• Title, Summary, Keyword: Direct LDL cholesterol

### Validity for Use of Non-HDL Cholesterol Rather than LDL Cholesterol

• Kwon, Se-Young;Na, Young-Ak
• Korean Journal of Clinical Laboratory Science
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• v.45 no.2
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• pp.54-59
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• 2013
• NonHDL cholesterol values have been suggested as a risk marker for cardiovascular disease. NonHDL cholesterol values were calculated, using a very simple measurement [nonHDL cholesterol=serum total cholesterol-HDL cholesterol]. This formula is very useful as a screening tool for identifying dyslipoproteinemias, risk assessment, and assessing the results of hypolipidemic therapy. The data from the 2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,992 subjects with lipid panels (Cholesterol, HDL, LDLdirect and Triglycerides) results. We studied the relationship between nonHDL cholesterol and LDL cholesterol. As a result, nonHDL cholesterol values were plotted against the LDL direct and calculated values. The linear regression equation for nonHDL cholesterol and direct LDL cholesterol was $nonHDLchol=23.60+1.03{\times}LDLdirect$ (p<0.0001, $r^2=0.80$) in all subjects. The subjects were classified into triglyceride values. When triglycerides are below 400 mg/dL, the linear fit to LDL direct is found to be $[nonHDLchol=17.34+1.07{\times}LDLdirect]$ (p<0.0001, $r^2=0.88$) and to the Friedewald LDL calculation is $[nonHDLchol=23.10+1.02{\times}LDLcalc]$ (p<0.0001, $r^2=0.82$). For triglycerides above 400 mg/dL, the linear fit equation is $[nonHDLchol=87.57+0.92{\times}LDLdirect]$ (p<0.0001, $r^2=0.50$) and to the LDL calculated, it is $[nonHDLchol=142.70+0.50{\times}LDLcalc]$ (p<0.0001, $r^2=0.32$). This study provides examples of the utility of nonHDL cholesterol concentrations in clinical medicine.

### Comparison of LDL-Cholesterol direct measurement with the estimate using various formula

• Kwon, Se Young;Na, Young-Ak
• Korean Journal of Clinical Laboratory Science
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• v.44 no.3
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• pp.103-111
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• 2012
• Low-Density Lipoprotein cholesterol (LDLC) is the most important marker for the treatment of hyperlipidemia in NCEP-ATP III(National Cholesterol Education Program-Adult Treatment Panel III) guideline. Therefore, LDL cholesterol is pathologically meaningful, accurate measurement should be a top priority. Currently, LDLC is directly measured in most cases, but, the estimate is still used in mass health examination or screening test. This study is about the comparison of LDL-Cholesterol direct measurement with the estimate using various formula (Friedewald: [LDL-F=TC-HDL-TG/5], Nakajima: [LDL-N=TC-HDL-TG/4], Hattori: [LDL-H =0.94TC-0.94HDL-0.19TG], Puavilai: [LDL-P=TC-HDL-TG/6], Carvalho: [LDL-C=3(TC-HDL)/4]) for calculating more accurate value. We analyzed total cholesterol (TC), try-glyceride (TG), high-density lipoprotein cholesterol (HDLC), and LDLC levels of 210 subjects between June and November in 2011. Until now, the Friedewald formula is the most commonly used estimate for the LDLC. When Friedewald formula was applied, the correlation coefficient (r) was 0.940, showing high correlation. But, the result of the direct method was significantly different, compared with those of the Friedewald formula in triglyceride levels ${\geq}400mg/dL$(p<0.05). There was the highest correlation when we used LDL-P formula(r=0.947) in triglyceride levels <400 mg/dl. Also there was the lowest mean difference regardless of triglyceride level. Therefore, the study showed that TG/6 is more precise means of calculation than TG/5. On the other hand, the calculation of LDL-Cholesterol was underestimated, compared with direct measurement. It is necessary to have more data and modified Friedewald formula should be used for the accurate calculation.

### Dietary Fatty Acids and Blood Cholesterol

• Hayes, K.C.;Khosla, Pramod;Pronczuk, Andrzej;Lindsey, Saralyn
• Journal of Nutrition and Health
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• v.24 no.4
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• pp.378-392
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• 1991
• A series of studies in monkeys and hamsters, and reevaluation of published human data, indicate that dietary saturated fatty acids exert a dissimilar metabolic impact on cholesterol metabolism. Myristic acid(14 : 0) appears to have a major cholesterol-raising effect by means of decreasing LDL receptor activity and by increasing the direct production of LDL (from sources other than VLDL-catabolism) Palmitic acid (16 : 0) appears neutral in most cases (plasma cholesterol<200mg/dl) or until the LDL receptor is down-regulated, as with high cholesterol intake or obesity. In such cases. the down-regulated LDL receptors coupled with an increased VLDL production (induced by 16 : 0 and 18 : 1) can divert VLDL remnants to LDL and expand the LDL pool. Furthermore. the cholesterolemic impact of any saturated fatty acid can be countered up to a saturable 'threshold' level by dietary linoleic acid (18 : 2) which up-regulates the LDL receptor. Once above this 'threshold' the major fatty acids (16 : 0, 18 : 0, 18 : 1, 18 : 2, 18 : 3) appear to exert an equal impact on the circulating cholesterol concentration.

