Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.8
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pp.5492-5500
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2015
Low-density lipoprotein cholesterol (LDL-C) is a major modifiable risk factor for cardio- cerebrovascular disease. In clinical practice, however, it is primarily calculated using the Friedewald formula as a cost-effective method. The aim of this study was to compare Friedewald-estimated and directly measured LDL-C values and assess the concordance in guideline LDL-C risk classification between the two methods. The data were derived from the 2009 and 2010 Korea National Health and Nutrition Survey (KNHANES). Analysis was done for 4,319 subjects with lipid panels-total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), directly measured LDL-C using an enzymatic homogeneous assay, and triglycerides (TG). For subjects with TG lower than 400 mg/dL, Friedewald-estimated and directly measured LDL-C were highly correlated (r = 0.958, p < 0.001) and overall concordance was 82.7%. As TG increased, overall concordance decreased. Overall concordance was 85.4% at TG lower than 150 mg/dL; 78.2% at TG of 150-199 mg/dL; and 71.4% at TG of 200-399 mg/dL. The Friedewld equation tended to overestimate LDL-C when TG are of < 150 mg/dL; however, underestimate LDL-C when TG are of ${\geq}150mg/dL$. As a result, Friedewald estimation misclassified 382 subjects (9.1%) in a higher category versus 348 subjects (8.3%) in a lower category. Our findings suggest that overestimation of LDL-C by the Friedewald formula can be a great problem as well as underestimation.
Purpose: This study was aimed to determine the optimum low-density lipoprotein : high-density lipoprotein-cholesterol (LDL : HDL-C) ratio for predicting coronary heart disease(CHD) in Korean people. Methods: It was analyzed this data of 5,431 adults who had undergone health examinations in a hospital in Gyeonggi-do between January 2006 and December 2007. The covariation of the coronary risk factors such as age, HbA1C, systolic blood pressure(SBP), and waist-to-stature ratio(WSR) were analyzed by using logistic regression analysis. Results: The LDL : HDL-C ratio in the male and female groups was mostly distributed between 1.5 and 4.0. The LDL : HDL-C ratio was the most significant cholesterol-related parameter influencing CHD (male: B = .306, p = .054, female : B = .940, p = .010), followed by LDL-C and total cholesterol. It was observed a sharp increase in the odds ratios for LDL : HDL-C ratios of 2.25 - 2.50(male) and 2.00 - 2.25(female). A significant difference was observed in both male(2.25 : $x^2$ = 2.494, p = .072) and female(2.00 : $x^2$ = 413.742, p = .000) groups. Conclusion: The risk level of CHD was set to 2.25 for males and 2.00 for females. Therefore, the optimum LDL : HDL-C ratio for Koreans should be far lower than that for the people in western countries.
The purpose of this study was to investigate the correlations among the anthropometry, serum lipid levels and nutrient intake in Korean female university students. The subjects were 119 female students at a university located in Incheon. This study was conducted using a self-administered questionnaire. Anthropometric data were measured and blood lipid levels were analyzed. Nutrient intake collected from 3 day-recalls was analyzed by the Computer Aided Nutritional Analysis Program. The data were analyzed by SPSS 10.0 program. Average age, height and weight of the subjects were 20.9 years, 160.1cm and 54.3kg, respectively. Average serum TG (triglyceride), total cholesterol, HDL-C (high density lipoprotein-cholesterol) and LDL-C (low density lipoprotein-cholesterol) levels of the subjects were 69.47mg/dl, 146.85 mg/dl, 50.49mg/dl and 82.52mg/dl, respectively. Average AI (atherogenic index) of the subjects was 2.03, which was in the normal range based on risk values. Average intake of most nutrients except protein, vitamin B$_1$, vitamin C and phosphorus were lower than the Korean RDA. Especially calcium and iron intakes of the subjects were under 65% of the Korean RDA. Serum TG, total cholesterol and LDL-C levels were negatively correlated with DBP (diastolic blood pressure). HDL-C/LDL-C and HDL-C/total cholesterol were positively correlated with height. Age was positively correlated with phosphorus intake. DBP of the subjects was positively correlated with calcium and iron intakes. Serum TG level was positively correlated with total cholesterol, HDL-C, LDL-C and AI, while negatively correlated with HDL-C/total cholesterol. Total cholesterol level was positively correlated with HDL-C, LDL-C and AI, while negatively correlated with HDL-C/LDL-C, HDL-C/total cholesterol. HDL-C level was positively correlated with LDL-C, HDL-C/LDL-C and HDL-C/total cholesterol, while negatively correlated with AI. LDL-C level was negatively correlated with HDL-C/LDL-C and HDL-C/total cholesterol, while positively correlated with AI HDL-C/LDL-C ratio was positively correlated with HDL-C/total cholesterol and AI. HDL-C/total cholesterol was negatively correlated with AI. Fat intake was positively correlated with total cholesterol, HDL-C level, and vitamin B$_2$ intake was positively correlated with TG, HDL-C/LDL-C. Therefore, nutrition education is necessary for female university students to promote the lipid profile and to optimize the nutritional status. (J Community Nutrition 4(3) : 151∼158, 2002)
