Lipids in Health and Disease最新文献

{"title":"Cascade screening and genetic variant pathogenicity assessment for familial hypercholesterolemia in a township‑based elderly population.","authors":"Hongying Wang, Yaqiong Ren, Ailong Xue, Lijun Zhou, Rongyan Zhang, Yue Cao, Yuan Zhang, Xueqian Wang, Zhigang Feng, Haitao Lv, Miao Hou","doi":"10.1186/s12944-026-02976-5","DOIUrl":"10.1186/s12944-026-02976-5","url":null,"abstract":"<p><strong>Background: </strong>Familial hypercholesterolemia (FH) is a common, autosomal semi-dominant inherited disorder causing premature cardiovascular disease. However, it remains underdiagnosed, especially in community settings. Early diagnosis, particularly in children, is critical for timely intervention. Furthermore, the pathogenicity of genetic variants of uncertain significance poses a major challenge for clinical interpretation.</p><p><strong>Methods: </strong>We conducted a systematic screening program in a town in Wujiang District, Suzhou, China. Eligible individuals (based on LDL-C ≥ 3.8 mmol/L, family history, or voluntary participation) underwent genetic testing for FH-related genes (LDLR, PCSK9, APOB and LDLRAP1) and pharmacogenetic variants (SLCO1B1 and APOE). Cascade screening was offered to relatives of probands with putative pathogenic variants. Identified variants were functionally characterized through in vitro assays, including intracellular expression, PCSK9 secretion, LDLR degradation and LDL uptake assays.</p><p><strong>Results: </strong>Among 27 eligible participants, 13 (48.1%) carried putative pathogenic variants, with the majority (11/13) in LDLR. Cascade screening of eight families identified 13 additional carriers, with no pediatric carriers detected. Functional assays demonstrated that LDLR c.190delT and c.1448G > A resulted in complete loss of function, while c.1879G > A impaired protein maturation and reduced function to approximately 50% of wild-type. Other missense variants exhibited partial loss of function. For PCSK9, the c.658G > A variant was experimentally confirmed as a gain-of-function variant through in vitro studies.</p><p><strong>Conclusions: </strong>This study establishes a comprehensive FH diagnostic model from community screening to functional validation. Our findings confirm a high FH prevalence in this Chinese cohort and underscore the indispensable role of functional assays and pharmacogenetics in enabling precise diagnosis and personalized management.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-traditional metabolic indices predict incident circadian syndrome in middle-aged and older Chinese adults: a nationwide prospective cohort study and machine learning analysis.","authors":"Kangrong Li, Gaoming Zeng, Siyuan Tan, Zixi Zhang, Jiayi Zhu, Zhongjun Ma, Qiuzhen Lin, Zhenjiang Liu, Na Liu, Qiming Liu","doi":"10.1186/s12944-026-02972-9","DOIUrl":"10.1186/s12944-026-02972-9","url":null,"abstract":"<p><strong>Background: </strong>Circadian syndrome (CircS) augments the conventional metabolic syndrome construct by adding disturbed sleep and depressive features. Whether composite metabolic indices that combine insulin-resistance, atherogenic-lipid, and inflammatory signals can forecast CircS prior to its onset has not been systematically investigated. The present work evaluated eight such composite markers in a population-based sample of Chinese adults aged 45 years or older.</p><p><strong>Methods: </strong>Drawing on the China Health and Retirement Longitudinal Study (CHARLS), we followed 4,325 CircS-free adults from 2011 through 2015. Eight baseline metabolic composites were analysed through robust-variance modified Poisson regression, four-knot restricted cubic splines, incremental receiver operating characteristic (ROC) metrics, bidirectional mediation under a quasi-Bayesian framework, multiple sensitivity checks, and a head-to-head benchmarking of 10 machine-learning algorithms complemented by SHapley Additive exPlanations (SHAP) interpretation.