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Keywords = TG/HDL-C ratio

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15 pages, 643 KB  
Article
Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers
by Pere Riutord-Sbert, Pedro Juan Tárraga López, Ángel Arturo López-González, Irene Coll Campayo, Carla Busquets-Cortés and José Ignacio Ramírez Manent
J. Clin. Med. 2025, 14(19), 7039; https://doi.org/10.3390/jcm14197039 - 5 Oct 2025
Abstract
Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular [...] Read more.
Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95% CI 3.70–4.75) and AD (OR 2.95, 95% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. Full article
(This article belongs to the Section Cardiovascular Medicine)
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16 pages, 1872 KB  
Article
Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers
by María Dolores Marzoa Jansana, Pedro Juan Tárraga López, Juan José Guarro Miquel, Ángel Arturo López-González, Pere Riutord Sbert, Carla Busquets-Cortés and José Ignacio Ramírez-Manent
J. Clin. Med. 2025, 14(19), 6876; https://doi.org/10.3390/jcm14196876 - 28 Sep 2025
Abstract
Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This [...] Read more.
Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p < 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p < 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions. Full article
(This article belongs to the Section Cardiovascular Medicine)
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13 pages, 2135 KB  
Article
Thymoquinone Versus Metformin in Letrozole-Induced PCOS: Comparative Insights into Metabolic, Hormonal, and Ovarian Outcomes
by Onder Ercan, Recep Dokuyucu, Ergun Yuksel and Tumay Ozgur
J. Clin. Med. 2025, 14(18), 6561; https://doi.org/10.3390/jcm14186561 - 18 Sep 2025
Viewed by 221
Abstract
Objectives: This study aimed to evaluate the effects of thymoquinone (TMQ) on metabolic, hormonal, and ovarian dysfunctions in a letrozole-induced polycystic ovary syndrome (PCOS) rat model and compare its efficacy with metformin, which is widely recognized as the first-line pharmacological treatment for [...] Read more.
Objectives: This study aimed to evaluate the effects of thymoquinone (TMQ) on metabolic, hormonal, and ovarian dysfunctions in a letrozole-induced polycystic ovary syndrome (PCOS) rat model and compare its efficacy with metformin, which is widely recognized as the first-line pharmacological treatment for PCOS. Methods: Thirty-two female Wistar Albino rats were randomly assigned into four groups: control (I), PCOS (II), PCOS + metformin (III), and PCOS + Thymoquinone (IV). PCOS was induced using 1 mg/kg/day letrozole for 21 days, followed by treatment with either metformin (500 mg/kg/day) or thymoquinone (50 mg/kg/day) for 30 days. Metabolic (glucose, insulin, HOMA-IR, lipid profile), hormonal (estrone, estradiol, testosterone, androstenedione), and histopathological parameters were assessed. Results: PCOS induction resulted in significant metabolic, hormonal, and ovarian dysfunctions. Final body weight was significantly higher in PCOS (309.0 ± 7.5 g) vs. control (275.3 ± 8.2 g, p < 0.001), but reduced by metformin (294.0 ± 7.4 g, p < 0.01) and thymoquinone (305.7 ± 7.5 g, p < 0.01). Glucose levels were significantly elevated in PCOS (341.8 ± 16.8 mg/dL) vs. control (260.0 ± 15.8 mg/dL, p < 0.01), while metformin (290.2 ± 19.7 mg/dL, p < 0.05) and thymoquinone (320.3 ± 13.7 mg/dL, p < 0.05) reduced glucose levels. Insulin and HOMA-IR were significantly increased in PCOS (p < 0.001), but reduced by both treatments (p < 0.01). Lipid profile improvements were observed, with significant reductions in TG and LDL-C and increases in HDL-C in both treatment groups (p < 0.05–0.01). PCOS induced hyperandrogenism, with increased testosterone and androstenedione (p < 0.05), and a decreased E2/E1 ratio (p < 0.001), which were significantly improved by metformin and thymoquinone (p < 0.01). Ovarian histopathology showed increased cystic and atretic follicles and reduced corpus luteum in PCOS (p < 0.05–0.01), which were significantly improved by both treatments. Conclusions: TMQ exerts metabolic, hormonal, and ovarian protective effects comparable to metformin, supporting its potential as a natural therapeutic alternative for PCOS management. Given that metformin is already established as a first-line pharmacological therapy, our findings suggest that TMQ may provide a promising complementary or alternative approach. Further clinical studies are warranted to evaluate its safety and efficacy in human PCOS patients. Full article
(This article belongs to the Special Issue New Challenges and Perspectives in Polycystic Ovary Syndrome)
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14 pages, 1611 KB  
Article
Distinct Metabolomic and Lipoprotein Signatures in Gall Bladder Cancer Patients of Black African Ancestry
by John Devar, Nnenna Elebo, Ashna Makan, Ariel Pincus, Nicola Lahoud, Stefano Cacciatore, Geoffrey Candy, Martin Smith and Ekene Emmanuel Nweke
Cancers 2025, 17(17), 2925; https://doi.org/10.3390/cancers17172925 - 6 Sep 2025
Viewed by 657
Abstract
Background: Gall bladder cancer (GBC) is the most common biliary tract malignancy and is often diagnosed at advanced stages, partly due to the absence of reliable biomarkers and limited understanding of its biology in African populations. This study aimed to characterize the metabolomic [...] Read more.