Epidemiologic studies have shown that low-density lipoprotein cholesterol (LDL-C) is a strong risk factor, whilst high-density lipoprotein cholesterol (HDL-C) reduces the risk of coronary heart disease (CHD). Therefore, strategies to manage dyslipidemia in an effort to prevent or treat CHD have primarily attempted at decreasing LDL-C and raising HDL-C levels. Cholesteryl ester transfer protein (CETP) mediates the exchange of cholesteryl ester for triglycerides between HDL and VLDL and LDL. We have published the first report indicating that a group of Japanese patients who were lacking CETP had extremely high HDL-C levels, low LDL-C levels and a low incidence of CHD. Animal studies, as well as clinical and epidemiologic evidences, have suggested that inhibition of CETP provides an effective strategy to raise HDL-C and reduce LDL-C levels. Four CETP inhibitors have substantially increased HDL-C levels in dyslipidemic patients. This review will discuss the current status and future prospects of CETP inhibitors in the treatment of CHD. At present anacetrapib by Merck and evacetrapib by Eli Lilly are under development. By 100mg of anacetrapib HDL-C increased by 138%, and LDL-C decreased by 40%. Evacetrapib 500 mg also showed dramatic 132% increase of HDL-C, while LDL-C decreased by 40%. If larger, long-term, randomized, clinical end point trials could corroborate other findings in reducing atherosclerosis, CETP inhibitors could have a significant impact in the management of dyslipidemic CHD patients. Inhibition of CETP synthesis by antisense oligonucleotide or small molecules will produce more similar conditions to human CETP deficiency and may be effective in reducing atherosclerosis and cardiovascular events. We are expecting the final data of prospective clinical trials by CETP inhibitors in 2015.
Small dense LDL(LDL III) is emerging as a major risk factor for coronary artery disease. LDL III generation is associated with high triglyceride concentration, high hepatic lipase activity, and high cholesterol ester transfer protein (CETP) levels. CETP polymorphisms have been reported to be associated with coronary artery disease. In this study, we investigated the relationship between CETP polymorphism and LDL III generation. VLDL1, VLDL2, IDL and LDL subfractions were measured in 87 normal healthy Korean subjects who had been SNP genotyped for Taq1B, I405v and A629C. We found no differences in LDL subfractions and lipoprotein composition between homozygotes for Taq1B2B2, and those for Taq1B1B1 and Taq1B1B2. There were no differences in LDL subfractions and lipoprotein composition between homozygotes for 629AA, and those for 629AC and -629CC. However, homozygotes for 405VV had a significantly lower LDL III concentration and proportion than those for 405II and 405IV. We concluded that, among the Taq1B, I405V and A629C polymorphisms, only the 1405V polymorphism was associated with the concentration and proportion of LDL III.
The ability of Hep-G2 cells to process $[^{125}I]LDL$ under basal conditions was investigated. The receptor-binding and internalization of $[^{125}I]LDL$ increased with the time of incubation in a saturable manner. After 4 h of incubation, 31.4 ng of $[^{125}I]LDL$ was cell bound. The cells rapidly internalized $[^{125}I]LDL$ via specific, receptor-mediated endocytosis. The amount of internalized $[^{125}I]LDL$ reached a maximun of 96.7 ng at 2 h of incubation and remained constant for the next 2 h. The rate of degradation of internalized $[^{125}I]LDL$ proceeded in a linear manner over the entire 4 h of incubation after an initial lag period. The effects of individial fatty acids (C18:0. C18:1, C18:2. and C18:3), differing in their degree of unsaturation. on the receptor-binding, internalization and degradation of $[^{125}I]LDL$ were also investigated. Inclusion of 1.0 mM of each fatty acid into the culture medium significantly increased $[^{125}I]LDL$ metabolism in Hep-G2 cells. Among the fatty acids tested, stearic acid had the least effect on the receptor-binding activity. There were no significant differences among the unsaturated fatty acids in LDL-receptor binding. The effect of individual fatty acids on the $[^{125}I]LDL$ uptake was similar to that of the receptor-binding. showing a significantly lower effect with stearic acid. The amount of degraded material of internalized $[^{125}I]LDL$ was the lowest with stearic acid when it was compared with unsaturated fatty acids.