</p><p><strong>Results: </strong>Over 4 years, 1,025 incident CircS cases (23.7%) accrued. Every index remained independently linked to CircS once multivariable adjustment was applied. The steepest positive gradient belonged to the triglyceride-glucose body mass index (TyG-BMI; extreme-quartile risk ratio [RR] 4.56, 95% CI 3.35-6.21; per-standard-deviation RR 1.87, 95% CI 1.66-2.10), whilst the estimated glucose disposal rate (eGDR) demonstrated the most pronounced inverse gradient (RR 0.28, 95% CI 0.20-0.38). The largest discrimination gain belonged to the cholesterol-HDL-C-glucose (CHG) index (area under the curve [AUC] 0.737; continuous net reclassification improvement 0.379; DeLong P < 0.001). Reverse-path mediation indicated that the CHG index and the metabolic score for insulin resistance (METS-IR) jointly carried part of the high-sensitivity C-reactive protein (hs-CRP)-CircS signal. On the held-out test set, logistic regression reached the top area under the curve (0.746), and the XGBoost SHAP ranking placed eGDR first among predictors.</p><p><strong>Conclusions: </strong>Eight non-traditional metabolic composites anticipated incident CircS, and within this panel eGDR, TyG-BMI, and the CHG index carried the most consistent predictive information. Incorporating such readily obtainable indices into routine assessment could facilitate earlier CircS risk identification in ageing populations.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-glucose index and anti-Ro52 antibody for identification of cardiovascular disease in patients with primary Sjögren's disease.","authors":"Xuan-Yi Zhou, Yan Zhang, Chun-Xin Lei, Zi-Han Liu, Jia-Qi Chen, Xi-Ya Zhang, Bo-Jie Tang, Yun-Jie Zhao, Zi-Han Wang, Qing-Wen Tao, Jing Luo","doi":"10.1186/s12944-026-02964-9","DOIUrl":"10.1186/s12944-026-02964-9","url":null,"abstract":"<p><strong>Background: </strong>Primary Sjögren's disease (pSjD) confers a markedly elevated risk for developing CVD, an important contributor to mortality in this population. This study was designed to identify factors associated with CVD in pSjD and to develop a classification model.</p><p><strong>Methods: </strong>In this cross-sectional analysis of pSjD individuals (2013-2023), multivariable logistic regression was used to identify CVD-related factors. A classification model was constructed with variable selection via LASSO regression and the Boruta algorithm.</p><p><strong>Results: </strong>Among 734 patients with pSjD, 192 (26.2%) had CVD. Age (odds ratio [OR]: 1.06, P < 0.001), body mass index (BMI; OR: 1.14, P < 0.001), triglyceride-glucose (TyG) index (OR: 3.49, P < 0.001), and positive anti-Ro52 status (OR: 1.58, P = 0.022) were independent correlates of CVD in pSjD. Moreover, age, BMI, and TyG index showed a trend of gradually increasing CVD risk in patients with pSjD (P < 0.05). A five-variable classification model incorporating age, BMI, TyG index, anti-Ro52 antibody, and corrected QT interval was developed to identify CVD status. Good discrimination (area under the curve: 0.768), proper calibration, and clinical applicability were observed for this model. Its performance remained robust upon internal validation and testing in the test set (area under the curve: 0.753 and 0.821).</p><p><strong>Conclusion: </strong>The TyG index and anti-Ro52 antibody serve as significant factors associated with prevalent CVD in patients with pSjD. A novel classification model that integrates these biomarkers with age, BMI, and corrected QT interval showed good performance and generalizability, and may provide a practical tool for identifying cardiovascular status in this population.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of lipoprotein(a) and composite inflammatory indices with functional outcomes in acute ischemic stroke: a prospective cohort study.","authors":"Yi Tang, Yueyu Zhang, Xinyi Chen, Zilong Yue, Yu Wang, Shuaizhou Wang, Xun He, Yuankui Wu, Jie Hu, Zhonghua Sun, Juncang Wu","doi":"10.1186/s12944-026-02975-6","DOIUrl":"10.1186/s12944-026-02975-6","url":null,"abstract":"<p><strong>Background: </strong>Dysregulated lipid metabolism and systemic inflammatory cascades significantly disrupt the neurofunctional trajectory of acute ischemic stroke (AIS). However, the precise pathomechanisms underlying the interactive pathogenic effects of lipoprotein(a) [Lp(a)] and whole-blood composite inflammatory markers in prognostic interventions remain elusive. This study aims to investigate whether Lp(a) and multiple traditional blood inflammation markers jointly influence the early and 90-day functional outcomes in elderly AIS patients.