Background: Gall bladder cancer (GBC) is the most common biliary tract malignancy and is often diagnosed at advanced stages, partly due to the absence of reliable biomarkers and limited understanding of its biology in African populations. This study aimed to characterize the metabolomic and lipoprotein profiles of GBC patients of Black African ancestry. Methods: NMR spectroscopy was used to profile the serum samples. Group comparisons used Wilcoxon tests, correlations used Spearman’s rank test, unsupervised analysis was carried out using the KODAMA algorithm, partial least squares modeling estimated free cholesterol (FC) to cholesterol ester (CE) ratios, while multivariate logistic regression evaluated independent predictors. Results: GBC patients showed altered ethanol levels and dysregulated lipoproteins, including increased IDL-C, IDL-TG, and LDL-TG, and decreased HDL-C, HDL-P, and medium HDL-P. Total and conjugated bilirubin strongly correlated with lipoproteins. Unsupervised analysis revealed a GBC subgroup with abnormal lipoprotein profiles and elevated FC/CE ratios, suggesting cholestasis-related LpX formation. Elevated asparagine, reduced ethanol, and an inflammatory metabolic signature characterized the GBC fingerprint. Ethanol and bilirubin emerged as independent predictors of GBC. Conclusions: GBC patients exhibit distinct metabolomic and lipoprotein alterations that may underlie disease progression and serve as potential biomarkers. These findings enhance understanding of GBC pathophysiology in African populations and may inform future diagnostic strategies. Full article
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14 pages, 935 KB  
Article
TG/HDL-C Ratio as a Superior Diagnostic Biomarker for Coronary Plaque Burden in First-Time Acute Coronary Syndrome
by Fatih Aydin, Bektaş Murat, Selda Murat and Hazal Dağhan
Diagnostics 2025, 15(17), 2222; https://doi.org/10.3390/diagnostics15172222 - 2 Sep 2025
Viewed by 618
Abstract
Background: Present ACS risk stratification predominantly depends on LDL-C, yet its diagnostic accuracy for coronary plaque burden remains limited. We examined whether extensive lipid profiling, specifically the TG/HDL-C ratio, could function as a more effective diagnostic instrument for forecasting significant plaque burden [...] Read more.