### Analysis of Correlations among Bone Mineral Density, Serum Lipid Levels, and Cognitive Function in the Elderly with Dementia (치매노인에서 골밀도 및 혈중 지질농도와 인지기능과의 상관관계 분석)

• Kim, Soo-Han;Kim, Ji-Sung
• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.149-155
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• 2012
• Purpose : The purpose of this study was to analyze the correlations among bone mineral density(BMD), serum lipid levels, and cognitive function in the elderly with dementia. Methods : We recruited seventy elderly with dementia(men=35, women=35) to participate in the Korean mini mental state examination(K-MMSE). Their T-scores and serum lipid levels were analyzed for correlation analysis. Results : The results of this study showed that there are significant correlations between cognitive function and three factors BMD, low-density lipoprotein cholesterol(LDL-C) level, and total cholesterol(TC) level. The cognitive function scores increased proportionally with BMD but were inversely proportional to LDL-C and TC levels. There were no significant relations among cognitive function, high-density lipoprotein cholesterol(HDL-C) level, and triglyceride(TG) level. Conclusion : These results indicate that there is a direct proportionality between cognitive function and BMD and inverse proportionalities between cognitive function and LDL-C level and between cognitive function and TC level. Therefore, these levels can be indices for preventing and predicting dementia.

### Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials

• Kwak, Jin Sook;Kim, Ji Yeon;Paek, Ju Eun;Lee, You Jin;Kim, Haeng-Ran;Park, Dong-Sik;Kwon, Oran
• Nutrition Research and Practice
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• v.8 no.6
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• pp.644-654
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• 2014
• BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.

### Antihyperlipidemic Effect of Dietary Lentinus edodes on Plasma, Feces and Hepatic Tissues in Hypercholesterolemic Rats

• Yoon, Ki-Nam;Alam, Nuhu;Lee, Jae-Seong;Cho, Hae-Jin;Kim, Hye-Young;Shim, Mi-Ja;Lee, Min-Woong;Lee, Tae-Soo
• Mycobiology
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• v.39 no.2
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• pp.96-102
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• 2011
• We investigated diet supplementation with shiitake mushroom fruiting bodies on biochemical and histological changes in hypercholesterolemic rats. Six-wk old female Sprague-Dawley albino rats were divided into three groups of 10 rats each. A diet containing 5% Lentinus edodes fruiting bodies given to hypercholesterolemic rats reduced plasma total cholesterol, triglyceride, low-density lipoprotein (LDL), total lipid, phospholipids, and the LDL/high-density lipoprotein ratio by 34.33, 53.21, 75.00, 34.66, 25.73, and 71.43%, respectively. Feeding mushroom also significantly reduced body weight in hypercholesterolemic rats. However, it had no detrimental effects on plasma albumin, total bilirubin, direct bilirubin, creatinine, blood urea nitrogen, uric acid, glucose, total protein, calcium, sodium, potassium, chloride, inorganic phosphate, magnesium, or enzyme profiles. Feeding mushroom increased total lipid and cholesterol excretion in feces. The plasma lipoprotein fraction, separated by agarose gel electrophoresis, indicated that L. edodes significantly reduced plasma ${\beta}$ and pre-${\beta}$-lipoprotein but increased ${\alpha}$-lipoprotein. A histological study of hepatic cells by conventional hematoxylin-eosin and oil red-O staining showed normal findings for mushroom-fed hypercholesterolemic rats. These results suggest that shiitake mushrooms could be recommended as a natural cholesterol lowering substance in the diet.