</p><p><strong>Methods: </strong>This prospective cohort study enrolled patients aged ≥ 60 years diagnosed with AIS. Baseline Lp(a) levels and seven systemic inflammatory indices, including the C-reactive protein-to-albumin ratio (CAR), were measured upon admission. The primary endpoint was poor functional outcome, defined as a modified Rankin Scale (mRS) score ≥ 3 at 90 days post-onset. The associations were evaluated using multivariable logistic regression, weighted quantile sum (WQS) regression, and exploratory mediation analyses.</p><p><strong>Results: </strong>Among 732 included patients, 108 (14.8%) experienced a poor functional outcome at 90 days. In fully adjusted models, each 1-standard deviation (SD) increase in Lp(a) was independently associated with a more than twofold higher odds of a 90-day poor outcome (odds ratio [OR], 2.12; 95% CI, 1.70-2.66). Patients in the highest Lp(a) tertile faced significantly increased risk compared with those in the lowest tertile (OR, 2.74; 95% CI, 1.52-5.07). Among the evaluated inflammatory indices, CAR showed the most robust independent association with 90-day poor outcomes (OR per 1-SD increase, 1.59; 95% CI, 1.28-2.13). Notably, patients presenting with both high Lp(a) and high CAR exhibited the greatest risk for an adverse 90-day prognosis (OR, 4.60; 95% CI, 2.29-9.81). Compared with individual inflammatory markers, Lp(a) demonstrated modest prognostic discriminatory ability (AUC, 0.696). Exploratory mediation analysis suggested that CAR mediated only a limited proportion of the association between Lp(a) and 90-day poor outcome, with an indirect effect estimate of 0.008 (95% CI, 0.002-0.026; P = 0.011).</p><p><strong>Conclusions: </strong>Elevated baseline Lp(a) and CAR were independently associated with poor early and 90-day functional outcomes in this cohort of older patients with AIS. Concurrent elevation of Lp(a) and CAR was associated with the highest odds of adverse outcome.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotype-dependent effects of IL-17A inhibitors on lipid profiles in moderate-to-severe plaque psoriasis: a retrospective cohort study.","authors":"Chao Wu, Si-Fan Wang, Dian-Mo Li, Chun-Xia He, Hong-Zhong Jin","doi":"10.1186/s12944-026-02974-7","DOIUrl":"10.1186/s12944-026-02974-7","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is associated with elevated cardiovascular risk, partly mediated through dyslipidemia and the interleukin-23/Th17 inflammatory axis. Interleukin-17A (IL-17A) inhibitors demonstrate superior dermatologic efficacy, but their effects on lipid metabolism remain controversial. Most previous studies analyzed lipid changes at the population level without stratifying by baseline lipid phenotypes. This study aimed to evaluate the phenotype-specific effects of IL-17A inhibitors on lipid profiles and identify risk factors for dyslipidemia in moderate-to-severe plaque psoriasis.</p><p><strong>Methods: </strong>This retrospective cohort study included 353 patients with moderate-to-severe plaque psoriasis (body surface area [BSA] ≥ 3%) treated with IL-17A inhibitors (secukinumab or ixekizumab) for one year. Patients were stratified into five mutually exclusive lipid phenotypes according to the 2023 Chinese guidelines for lipid management. Multivariable logistic regression identified independent risk factors for dyslipidemia. Lipid changes were assessed using paired tests with Benjamini-Hochberg false discovery rate (FDR) correction. Sensitivity analyses were performed in the BSA ≥ 10% subgroup (n = 274).