Nutritional Antioxidants and Lipid Profile in Newly Diagnosed Rheumatoid Arthritis Patients

Introduction: Rheumatoid arthritis (RA) is a chronic progressive autoimmune disorder characterized by symmetric erosive synovitis. The pathogenesis of bone erosion and joint deformities are not fully understood. The aim of this study was to find out vitamin C and E levels along with the lipid profile in newly diagnosed cases of RA. Materials and Methods: The patients for the study were selected from individuals attending the routine checkup in an Outpatient Department. Based on the criteria led by the American Rheumatism Association (ARA), the newly diagnosed patients were taken as cases and other normal individuals were taken as control group in the study. A total of 50 subjects were included in the study with the age group of 48 ± six years for both genders. Serum Vitamin-E was determined by the colorimetric method and serum Vitamin-C was estimated by the dinitro phenyl hydrazine method. Serum total cholesterol, HDL-cholesterol, triglycerides, and VLDL levels were estimated by the enzymatic method. LDL- cholesterol was calculated by the Friedewald's formula. Results: The levels of nutritional antioxidants vitamin E and C were different significantly in RA patients compared to control group. The lipid profile parameters were also different significantly in RA patients compared to the controls. Conclusion: Patients with RA presented with an imbalance in the oxidant-antioxidant system that markedly increased lipid peroxidation products and significantly decreased lipid soluble antioxidant vitamin E. These changes might play a role in the tissue damage and inflammation process in this disease

Effect of Antiretroviral Therapy on Circulating Lipid Levels in Human Immunodeficiency Virus Infected Patients: A Cross-sectional Study

Introduction: The antiretroviral drugs have improved the quality and extent of life of Human Immunodeficiency Virus (HIV) infected patients, yet like any other long-term medication, these are known to cause several adverse effects. One such adverse effect is on the lipid metabolism in individuals on Antiretroviral Therapy (ART). Aim: To analyse the effect of ART on the circulating lipid levels in HIV patients. The secondary aim was to compare the lipid changes in patients treated with ZLN (Zidovudine+Lamivudine +Nevirapine) drug regimen against those, with TLE (Tenofovir+ Lamivudine+Efavirenz). Materials and Methods: This cross-sectional study was conducted from December 2019 to March 2021 at the District Hospital, Chamarajanagar Karnataka, India. A total of 200 HIV positive patients between 18-55 years of age with no associated co-morbidities and who have been on ART were recruited into this study. Of the total 91 patients were on TLE (Tenofovir+ Lamivudine+ Efavirenz) and 109 were on ZLN (Zidovudine+ Lamivudine+Nevirapine) regimen. Blood samples were collected from all the patients and lipid profile analysis was done. results: Statistically significant increase was observed in all lipid parameters in the ZLN group compared to TLE group. Serum Total Cholesterol (TC) {ZLN 190.92±43.57 vs 164.23±40.7 in TLE group (p-value <0.0001)} serum Low Density Lipoprotein Cholesterol (LDL-C) {ZLN 120.44±35.46 vs 100.81±26.84 in TLE group (p-value <0.0001)}, Triglyceride (TG) {ZLN 245.68±132.42 vs 171.56±77.30 in TLE group (p-value <0.0001)} and High Density Lipoprotein Cholesterol (HDL-C) {ZLN 60.71±17.51 vs 53.31±13.8 in TLE group (p-value=0.0012)}. Also the non HDL-C levels {ZLN 130.2±39.51 vs 110.91±36.87 in TLE group (p-value <0.0005)} were higher in patients receiving ZLN drug regimen than those who were on TLE. Of the 200 HIV patients, 53 were taking ART for less than five years (mean 2.51±1.12 years), 109 were receiving ART between 5-10 years (mean 7.78±1.50 years), 38 patients were on ART treatment for more than 10 years (mean 11.73±0.76 years). A positive significant association between lipid derangement and disease/ ART duration was observed. conclusion: Lipid abnormalities were more in HIV patients on ZLN drug regimen, than those on TLE regimen. The longer course of disease/ART is associated with imminent lipoprotein derangement. Periodic monitoring of lipid levels are recommended in these patients

Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients

Introduction: Thyroid hormones regulate growth, metabolism and cellular differentiation in our body. Thyroid disorders are among the commonly encountered endocrinopathies across the globe in the recent past. Hypothyroidism is prevalent to the extent of 9.45-11.73% among urban inland regions of India as reported in a recent survey. Thyroid hormones influence lipid metabolism. The dyslipidemia in hypothyroidism presents as high serum Total Cholesterol (TC) levels, elevated Low Density Lipoprotein-Cholesterol (LDL-C) levels, hypertriglyceridemia and Increased Triglyceride (TGL)- Rich Lipoproteins or Remnant Lipoproteins (RLPs). Non High Density Lipoprotein-Cholesterol (Non-HDL-C) reflects the cholesterol content of these RLPs. The potential of Non-HDL-C seems to be underutilised in patients with hypothyroidism. Aim: To know the levels of Non-HDL-C in hypothyroid patients as compared to normal subjects and to assess its reliability to predict the future cardiovascular risk in hypothyroid patients. Materials and Methods: The study was a case-control study, that was conducted in District Hospital, Chamarajanagar, Karnataka, India, between December 2019 to September 2020, involving two groups. The first group were the cases, consisting of 50 hypothyroid patients between 18 and 55 years of age, 50 healthy age and sex matched controls were selected and inducted into this study. The ‘Case group was further divided into “Known cases” and ‘New cases’, based on the disease course. The ‘New cases’ are further classified into group of ‘Overt Hypothyroids’ and ‘Subclinical hypothyroids’. In all the subjects of present study, serum TC and serum HDL- Cholesterol (HDL-C) was estimated. The value of HDL-C was subtracted from TC level and Non-HDL-C level was calculated for all the study subjects. The values of the lipid fractions in both groups and in the subgroup were tabulated and compared using suitable statistical tool. Results: In the present study it was noted that Non-HDL-C was significantly high in hypothyroid patients when compared to healthy controls (p=0.02). Also, the newly diagnosed hypothyroid patients had significantly high Non-HDL-C levels than controls (p=0.01). The subgroup of ‘Known cases’ who were on Levo- thyroxine replacement did not show significantly elevated Non- HDL-C levels. Overt Hypothyroid (OH) patients had higher values of Non-HDL-C than those with Subclinical Hypothyroidism (SCH). Conclusion: At each level of the present study, (controls vs cases, known vs new cases and OH vs SCH) non-HDL-C has emerged in an expected pattern, which is consistent with pathophysiology, course and severity of the disease. Therefore, present study suggest the feasibilty of non-HDL-C replacing the traditional lipid profile assays for assessment of dyslipidemia in hypothyroid patients.</jats:p

Nutritional Antioxidants and Lipid Profile in Newly Diagnosed Rheumatoid Arthritis Patients

Introduction: Rheumatoid arthritis (RA) is a chronic progressive autoimmune disorder characterized by symmetric erosive synovitis. The pathogenesis of bone erosion and joint deformities are not fully understood. The aim of this study was to find out vitamin C and E levels along with the lipid profile in newly diagnosed cases of RA. Materials and Methods: The patients for the study were selected from individuals attending the routine checkup in an Outpatient Department. Based on the criteria led by the American Rheumatism Association (ARA), the newly diagnosed patients were taken as cases and other normal individuals were taken as control group in the study. A total of 50 subjects were included in the study with the age group of 48 ± six years for both genders. Serum Vitamin-E was determined by the colorimetric method and serum Vitamin-C was estimated by the dinitro phenyl hydrazine method. Serum total cholesterol, HDL-cholesterol, triglycerides, and VLDL levels were estimated by the enzymatic method. LDL- cholesterol was calculated by the Friedewald's formula. Results: The levels of nutritional antioxidants vitamin E and C were different significantly in RA patients compared to control group. The lipid profile parameters were also different significantly in RA patients compared to the controls. Conclusion: Patients with RA presented with an imbalance in the oxidant-antioxidant system that markedly increased lipid peroxidation products and significantly decreased lipid soluble antioxidant vitamin E. These changes might play a role in the tissue damage and inflammation process in this disease.</jats:p