Background: Present ACS risk stratification predominantly depends on LDL-C, yet its diagnostic accuracy for coronary plaque burden remains limited. We examined whether extensive lipid profiling, specifically the TG/HDL-C ratio, could function as a more effective diagnostic instrument for forecasting significant plaque burden in treatment-naïve first-time ACS patients. Methods: Among 722 ACS patients screened, 376 treatment-naïve patients undergoing PCI with complete lipid data were included. Exclusions (n = 346) were due to prior CAD, lipid-lowering therapy, renal/hepatic dysfunction, malignancy, pregnancy, or incomplete data. Coronary plaque burden was quantified by QCA, and patients were stratified by lesion count (0, 1, 2, 3, ≥4). The levels of lipids (LDL-C, HDL-C, TC, TG) and their ratios (LDL/HDL-C, TC/HDL-C, TG/HDL-C) were measured. Analyses included ANOVA (with Bonferroni correction), correlation, ordinal regression, and logistic regression (≥3 vs. <3 lesions). ROC analysis determined thresholds. Results: TG/HDL-C ratio increased progressively from 3.3 (0 lesions) to 5.3 (≥4 lesions). After Bonferroni correction, only TG/HDL-C retained significance (p = 0.009). Logistic regression confirmed TG/HDL-C as an independent predictor of high plaque burden (OR 1.25, 95% CI 1.09–1.42, p = 0.004), outperforming LDL-C. Conclusions: TG/HDL-C ratio is a superior diagnostic biomarker compared to LDL-C for identifying extensive coronary plaque burden. Integration into admission lipid profiling offers a cost-effective, actionable tool. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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23 pages, 1769 KB  
Article
From Systemic Inflammation to Vascular Remodeling: Investigating Carotid IMT in COVID-19 Survivors
by Emilia Bielecka, Piotr Sielatycki, Paulina Pietraszko, Sara Anna Frankowska and Edyta Zbroch
Viruses 2025, 17(9), 1196; https://doi.org/10.3390/v17091196 - 30 Aug 2025
Viewed by 1156
Abstract
Background: Atherosclerosis is a chronic inflammatory condition that underlies both cardiovascular and cerebrovascular complications. Emerging evidence suggests that COVID-19 may play a role in its progression. Purpose: The aim of the study was to evaluate the potential impact of SARS-CoV-2 infection on the [...] Read more.
Background: Atherosclerosis is a chronic inflammatory condition that underlies both cardiovascular and cerebrovascular complications. Emerging evidence suggests that COVID-19 may play a role in its progression. Purpose: The aim of the study was to evaluate the potential impact of SARS-CoV-2 infection on the development of atherosclerosis. Patients and Methods: Common carotid artery (CCA) intima media thickness (IMT) was measured by ultrasonography twice, 12–18 months apart, in a cohort of 92 patients (47 with COVID-19 and 45 controls). Clinical data were collected from medical histories, physical examinations, and laboratory findings. Results: Baseline IMT values were comparable between the study groups (0.85 mm vs. 0.78 mm). However, the COVID-19 group exhibited a significantly greater increase in IMT over time, with a median change of 0.13 mm compared to 0.05 mm in the controls (p = 0.018). Furthermore, 69.2% of COVID-19 patients exceeded the median IMT progression threshold compared to 36% in the control group (p = 0.017). An elevated level of C-reactive protein (CRP) and a higher triglyceride (Tg)-to-High-Density Lipoprotein Cholesterol (HDL) ratio were significantly associated with increased IMT in the COVID-19 group. Age and heart rate were identified as significant predictors of IMT progression across both groups. Conclusions: COVID-19 may accelerate the progression of subclinical atherosclerosis. The strong associations of CRP and the TG/HDL ratio with IMT highlight the potential roles of chronic inflammation and metabolic dysregulation in driving these vascular changes. Further large-scale, multicenter studies are needed to elucidate the underlying mechanisms, confirm these observations, and guide targeted preventive and therapeutic strategies for individuals with an increased cardiovascular and cerebrovascular risk. Full article
(This article belongs to the Special Issue COVID-19 Complications and Co-infections)
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15 pages, 838 KB  
Article
Predictive Utility and Metabolomic Signatures of TG/HDL-C Ratio for Metabolic Syndrome Without Cardiovascular Disease and/or Diabetes in Qatari Adults
by Noora Kano, Najeha Anwardeen, Khaled Naja, Asma A. Elashi, Ahmed Malki and Mohamed A. Elrayess
Metabolites 2025, 15(9), 574; https://doi.org/10.3390/metabo15090574 - 28 Aug 2025
Viewed by 751
Abstract
Background: Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), especially in Middle Eastern populations with a high metabolic burden. This study aimed to evaluate the predictive utility of different lipid ratios, including triglyceride-to-high-density [...] Read more.
