysiology is insulin resistance (IR) linked directly to obesity and inflammation within adipose depots. Adipose inflammation and dysfunction lead to increases in triglycerides (TGs) and free fatty acids (FFAs) that in turn impact glucose utilization in other key tissues such as the liver and skeletal muscle.</div></div><div><h3>SOURCES OF MATERIAL</h3><div>Screening for diabetes risk in youth is difficult as the current diagnostic criteria yield very few cases that actually progress to overt diabetes, and prevention strategies to delay the onset of YOT2D are lacking.</div></div><div><h3>ABSTRACT OF FINDINGS</h3><div>Identifying the progression towards and early diagnosis of YOT2D is paramount as it is much more aggressive than adult-onset T2D, including early signs of beta cell failure, necessitating rapid intensification of therapy to avoid later complications. Recently, the pharmacologic options for treatment of those &lt;18 years of age have increased which is anticipated to improved outcomes.</div></div><div><h3>CONCLUSION</h3><div>Identifying specific factors in youth at the highest risk for progression to youth-onset T2D is needed to move toward more effective prevention and therapeutic strategies with the goal of maintaining health and wellness of this vulnerable population.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 29-36"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic syndrome in youth - A fresh look at an old problem","authors":"Don P. Wilson MD, FNLA ,&nbsp;Amy S. Shah MD, MS","doi":"10.1016/j.jacl.2025.03.005","DOIUrl":"10.1016/j.jacl.2025.03.005","url":null,"abstract":"<div><div>The clustering of cardiometabolic risk factors, commonly referred to as metabolic syndrome (MetS), has become increasingly prevalent among youth &lt;18 years of age. Although its definition in this population is often debated, as in adults MetS is typically characterized by central obesity, high blood pressure, dyslipidemia (elevated triglycerides and low high density lipoprotein cholesterol), and glucose dysregulation, with insulin resistance as the common link. MetS frequently originates in childhood, tracks into adulthood, and is associated with comorbidities such as fatty liver disease and polycystic ovarian syndrome. Furthermore, it significantly increases the risk of developing type 2 diabetes and cardiovascular disease later in life. In this article, we discuss MetS, its components, associated comorbidities, evaluation, and management strategies in the era of recent medications now approved for use in pediatrics. While short-term use of weight loss medications, such as glucagon-like peptide-1 receptor agonists, has been shown to be effective, the safety and long-term benefits have not been determined.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 4-14"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The key to exercise in youth…just do it!","authors":"Rebekah A. Tracy MS","doi":"10.1016/j.jacl.2025.04.205","DOIUrl":"10.1016/j.jacl.2025.04.205","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Increased screen time (ST), sedentary behaviors (SB), and limited physical activity (PA) have led to an increase in childhood obesity and various obesity related co-morbidities among children and adolescents. The purpose of this article is to discuss consequences of increased SB/ST, importance of PA, accessibility to PA, and solutions to increase children and adolescents' daily movement.</div></div><div><h3>METHODS</h3><div>This article will review the evidence-based research regarding consequences of increased ST/SB and subsequent decreases in PA. Several studies are reviewed and a detailed discussion of each key is provided.</div></div><div><h3>RESULTS</h3><div>Ample data support high levels of SB/ST and limited PA can contribute to adverse health outcomes. The details listed in this article help promote PA options including accessibility, inclusive options, and inside ideas for PA.</div></div><div><h3>CONCLUSION</h3><div>A variety of factors such as ST, SB, and limited PA contribute to childhood obesity and related comorbidities. Clinicians, parents/caregivers, and others play a key role in helping children stay active and maintaining a healthy weight.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 48-53"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New directions in childhood obesity treatment – A path forward or wishful thinking?","authors":"Jessica L. Reilly MD ,&nbsp;Shruthi Arora MD ,&nbsp;Kelsey Chatman MD ,&nbsp;Zenobia Cooper MBBS ,&nbsp;Daniel S. Hsia MD","doi":"10.1016/j.jacl.2025.05.010","DOIUrl":"10.1016/j.jacl.2025.05.010","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The advent of highly effective pharmacotherapy that induces significant weight loss has revolutionized the treatment of obesity. Since 2020, these medications have been approved for use in children with obesity 12 years of age and older, and the American Academy of Pediatrics 2023 Clinical Practice Guidelines have endorsed their use.</div></div><div><h3>SOURCES OF MATERIAL</h3><div>Specifically, glucagon-like peptide 1 (GLP-1) agonists and similar related nutrient stimulated hormones induce weight loss of &gt;15% of baseline body weight in clinical trials.</div></div><div><h3>ABSTRACT OF FINDINGS</h3><div>However, these benefits must be balanced with the known side effects and other potential unknown effects especially in growing children and adolescents. Moreover, barriers to access and long-term effects of these medications need to be addressed.