</p><p><strong>Results: </strong>Dyslipidemia was present in 72.2% of patients, with mixed dyslipidemia (26.1%) and hypertriglyceridemia (21.2%) being predominant. BMI ≥ 28 kg/m² (OR = 3.35, 95% CI 1.79-6.28, P < 0.001) and male sex (OR = 2.37, 95% CI 1.40-4.01, P = 0.001) were independent risk factors. Phenotype-specific effects were observed: mixed dyslipidemia patients showed significant reductions in TC (0.47 mmol/L), TG (0.46 mmol/L), and LDL-C (0.18 mmol/L) (all FDR-adjusted P ≤ 0.010); hypercholesterolemia patients demonstrated reductions in TC (0.49 mmol/L) and LDL-C (0.43 mmol/L) (both FDR-adjusted P < 0.001). Among 110 patients with baseline LDL-C ≥ 3.4 mmol/L, 31.0% achieved LDL-C < 3.4 mmol/L. Hypertriglyceridemia patients showed no significant changes after FDR adjustment. Isolated low HDL-C patients exhibited modest increases in HDL-C and LDL-C. Normal lipid patients experienced mild increases in TG and LDL-C within normal ranges. Psoriasis Area and Severity Index (PASI) improvement showed no correlation with lipid changes (all FDR-adjusted P > 0.05). Sensitivity analyses confirmed the robustness of all primary findings.</p><p><strong>Conclusions: </strong>IL-17A inhibitors exert heterogeneous, phenotype-dependent effects on lipid metabolism. Patients with elevated baseline cholesterol may derive dual dermatologic and cardiometabolic benefits, while those with normal lipids require monitoring for modest unfavorable changes. These findings support phenotype-guided treatment selection and individualized lipid monitoring strategies.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the Mediterranean diet and its association with atherogenic indices and lipid profile in individuals seeking a weight-loss dietary program: what role for body fat?","authors":"Francesca Menichetti, Silvia Gallosti, Ramona De Amicis, Federica Sileo, Andrea Foppiani, Giorgia Pozzi, Simona Bertoli, Alberto Battezzati, Alessandro Leone","doi":"10.1186/s12944-026-02960-z","DOIUrl":"10.1186/s12944-026-02960-z","url":null,"abstract":"<p><strong>Background: </strong>The Mediterranean diet is widely recognized for its cardiovascular benefits, but its specific effects on atherogenic indices remain unclear, particularly in individuals seeking a weight-loss dietary program, where excess fat mass may mitigate the diet's protective effects.</p><p><strong>Methods: </strong>To explore this relationship, a cross-sectional study was conducted involving 10,286 participants enrolled in a weight-loss dietary program. Anthropometric and biochemical data were collected, and adherence to the Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener questionnaire. Lipid profiles, including total cholesterol, LDL-C, HDL-C, and triglycerides, were analyzed to calculate the following atherogenic indices: atherogenic index of plasma, Castelli risk indices I and II, lipoprotein combine index, atherogenic coefficient, and atherogenic combined index.</p><p><strong>Results: </strong>Multivariate linear regression models, adjusted for sex, age, body mass index, smoking, physical activity, sociodemographic factors, and use of lipid-lowering medications, showed that each one-point increase in the Mediterranean diet adherence score was significantly associated with reductions in the atherogenic index of plasma (- 0.003, 95%CI: 0.006, - 0.000), the atherogenic coefficient (- 0.013, 95%CI: - 0.024, - 0.001), Castelli risk index I (- 0.013, 95%CI: - 0.024, - 0.001), and the atherogenic combined index (- 0.004, 95%CI: - 0.007, - 0.000), with a marginal association observed for Castelli risk index II (- 0.009, 95%CI: - 0.019, 0.000). Significant associations were also observed for total cholesterol (- 3.453 mg/dl, 95%CI: -5.911, -0.995), LDL (- 3.225 mg/dl, 95%CI: -5.402, -1.048), and HDL-C concentrations (+ 0.255 mg/dl, 95%CI: 0.098, 0.412). However, except for HDL, these associations lost statistical significance after adjusting for body fat percentage. Significant interactions between Mediterranean diet adherence score and body fat percentage were observed for several atherogenic indices, including the atherogenic coefficient, Castelli risk index I, Castelli risk index II, and the atherogenic combined index as well as for total cholesterol and LDL, suggesting that the protective effects of the Mediterranean diet diminish as fat mass increases.