Background: Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), especially in Middle Eastern populations with a high metabolic burden. This study aimed to evaluate the predictive utility of different lipid ratios, including triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C), total cholesterol (TC)/HDL-C, low-density lipoprotein (LDL-C)/HDL-C, and non-HDL-C/HDL-C, for identifying MetS. In addition, we aimed to characterise the underlying metabolic dysregulation using the most predictive lipid ratio by comparing metabolomic profiles between high-risk (T3) and low-risk (T1) groups. Method: We conducted a cross-sectional study using data from 2179 Qatari adults without CVD and/or T2DM. The predictive value of each lipid ratio for MetS was compared. Untargeted metabolomics was performed to profile metabolic changes between T3 and T1. Results: After adjustment for age, sex, and BMI, TG/HDL-C showed the highest discriminative ability for MetS (AUC = 0.896, 95% CI: 0.88–0.91; OR = 4.36, 95% CI: 3.63–5.28, p < 0.0001). In pairwise AUC comparisons, TG/HDL-C outperformed LDL-C/HDL-C (p = 2.6 × 10−4, after correction for multiple comparisons), with no significant differences versus other ratios. The high-risk group exhibited raised levels of phosphatidylethanolamines, phosphatidylinositols, and diacylglycerols, and lower levels of sphingomyelins and plasmalogens. These lipid classes have been suggested to be implicated in insulin resistance and metabolic dysfunction. Elevated monoacylglycerols were identified in high-TG/HDL-C groups, representing a previously underreported pattern. Conclusions: The TG/HDL-C ratio showed a better association with MetS compared with other lipid ratios and was linked to distinct metabolomic signatures. These findings suggest potential value for early risk evaluation, but longitudinal and mechanistic studies are needed to confirm clinical applicability. Full article
(This article belongs to the Special Issue Current Research in Metabolic Syndrome and Cardiometabolic Disorders)
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33 pages, 7216 KB  
Systematic Review
Blood Lipid Levels in Response to Almond Consumption: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Kathy Musa-Veloso, Caroline Gauntlett, Katrina Geronimo, Isabella Vicente and Samuel Pak Lam Ho
Nutrients 2025, 17(17), 2791; https://doi.org/10.3390/nu17172791 - 28 Aug 2025
Viewed by 2372
Abstract
Background/Objectives: While the benefits of almond consumption in reducing levels of TC and LDL-C are well established, the effects on additional lipids that have emerged as important predictors of cardiovascular disease, such as ApoB and the ratio of ApoB:ApoA, are not well characterized. [...] Read more.
Background/Objectives: While the benefits of almond consumption in reducing levels of TC and LDL-C are well established, the effects on additional lipids that have emerged as important predictors of cardiovascular disease, such as ApoB and the ratio of ApoB:ApoA, are not well characterized. In this systematic review and meta-analysis, the effects of almond consumption on blood lipids were comprehensively assessed. Methods: On 12 May 2025, ProQuest Dialog™ was used to search ten literature databases (AdisInsight: Trials; Allied & Complementary Medicine™; BIOSIS Previews®; CAB ABSTRACTS; Embase®; Embase Preprints; Foodline®: SCIENCE; FSTA®; MEDLINE®; National Technical Information Service). Randomized controlled trials at least 4 weeks in duration were included if the investigational product was almonds; the control was void of nuts/tree nuts; the subjects were adults without CVD; and blood lipid levels were assessed. Health Canada’s Quality Appraisal Tool for Intervention Studies was used to assess each study’s risk of bias. The mean difference in the effect for each parameter was pooled across studies in a random effects model, using the inverse of the variance as the weighting factor. Results: 36 publications (48 almond–control datasets) representing 2485 participants were included. Almond consumption significantly reduced LDL-C (−0.132 mmol/L; 95% CI: −0.190, −0.075 mmol/L; p < 0.001), TC (−0.160 mmol/L; 95% CI: −0.218, −0.101 mmol/L; p < 0.001), non-HDL-C (−0.204 mmol/L; 95% CI: −0.281, −0.127 mmol/L; p < 0.001), TC:HDL-C (−0.154; 95% CI: −0.246, −0.063; p = 0.001), LDL-C:HDL-C (−0.112; 95% CI: −0.199, −0.026; p = 0.011), ApoB (−4.552 mg/dL; 95% CI: −6.460, −2.645 mg/dL; p < 0.001), and ApoB:ApoA (−0.027; 95% CI: −0.046, −0.008; p = 0.006), with a borderline significant reduction in TG (−0.037 mmol/L; 95% CI: −0.079, 0.005; p = 0.085) and no effects on HDL-C, ApoA, or Lp[a]. The effects persisted when the analyses were limited to higher quality studies, except for the reduction in TG. Conclusions: Almond consumption improves levels of LDL-C, TC, non-HDL-C, TC:HDL-C, LDL-C:HDL-C, ApoB, and ApoB:ApoA, though dedicated clinical trials are needed to better understand effects on TG levels. Full article
(This article belongs to the Special Issue Nuts for Human: The Role of Nuts in a Healthy Diet)
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19 pages, 2301 KB  
Article
Lactase Persistence-Associated rs4988235 Polymorphism: A Novel Genetic Link to Cardiovascular Risk via Modulation of ApoB100 and ApoAI
by Nihad Kharrat Helu, Habib Al Ashkar, Nora Kovacs, Roza Adany and Peter Piko
Nutrients 2025, 17(17), 2741; https://doi.org/10.3390/nu17172741 - 24 Aug 2025
Viewed by 1430
Abstract
Background/Objectives: As part of the human adaptation to dairy consumption, the presence of the rs4988235-T variant in the MCM6 gene primarily determines lactase persistence in adult European populations, increasing the expression of the lactase-encoding LCT gene. Carriers of the C/C variant are [...] Read more.