</div></div><div><h3>CONCLUSION</h3><div>In this review, we discuss important considerations for the utilization of these newer weight loss agents in the rapidly evolving landscape of weight loss pharmacotherapy in children and adolescents.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 54-60"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic syndrome in youth - Rite of passage or cause for concern?","authors":"Christine Brichta MD, MPH ,&nbsp;Justin R. Ryder PhD","doi":"10.1016/j.jacl.2025.03.003","DOIUrl":"10.1016/j.jacl.2025.03.003","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 1-3"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and treatment of polycystic ovary syndrome in adolescents: A primer for the lipidologist","authors":"Sarah E. Swauger MD,&nbsp;Nancy A. Crimmins MD","doi":"10.1016/j.jacl.2025.04.184","DOIUrl":"10.1016/j.jacl.2025.04.184","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Polycystic ovary syndrome (PCOS) is a disorder characterized by menstrual irregularity andhyperandrogenism.</div></div><div><h3>MATERIAL</h3><div>In this article, we aim to review the clinical features of PCOS and the co-morbidities that often accompany the condition.</div></div><div><h3>FINDINGS</h3><div>Insulin resistance and obesity have an influence on disease pathogenesis, and many adolescents with PCOS have metabolic comorbidities (type 2 diabetes, liver disease, cardiovascular disease).</div></div><div><h3>CONCLUSION</h3><div>Early identification and treatment of adolescent females with PCOS can improve metabolic health, mental health, and fertility outcomes, with an emphasis on the importance of lifestyle modifications, pharmacologic use when indicated, and multidisciplinary care.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 37-42"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is heart-healthy eating achievable in youth?","authors":"Lauren Williams MCN, RDN, LD","doi":"10.1016/j.jacl.2025.04.182","DOIUrl":"10.1016/j.jacl.2025.04.182","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Lifestyle modification has long been regarded as a mainstay of treatment for youth with metabolic syndrome, obesity, and dyslipidemia. Currently, many children and adolescents are not meeting recommended intakes of key dietary components while also overconsuming sodium, added sugars, and saturated fats.</div></div><div><h3>OBJECTIVE</h3><div>To determine if previous lifestyle intervention trials have been effective in improving diet quality or cardiometabolic parameters in youth.</div></div><div><h3>METHODS</h3><div>A review of current literature was completed to determine current nutrient intake in youth, outcomes of previous lifestyle intervention trials, and recent data on confounding nutrition factors such as school-based meals and disordered eating.</div></div><div><h3>RESULTS</h3><div>Studies demonstrate nutrition counseling and lifestyle modification improve cardiometabolic health parameters, but results vary based on duration/intensity of the intervention and degree of parental involvement.</div></div><div><h3>CONCLUSION</h3><div>Studies demonstrate heart-healthy eating is achievable in youth, with trials showing improvements made to diet quality and nutrition-related cardiometabolic health markers. However, special considerations relevant to this age group should be considered when devising a nutrition care plan, as they may confound the progress in achieving a heart-healthy eating style.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 43-47"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension in youth with metabolic syndrome","authors":"Jhanahan Sriranjan BSc, MD ,&nbsp;Claire Adams BMSc ,&nbsp;Rahul Chanchlani MD, MSc, FASN, FISN, FRCPC ,&nbsp;Manish D. Sinha MBBS, PhD, MRCPCH","doi":"10.1016/j.jacl.2025.05.018","DOIUrl":"10.1016/j.jacl.2025.05.018","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Hypertension continues to increase in its prevalence in children and adolescents globally. This evolving health issue has been associated with the concurrent world-wide rise in childhood obesity.</div></div><div><h3>SOURCES OF MATERIAL</h3><div>In this review, we aim to improve the awareness of hypertension in youth with metabolic syndrome (MetS) highlighting key published data. This review examines the interplay between MetS and hypertension during childhood and adolescence, covering its epidemiology, pathophysiology, screening, diagnosis, and potential management strategies.</div></div><div><h3>ABSTRACT OF FINDINGS</h3><div>Hypertension and obesity are integral features of MetS, which describes a clustering of metabolic risk factors hallmarked by insulin resistance that significantly increases the risk of cardiovascular disease in adulthood. Children at risk of developing hypertension and MetS share many modifiable and non-modifiable risk factors, which are derived from common pathophysiological mechanisms. Identifying at-risk individuals through targeted screening is crucial, given their long-term adverse cardiovascular outcomes in young adulthood.</div></div><div><h3>CONCLUSION</h3><div>Management of hypertension and MetS requires a stepwise, multidisciplinary approach, central to which is the recognition that adoption of healthy lifestyle intervention over the lifespan is key to prevention, with consideration for pharmacotherapy and other medical interventions as indicated.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 15-28"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}