</p><p><strong>Conclusions: </strong>Although adherence to the Mediterranean diet is associated with more favorable lipid profiles and atherogenic indices, these benefits are modulated by body composition, particularly fat mass. These findings highlight the importance of integrated dietary strategies that combine nutritional quality with body fat reduction to support cardiovascular prevention.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of ANGPTL3/4/8 proteins and complexes with heart failure and heart failure mortality.","authors":"Günther Silbernagel, Ann-Cathrin Maas, Hongxia Li, Deven Lemen, Yan Q Chen, Eugene Y Zhen, Yi Wen, Marcus E Kleber, Graciela Delgado, Angela P Moissl, Winfried März, Alexander Niessner, Hubert Scharnagl, Robert J Konrad","doi":"10.1186/s12944-026-02973-8","DOIUrl":"10.1186/s12944-026-02973-8","url":null,"abstract":"<p><strong>Background: </strong>Angiopoietin-like 3/4/8 (ANGPTL3/4/8) proteins play critical roles in modulating lipid metabolism through calorically sensitive and tissue-specific regulation of lipoprotein lipase (LPL) activity via formation of ANGPTL3/8 and ANGPTL4/8 complexes. ANGPTL3/4/8 proteins are also associated with cardiovascular risk. Circulating levels of ANGPTL3, ANGPTL4/8, and C-terminal domain-containing ANGPTL4 (CD-ANGPTL4) have been associated with overall cardiovascular mortality. In this study, we investigated the associations of ANGPTL3/4/8 proteins and complexes with heart failure (HF) and HF death.</p><p><strong>Methods: </strong>We studied 2,394 participants of the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study, a cohort of patients referred for coronary angiography. HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) were diagnosed at baseline. There was a follow-up period with a median (interquartile range) duration of 9.80 (8.75-10.40) years. ANGPTL3/4/8 proteins and complexes were measured at baseline using dedicated immunoassays, and their serum concentrations were compared to HF data.</p><p><strong>Results: </strong>There was an inverse association of ANGPTL3/8 with the N-terminal prohormone of B-type natriuretic peptide (NT-proBNP). ANGPTL3 was positively associated with NT-proBNP, HFpEF, and the New York Heart Association (NYHA) functional class. ANGPTL4/8 was positively associated with HFrEF, HFpEF, and NT-proBNP and was inversely associated with the left ventricular ejection fraction (LVEF). CD-ANGPTL4 was positively associated with the NYHA functional class, HFrEF, HFpEF, and NT-proBNP and was inversely associated with LVEF. A total of 101 participants died from HF. ANGPTL3/8 and ANGPTL4/8 were not associated with HF mortality. In contrast, ANGPTL3 and especially CD-ANGPTL4 were positively associated with HF death.</p><p><strong>Conclusions: </strong>We found positive associations of ANGPTL3 and CD-ANGPTL4 with HF and HF mortality. Of particular interest, serum levels of CD-ANGPTL4 demonstrated positive associations with HFrEF, HFpEF, NT-proBNP, and NYHA functional class and an inverse association with LVEF. CD-ANGPTL4 also demonstrated the strongest positive association with HF mortality. The explanation for these associations is not currently apparent. Further investigation will be required to understand more fully the possible biochemical mechanisms that may be responsible for these associations.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of combination therapy with statin and ezetimibe in patients failing to achieve target LDL levels at cardiology outpatient clinics in Turkey (COM-TR-OLDL): a real-world observational study.","authors":"Ayşe Çolak, Zeynep Kumral, Önder Öztürk, Ayşegül Ülgen Kunak, Ali Nizami Elmas, Ömer Bedir, Medeni Karaduman, Naci Babat, Umut Uyan, Nurcemal Şentürk, Sebahat Tekeli Şengül, Sefa Erdi Ömür, Şahbender Koç, Mehmet Ali Işık, Samet Uysal, Cennet Yıldız, Emre Asiltürk, Tuncay Güzel, Fahri Er, Alkım Ateşli Yazıcı, Emrah Yeşil, Fuat Bice, Cansu Öztürk, Murat Gökhan Yerlikaya, Lütfü Aşkın, Melisa Uçar, Murat Çakır, Ömer Uluuysal, Afag Özyıldız, Yusuf Demir Ozan, Tolga Kunak, Selçuk Öztürk, Özkan Karaca, Özkan Kayhan, Khayal Mirzayev, İlke Çelikkale, Emine Buket Kırdağ, Mehdi Zoghi, Asım Oktay Ergene","doi":"10.1186/s12944-026-02950-1","DOIUrl":"10.1186/s12944-026-02950-1","url":null,"abstract":"<p><strong>Background: </strong>Achieving target low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD) frequently requires combination lipid-lowering therapy. Single-pill combination (SPC) regimens may improve adherence compared with free-dose combinations (FDC) in real-world clinical practice.