Background/Objectives: As part of the human adaptation to dairy consumption, the presence of the rs4988235-T variant in the MCM6 gene primarily determines lactase persistence in adult European populations, increasing the expression of the lactase-encoding LCT gene. Carriers of the C/C variant are lactose intolerant, while carriers of the T/T or T/C variant have persistent lactase enzyme activity and are able to digest lactose in adulthood. While the association between lactose intolerance and increased cardiovascular risk (CVR) is well-known, the underlying causes have only been partly explored. The present study aimed to investigate the association of rs4988235 polymorphism with significant lipids affecting cardiovascular health and estimated CVR. Methods: The rs4988235 polymorphism was genotyped in 397 subjects from the general Hungarian population and 368 individuals from the Roma population. To characterize the overall lipid profile, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), apolipoprotein AI (ApoAI), and apolipoprotein B100 (ApoB100) levels were measured, and their ratios (TG/HDL-C, LDL-C/HDL-C, and ApoB100/ApoAI) were calculated. Cardiovascular risk was estimated using the Framingham Risk Score (FRS), Pooled Cohort Equations (PCE), Revised Pooled Cohort Equations (RPCE), and the Systematic Coronary Risk Evaluations (SCORE and SCORE2) algorithms. Adjusted linear and logistic regression analyses were performed, with p < 0.05 considered significant. Results: The Roma population had a significantly higher prevalence of the C/C genotype than the general population (65.5% vs. 40.3%, respectively). The results of the adjusted linear regression analysis showed a significant association between the C/C genotype and higher LDL-C level (B = 0.126, p = 0.047) and ApoB100 level (B = 0.046, p = 0.013), as well as a higher LDL-C/HDL-C ratio (B = 0.174, p = 0.021) and a higher ApoB100/ApoAI ratio (B = 0.045, p = 0.002), as well as a lower HDL-C level (B = −0.041, p = 0.049). The C/C genotype was also significantly associated with an increased cardiovascular risk (CVR) as estimated by the SCORE (B = 0.235, p = 0.034), SCORE2 (B = 0.414, p = 0.009), PCE (B = 0.536, p = 0.008), and RPCE (B = 0.289, p = 0.045) but not the FRS. After adjusting the statistical model further for ApoAI and ApoB100 levels, the significant correlation with the risk estimation algorithms disappeared (SCORE: p = 0.099; SCORE2: p = 0.283; PCE: p = 0.255; and RPCE: p = 0.370). Conclusions: Our results suggest that the C/C genotype of rs4988235 is associated with significantly higher ApoB100 and lower ApoAI levels and consequently higher ApoB100/ApoAI ratios, potentially contributing to an increased risk of cardiovascular disease. The results of the statistical analyses suggest that the association between lactose intolerant genotype and cardiovascular risk may be mediated indirectly via modification of the apolipoprotein profile. Full article
(This article belongs to the Special Issue Lipids and Lipoproteins in Cardiovascular Diseases)
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18 pages, 1920 KB  
Article
Uric Acid to Platelet Ratio (UAPR) and Its Link to Lipid Abnormalities: Findings from a Large Cohort Study in Saudi Arabia
by Yazeed Alshuweishi, Lama Izziddeen, Muath Alsaidan, Noha A. Alshuwayer, Faisal A. Alshuweishi and Ahmed M. Basudan
J. Clin. Med. 2025, 14(17), 5952; https://doi.org/10.3390/jcm14175952 - 22 Aug 2025
Viewed by 572
Abstract
Background: Lipid disturbance is a hallmark of cardiometabolic abnormalities and a primary contributor to cardiovascular disease risk. Immunometabolic markers show promise for better risk classification. This study evaluated the uric acid to Platelet ratio (UAPR) as lipid abnormality marker in a broad cohort [...] Read more.