### Hypolipidemic Activities of Dietary Pleurotus ostreatus in Hypercholesterolemic Rats

• Alam, Nuhu;Yoon, Ki-Nam;Lee, Tae-Soo;Lee, U-Youn
• Mycobiology
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• v.39 no.1
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• pp.45-51
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• 2011
• This work was conducted to investigate dietary supplementation of oyster mushroom fruiting bodies on biochemical and histological changes in hyper and normocholesterolemic rats. Six-week old female Sprague-Dawley albino rats were divided into three groups of 10 rats each. Feeding a diet containing a 5% powder of Pleurotus ostreatus fruiting bodies to hypercholesterolemic rats reduced plasma total cholesterol, triglyceride, low-density lipoprotein (LDL), total lipid, phospholipids, and LDL/high-density lipoprotein ratio by 30.18, 52.75, 59.62, 34.15, 23.89, and 50%, respectively. Feeding oyster mushrooms also significantly reduced body weight in hypercholesterolemic rats. However, it had no adverse effects on plasma albumin, total bilirubin, direct bilirubin, creatinin, blood urea nitrogen, uric acid, glucose, total protein, calcium, sodium, potassium, chloride, inorganic phosphate, magnesium, or enzyme profiles. Feeding mushroom increased total lipid and cholesterol excretion in feces. The plasma lipoprotein fraction, separated by agarose gel electrophoresis, indicated that P. ostreatus significantly reduced plasma ${\beta}$ and pre-${\beta}$-lipoprotein but increased ${\alpha}$-lipoprotein. A histological study of hepatic cells by conventional hematoxylin-eosin and oil red O staining revealed normal findings for mushroom-fed hypercholesterolemic rats. These results suggest that a 5% P. ostreatus diet supplement provided health benefits by acting on the atherogenic lipid profile in hypercholesterolemic rats.

### Economic Evaluation of Rosuvastatin and Atorvastatin for the Treatment of Dyslipidemia from a Korean Health System Perspective (이상지질혈증 환자에게 사용되는 Rosuvastain과 Atorvastatin의 경제성 평가)

• Suh, Sunghwan;Jung, Chang Hee;Hong, Soon-Jun;Kim, Jung-Sun;Song, Byung Ju;Sohn, Hyun Soon;Choi, Sung Hee
• Journal of Lipid and Atherosclerosis
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• v.5 no.1
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• pp.61-77
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• 2016
• Objective: This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system. Methods: The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated. Results: The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market. Conclusion: For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.

### The effect of walnut (Juglans regia L.) intake on improvement of blood lipid levels and vascular health: A meta-analysis (호두의 혈중 지질 수준 및 혈관 건강 개선 기능성 평가: 메타분석)

• Kwak, Jin Sook;Park, Min Young;Kwon, Oran
• Journal of Nutrition and Health
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• v.47 no.4
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• pp.236-246
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• 2014
• Purpose: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). Results: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.

### The Case-Control Study on the Risk Factors of Stroke in Korean Adults -Past Medical History, Life-Style Factors, Serum Lipid Level, Anthropometric Indices- (뇌졸중의 위험요인에 대한 환자-대조군연구 -과거병력, 생활습관, 혈청지질 및 비만요인을 중심으로-)

• Ko, Soeng-Gyu;Jung, Yong-Soo;Park, Kyoung-Hoon;Bu, Song-Ah
• The Journal of Internal Korean Medicine
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• v.22 no.3
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• pp.423-430
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• 2001
• Objects: The purpose of this case-control study was done to examine the relationship between stroke prevalence and the anthropometric indices(body mass index(BMI), modified Broca's method(Broca's index), waist circumference(WC), waist-hip ratio(WHR)), dyslipidemia, past medical history(heart disease, hypertension, diabetes mellitus(DM)), life-style factors(smoking, drinking) in Korean adults. Methods : The study group consisted of neurologically confirmed 116 stroke patients as the case group and 116 non-stroke patients as control group. Obesity were defined as $BMI{\geq}25kg/m^2,\;Broca's\;index{\geq}30%$, WC >94cm in male and WC >80cm in female, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Oyslipidemia were defined as total $cholesterol{\geq}200mg/dl,\;triglyceride{\geq}200mg/dl,\;HDL-cholesterol {\leq}35mg/dl,\;LDL-cholesterol{\geq}160mg/dl$. Information on life-style factors and past medical history was obtained from personal interview. The analysis of the data was done by means of chi-square test(Pearson's chi-square test, Fisher's exact test) and student t-test. Results: The results were as follow. In the study group: Hypertension had a 4:05 odds ratio, Broca's $index{\geq}30%$ had a 1.98 odds ratio, WC >94cm in male had a 2.17 odds ratio, WC >80cm in female had a 2.80 odds ratio, $WHR{\geq}0.9$ in male had a 4.66 odds ratio, $WHR{\geq}0.8$ in female had a 5.35 odds ratio, but heart disease, DM, life-style factors, serum lipid and 8MI had no direct relationship with odds ratio(nonsignificant). By student t-test, risk factors for stroke were found to be total cholesterol(p=0,025), LDL-cholesterol(p=0.013), WC(p=0.000) and WHR(p=0.000). Conclusions: This study suggests that people should be advised to control hyperlitension, hyperlipidemia and obesity since these carry a risk of stroke.