</p><p><strong>Methods: </strong>This retrospective observational study included 450 ASCVD patients with baseline LDL-C levels of 70-189 mg/dL who were followed in cardiology outpatient clinics between January 2023 and December 2024. Patients received atorvastatin-ezetimibe either as a single-pill combination (SPC, n = 392) or as a free-dose combination (FDC, n = 58). Primary endpoints were LDL-C reduction and treatment adherence (≥ 80% of prescribed doses). Secondary endpoints included LDL-C target attainment and adverse events. Non-parametric tests and chi-square/Fisher's exact tests were used for statistical analysis.</p><p><strong>Results: </strong>At 1 month, LDL-C levels were significantly lower in the SPC group compared with the FDC group (90.6 vs. 119 mg/dL; p = 0.005), and adherence was higher (89.8% vs. 70.7%; p < 0.001). At 4 months, LDL-C levels were comparable between groups, while continuous adherence remained significantly higher in the SPC group (86% vs. 69%; p = 0.001). A higher proportion of SPC-treated patients achieved LDL-C < 100 mg/dL at 1 month (81.9% vs. 67.2%; p = 0.009).</p><p><strong>Conclusions: </strong>In this real-world ASCVD cohort, SPC therapy with atorvastatin and ezetimibe was associated with superior adherence and comparable lipid-lowering efficacy despite lower statin doses. Fixed-dose combination strategies may represent an effective approach to optimize adherence and cardiovascular risk management.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between lipid accumulation product and visceral adiposity index and rheumatoid arthritis: NHANES 1999-2018.","authors":"Jinye Xu, Yunsheng Xu, Fuxin Wei","doi":"10.1186/s12944-026-02958-7","DOIUrl":"10.1186/s12944-026-02958-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While the Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) offer improved assessment of visceral fat distribution compared to traditional measures, their connection with rheumatoid arthritis (RA) has not been thoroughly explored. This research aimed to assess the links between LAP, VAI, and RA occurrence using nationally representative datasets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study analyzed information from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999-2018. RA status was determined based on self-reported physician diagnosis. Sex-specific formulas were employed to calculate LAP and VAI. Statistical techniques included weighted multivariable logistic regression with three progressive models, restricted cubic spline (RCS) analysis, piecewise linear regression, and subgroup analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study comprised 15,918 individuals, including 1,988 RA cases and 13,930 non-RA controls. RA patients demonstrated distinct demographic and clinical profiles compared to non-RA participants, exhibiting older age, greater female representation, reduced educational attainment (P = 0.03), and elevated frequencies of smoking, hypertension, and diabetes (all P &lt; 0.001). Both LAP and VAI measurements were markedly elevated in the RA group (P &lt; 0.001). After comprehensive covariate adjustment, LAP maintained a significant association with RA prevalence (OR = 1.002, P &lt; 0.001). Individuals in the highest LAP tertile displayed 41.0% greater RA prevalence (OR = 1.410, P &lt; 0.001), demonstrating a clear dose-response pattern (P for trend &lt; 0.001). RCS analysis identified a significant nonlinear LAP-RA relationship (P for nonlinearity &lt; 0.001), with a threshold effect at LAP = 43.45. Below this value, the