Background: Lipid disturbance is a hallmark of cardiometabolic abnormalities and a primary contributor to cardiovascular disease risk. Immunometabolic markers show promise for better risk classification. This study evaluated the uric acid to Platelet ratio (UAPR) as lipid abnormality marker in a broad cohort of Saudi adults. Methods: Data from 7781 adults in the Elta Medical Laboratory database were analysed. Subjects were stratified by lipid status, and UAPR levels were analyzed. Additionally, lipid abnormality distribution across UAPR tertiles and risk profiles, including ROC analysis, were evaluated. Results: UAPR were markedly increased in patients with abnormal lipid profiles while high UAPR (H-UAPR) subjects showed multiple dyslipidemic patterns including elevated levels of triglycerides (TG), low-density lipoprotein (LDL-C), non-high-density lipoprotein (non-HDL-C), and remnant cholesterol (RC), alongside reduced HDL-C levels. Notably, UAPR correlated with all lipid parameters, most strongly and inversely with HDL-C (r = −0.314) and remained independently associated with TG and HDL-C in multivariable regression. Consistently, H-UAPR was common across all dyslipidemic forms, especially low HDL-C, nearly twice as frequent as in N-UAPR (52.4% vs. 35.0%). The odds were specifically increased for low HDL-C (OR = 2.02, p < 0.0001) and a high TC/HDL-C ratio (OR = 2.94, p < 0.0001) in H-UAPR patients. ROC analysis demonstrated that UAPR had moderate yet significant diagnostic performance, particularly for identifying high TC/HDL-C (AUC = 0.671, p < 0.001) and HDL-C (AUC = 0.618, p < 0.001). Conclusions: UAPR shows considerable promise as an immunometabolic marker linked to various dyslipidemic forms with potential for hyperlipidemia screening and stratification, warranting further validation. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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24 pages, 2606 KB  
Article
The Comparison of Insulin Resistance Between Normal and Early Menopause Women Younger than Fifty Years Old by Machine Learning Methods
by Chun-Kai Wang, Dee Pei, Ta-Wei Chu and Kai-Jo Chiang
Diagnostics 2025, 15(16), 2074; https://doi.org/10.3390/diagnostics15162074 - 19 Aug 2025
Viewed by 645
Abstract
Background: The prevalence of type 2 diabetes (T2D) is on the rise, and insulin resistance (IR) is one of the key risk factors for developing T2D. This paper seeks to identify risk factors for IR in women with normal menstrual cycles (NM) [...] Read more.
Background: The prevalence of type 2 diabetes (T2D) is on the rise, and insulin resistance (IR) is one of the key risk factors for developing T2D. This paper seeks to identify risk factors for IR in women with normal menstrual cycles (NM) and early menopausal women (EM). Methods: EM women between 30 and 50 years old were compared with an NM control group. Four machine learning (ML) methods were trained using comprehensive physiological and lifestyle data to estimate a homeostasis model for insulin resistance (HOMA-IR dependent variable). Traditional multiple linear regression (MLR) was used as a benchmark for comparison. Results: A total of 948 participants were enrolled (NM: 410, EM: 538). On average, ML outperformed MLR, identifying the six key risk factors in the EM group (from most to least important) as waist–hip ratio (WHR), triglyceride (TG), glutamic-pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), HDL-Cholesterol (HDL-C), and lactic dehydrogenase (LDH). Rankings differed in the NM group, with WHR identified as the leading risk factor, followed by C-reactive protein (CRP), HDL-C, total bilirubin (TBIL), diastolic blood pressure (DBP), and white blood cell count (WBC). Conclusions: Using ML, we found that WHR and HDL-C are the common denominators in both EM and NM women, with additional correlations with TG, liver enzymes and LDH for EM women. These results clearly indicate the importance of estrogen protection, suppressing less important factors (TG, liver enzyme, and LDH), and only the stronger inflammatory markers become important (CRP, TBIL, and WBC). Once estrogen’s protection disappears, the suppression of CRP, TBIL, and WBC would become weaker. Since these 3 features are significantly correlated with body weight, for women under 50, reducing body weight is the most important factor in preventing hyperglycemia. Full article
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11 pages, 1192 KB  
Article
Comparative Study Between the Short-Term Effects of Replacement Therapy with Liquid and Tablet Formulations of Levothyroxine on Insulin Resistance Markers in Recently Thyroidectomized Female Patients
by Francesco Baratta, Federica Moscucci, Raffaella Bocale, Carmine Savoia, Nicholas Cocomello, Ilaria Lospinuso, Evaristo Ettorre, Giovambattista Desideri and Alfredo Pontecorvi
Metabolites 2025, 15(8), 547; https://doi.org/10.3390/metabo15080547 - 13 Aug 2025
Viewed by 645
Abstract
Background/Objectives: Levothyroxine (L-T4) replacement therapy is essential following total thyroidectomy. While liquid L-T4 formulations exhibit superior pharmacokinetic properties compared to tablets, their specific metabolic impact—particularly on insulin resistance—remains unclear. The aim of this study was to compare the short-term effects of liquid [...] Read more.