The purpose of this research was to examine the relationship between the plasma LDL particle size and blood lipid profile, dietary factors and anthropometric values (body mass index, waist circumference and waist/hip ratio). The subjects were 173 adults aged 23 to 81 years, selected from the Outpatient Clinic and Cardiovascular Department of the Seoul Municipal Hospital. Dietary data were obtained using a 3-day food record and analyzed using Korean and US nutrient databases. The subjects were divided into three groups by LDL particle size : type A (large buoyant LDL, > 25.5 nm, n=96), type I (Intermediate LDL,$25.2\leq-\leq25.5$ nm, n=18), and type B (small dense LDL, < 25.2 nm, n=59) groups. The type B group had higher age, waist circumference, and waist/hip ratio (WHR) than the type A and type I groups. Serum concentration of triglyceride, Apo B, LDL/HDL cholesterol ratio and atherogenic index were significantly higher in the type B group as compared to those in the other two groups. HDL cholesterol level and Apo A-I/Apo B ratio were significantly lower in the type B group than the other two groups. The plasma LDL particle size was highly correlated with triglyceride (r= -0.450), Apo B (r= -0.402) and HDL cholesterol (r= 0.418). However, there was no correlation between plasma LDL particle size and dietary intakes. This study showed that small dense LDL was an important biochemical risk factor that was associated with other risk factors.
The relationship between lipoprotein(a) and dyslipidemia is not clear. This study was therefore undertaken to investigate the relationship between lipoprotein(a) and dyslipidemia in elderly patients over 60 years. From 2014 to 2020, a total of 2,580 adults aged 60 years or older (73.31±7.24 years, 1,954 males) were enrolled in the study. The patients had checked into a general hospital, and data were obtained for lipoprotein(a), LDL-C, TG, HDL-C, hs-CRP, HbA1c, sex, age, BMI, dyslipidemia diagnosis, and use of lipid-lowering agents. BMI and HbA1c showed no correlation with lipoprotein(a), but hs-CRP (r=0.138), LDL-C (r=0.097), HDL-C (r=-0.089), TG (r=-0.073), and age (r=0.072) were significantly correlated to lipoprotein(a). The partial correlation between lipoprotein(a) and LDL-C, which was adjusted for variables, was significant only in the male gender (r=0.158, P<0.001). As the odds ratio of the 4th quartile of lipoprotein(a) (OR=1.376, 95% CI=1.038~1.822) for dyslipidemia was found to be significant in this study when the level of LDL-C, the primary target, could not be reduced even by taking lipid-lowering drugs, we propose that lipoprotein(a) should also be included among the several factors considered as secondary targets. Our results indicate that studies on various lipid factors considering the sex, age, types and use of lipid-lowering agents, are warranted.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.4
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pp.285-292
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2017
The purpose of this study was to investigate the relationship between the fasting blood sugar and serum lipid levels (TC, TG, HDL-C, LDL-C) and obesity indices (BMI, body fat rates, waist circumference, waist to hip ratio). The study sample consists of 1,473 manufacturing workers aged from 30 to 59 years, who underwent a health check-up at a university hospital during the period from Jan. to Dec. 2015. A data analysis was conducted to classify the subjects into the normal and abnormal groups according to their fasting blood sugar levels depending on the average values of the serum lipids and obesity indices. Multiple regression analyzes adjusted for sex and age were conducted for the factors affecting the fasting blood sugar level. As a result, the Serum TC, TG, LDL-C, BMI and waist circumference were found to be significantly higher in the abnormal fasting blood sugar level group than in the normal one, but the HDL-C was significantly lower in the abnormal group than in the normal one The fasting blood sugar level had a significant positive correlation with the TC, TG, LDL-C, BMI and waist circumference. The TC, TG, BMI and body fat were the significant factors affecting the fasting blood sugar. The above results suggest that the fasting blood sugar and serum lipid levels (TC, TG, HDL-C, LDL-C), obesity indices (BMI, body fat rates, waist circumference, waist to hip ratio) of manufacturing workers are significantly associated with each other.
This study was undertaken to produce a $F_{ab}$ fragment of a human monoclonal antibody reactive to oxidized and carbamylated low-density lipoprotein (oxLDL and cLDL) using phage display technology. An analysis of DNA sequences of this $F_{ab}$, termed plaque 15,16-46 $F_{ab}$, revealed that the rearranged $V_H$ was highly mutated. Complementarity-determining regions of the $V_H$ showed a very high R/S ratio and contained many positively charged amino acids. In direct binding and competitive ELISA, the $F_{ab}$ reacted strongly with both MDA-LDL and Cu-oxLDL forms of oxLDL, and also showed high affinity for cLDL. Immunofluorescence and immunohistochemical analyses showed that this $F_{ab}$ positively stained atherosclerotic aortic plaques in $ApoE^{-/-}$ mice as well as those in patients with atherosclerosis. The $F_{ab}$ also showed positive staining in placental decidua from patients with preeclampsia. It is suggested that the plaque 15,16-46 $F_{ab}$ against oxLDL and cLDL might possibly be applicable for developing a diagnostic reagent for both human and rodent animal research to detect and characterize atherosclerotic disease progression in atherosclerotic lesions as well as exploring the pathogenesis of atherogenic diseases such as preeclampsia.
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