association was notably stronger (OR = 1.0028, P &lt; 0.001), whereas above it the relationship plateaued (P = 0.096). In contrast, VAI exhibited no significant association with RA (P for overall = 0.397) or nonlinear pattern (P for nonlinearity = 0.864). Stratified analyses revealed that hypertension status significantly modified the LAP-RA association (P for interaction = 0.040), with hypertensive individuals showing more pronounced effects. Borderline age-related differences were also noted, with stronger associations among younger participants (&lt; 60 years) and in non-Hispanic White and non-Hispanic Black subgroups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This research indicates a potential link between LAP and RA occurrence, possibly highlighting the influence of abdominal fat deposition in RA development. Being an easily obtainable indicator that solely necessitates waist measurement and triglyceride assessment, LAP could function as an efficient preliminary screening method for identifying RA susceptibility in general healthcare environments. Additionally, it might contribute valuable insights for developing preventive approaches targetin","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative stress hyperglycemia ratio exposure and dynamic trajectories reveal prognostic determinants of acute hyperlipidemic pancreatitis: an 5-year cohort study.","authors":"Yiji Chen, Jianhua Wan, Wenqing Shu, Xiaoyu Yang, Huajing Ke, Wenhua He, Yin Zhu, Nonghua Lu, Liang Xia","doi":"10.1186/s12944-026-02970-x","DOIUrl":"10.1186/s12944-026-02970-x","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) and glycemic variability (GV) both reflect acute glycemic fluctuations, with established roles in cardiovascular and stroke diseases. However, their prognostic value in acute hyperlipidemic pancreatitis (HTG-AP) remains underexplored. Traditional assessments based on single measurements fail to capture the dynamic evolution. Therefore, this study aims to evaluate the early predictive value of Cumulative stress hyperglycemia ratio (CumSHR) and trajectory combined with GV in patients with hyperlipidemic pancreatitis.</p><p><strong>Methods: </strong>This study collected data from 959 patients with HTG-AP. SHR and GV were calculated using standardized formulas; CumSHR was derived from the area under the curve (AUC) based on SHR data from the 7 days prior to admission. Multivariable analyses and RCS analysis assessed whether CumSHR predicted severe hyperlipidemic acute pancreatitis (HTG-SAP). Subgroup stratification was performed based on clinically distinct glucose metabolic states, while Latent class growth mixture model (LCGMM) identified dynamic SHR trajectory sub-phenotypes. Kaplan-Meier (K-M) curves compared survival rates across different risk trajectory groups. Finally, machine learning models predicted HTG-SAP risk, and SHapley Additive exPlanations (SHAP) identified key predictors.</p><p><strong>Results: </strong>In the Jiangxi cohort, 162 cases (16.9%) of HTG-AP developed HTG-SAP. RCS analysis demonstrated a U-shaped association between CumSHR and HTG-SAP and persistent organ failure (POF) (P < 0.001). The LCGMM identified three dynamic trajectories: the sustained high-value group (SHG-T3) exhibited the highest risk of HTG-SAP (55.6%, compared with 10.6% in the low-value gradually decreasing group [LDG-T1]). Subsequently, stratified into normal glucose regulation (NGR), pre-diabetes Mellitus (Pre-DM), and diabetes mellitus (DM), high CumSHR + high GV showed increased risk compared to low CumSHR + low LGV (P < 0.05). Among machine learning models predicting HTG-SAP risk, the Naive-Bayes model demonstrated the highest predictive accuracy. SHAP analysis identified CumSHR as one of the most important predictors.</p><p><strong>Conclusions: </strong>This study demonstrates that CumSHR exhibits significant association with early assessment of severe conditions in patients with HTG-AP, with its trajectory effectively capturing dynamic changes to compensate for the limitations of static prediction.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}