Background/Objectives: Levothyroxine (L-T4) replacement therapy is essential following total thyroidectomy. While liquid L-T4 formulations exhibit superior pharmacokinetic properties compared to tablets, their specific metabolic impact—particularly on insulin resistance—remains unclear. The aim of this study was to compare the short-term effects of liquid versus tablet L-T4 replacement therapy on insulin resistance indices in recently thyroidectomized women and to identify baseline predictors of metabolic response. Methods: A post hoc analysis included 130 women randomized to receive either liquid or tablet L-T4 after total thyroidectomy. Metabolic parameters—including the homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides-glucose (TyG) index, and triglycerides-to-HDL cholesterol (TG/HDL-C) ratio—were assessed at baseline and after two months. Results: Both L-T4 formulations significantly improved insulin resistance indices over two months. Liquid L-T4 induced a more pronounced reduction in HOMA-IR (treatment effect p = 0.022) and fasting insulin levels (treatment effect p = 0.017) compared to the tablet formulation. No significant between-group differences were observed for TyG index or TG/HDL-C ratio. Changes in insulin resistance markers were independent of body mass index variations and were predicted by baseline metabolic parameters including insulin, glucose, and lipid levels. Conclusions: L-T4 replacement therapy improves insulin resistance markers shortly after thyroidectomy, with the liquid formulation exerting a greater effect on hepatic insulin sensitivity. These findings support the individualized selection of L-T4 formulations to optimize both endocrine and metabolic outcomes post-thyroidectomy. Full article
(This article belongs to the Section Endocrinology and Clinical Metabolic Research)
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16 pages, 1638 KB  
Systematic Review
Effect of Intermittent Fasting on Anthropometric Measurements, Metabolic Profile, and Hormones in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
by Yazan Ranneh, Mohammed Hamsho, Wijdan Shkorfu, Merve Terzi and Abdulmannan Fadel
Nutrients 2025, 17(15), 2436; https://doi.org/10.3390/nu17152436 - 25 Jul 2025
Viewed by 3017
Abstract
Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder characterized by excess body weight, hyperandrogenism, hyperglycemia, and insulin resistance often resulting in hirsutism and infertility. Dietary strategies have been shown to ameliorate metabolic disturbances, hormonal imbalances, and inflammation associated with PCOS. Recent [...] Read more.
Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder characterized by excess body weight, hyperandrogenism, hyperglycemia, and insulin resistance often resulting in hirsutism and infertility. Dietary strategies have been shown to ameliorate metabolic disturbances, hormonal imbalances, and inflammation associated with PCOS. Recent evidence indicates that intermittent fasting (IF) could effectively enhance health outcomes and regulate circadian rhythm; however, its impact on PCOS remain unclear. Objective: Therefore, this systematic review and meta-analysis aims to examine the effect of IF on women diagnosed with PCOS. Methods: Comprehensive research was conducted across three major databases including PubMed, Scopus, and Web of Science without date restrictions. Meta-analysis was performed using Cochrane Review Manager Version 5.4 software. Results: Five studies fulfilled the inclusion criteria. IF significantly reduced body weight (MD = −4.25 kg, 95% CI: −7.71, −0.79; p = 0.02), BMI (MD = −2.05 kg/m2, 95% CI: −3.26, −0.85; p = 0.0008), fasting blood glucose (FBG; MD = −2.86 mg/dL, 95% CI: −4.83, −0.89; p = 0.004), fasting blood insulin (FBI; MD = −3.17 μU/mL, 95% CI: −5.18, −1.16; p = 0.002), insulin resistance (HOMA-IR; MD = −0.94, 95% CI: −1.39, −0.50; p < 0.0001), triglycerides (TG; MD = −40.71 mg/dL, 95% CI: −61.53, −19.90; p = 0.0001), dehydroepiandrosterone sulfate (DHEA-S; MD = −33.21 μg/dL, 95% CI: −57.29, −9.13; p = 0.007), free androgen index (FAI; MD = −1.61%, 95% CI: −2.76, −0.45; p = 0.006), and C-reactive protein (CRP; MD = −2.00 mg/L, 95% CI: −3.15, −0.85; p = 0.006), while increasing sex hormone-binding globulin (SHBG; SMD = 0.50, 95% CI: 0.22, 0.77; p = 0.004). No significant changes were observed in waist-to-hip ratio (WHR), total cholesterol (TC), LDL, HDL, total testosterone (TT), or anti-Mullerian hormone (AMH). Conclusions: IF represents a promising strategy for improving weight and metabolic, hormonal, and inflammatory profiles in women with PCOS. However, the existing evidence remains preliminary, necessitating further robust studies to substantiate these findings. Full article
(This article belongs to the Special Issue Nutrition and Female Reproduction: Benefits for Women or Offspring)
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21 pages, 511 KB  
Systematic Review
Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
by Milos Milincic, Andja Cirkovic, Katarina Ivanovic, Stefan Dugalic and Miroslava Gojnic Dugalic
Medicina 2025, 61(7), 1290; https://doi.org/10.3390/medicina61071290 - 17 Jul 2025
Viewed by 607
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in [...] Read more.
Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. Materials and Methods: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I2 statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. Results: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, p < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; p < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, p < 0.001 for both, LDL-C: SMD = 0.33, 0.20, p < 0.001 for both), in pregnant women with GDM compared to those without the condition. Conclusions: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management. Full article
(This article belongs to the Section Obstetrics and Gynecology)
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12 pages, 275 KB  
Article
Associations of Butyrylcholinesterase Activity and Lipid-Related Indices with Obesity in Thai Children
by Kanjana Suriyaprom, Sujinda Songtrai, Nittiya Chowchaikong and Chutima Sirikulchayanonta
Int. J. Environ. Res. Public Health 2025, 22(7), 1107; https://doi.org/10.3390/ijerph22071107 - 14 Jul 2025
Viewed by 561
Abstract
Background: Childhood obesity is a significant global health concern. Butyrylcholinesterase (BChE) has been shown to play a role in lipid metabolism. This study aimed to assess BChE activity, obesity-related and lipid-related indices, and dyslipidemia in obese and non-obese children, and to investigate the [...] Read more.
Background: Childhood obesity is a significant global health concern. Butyrylcholinesterase (BChE) has been shown to play a role in lipid metabolism. This study aimed to assess BChE activity, obesity-related and lipid-related indices, and dyslipidemia in obese and non-obese children, and to investigate the associations of these parameters with obesity among Thai children. Methods: The study included 661 Thai children, consisting of 338 with obesity and 323 with a normal weight. Anthropometric measurements, metabolic parameters, obesity- and lipid-related indices, and BChE activity were evaluated. Results: The obese group exhibited significantly higher BChE activity and obesity-related and lipid-related indices compared to the non-obese group (p < 0.01). Additionally, metabolic parameters—including glucose levels, triglyceride-glucose (TyG) index, and TyG-related indices—as well as the lipid profile, which included triglycerides (TG), non-high-density lipoprotein cholesterol (non-HDL-C), and very-low-density lipoprotein cholesterol (VLDL-C), were all significantly elevated in the obese group (p < 0.01). Obesity was associated with dyslipidemia (p < 0.01). Moreover, BChE activity showed a positive correlation with obesity-related and lipid-related indices, along with several metabolic parameters (p < 0.002). The upper stratum of BChE activity (OR = 5.356), the non-HDL-C/HDL-C ratio (OR = 2.185), and the TG/HDL-C ratio (OR = 1.703) were found to be effective in evaluating and predicting the risk of obesity, even after adjusting for potential covariates (p < 0.01). Conclusions: These findings indicate a significant relationship between obesity and increased BChE activity, lipid-related indices, and dyslipidemia in Thai children. Therefore, changes in BChE activity may be considered a factor associated with obesity, enhancing its potential as a marker for obesity assessment. Full article
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