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Systemic hypertension arises from the interplay of numerous common and rare genetic variants spanning vascular, renal, endocrine, metabolic, and immune pathways. Modern genomic approaches triangulate evidence from candidate gene studies, biobank-scale genome-wide association studies (GWAS), and whole-exome or whole-genome sequencing, enabling stronger mechanistic inference. In this narrative synthesis, we focused on recent human studies emphasizing candidate gene analyses, GWAS, and sequencing efforts in hypertension, extracting data on study design, populations, key variants, and implicated biological pathways. Across methodologies, genetic evidence consistently supported central roles for endothelial nitric-oxide biology (NOS3) and oxidative or tonic regulation of arteriolar resistance (PRKG1, CYBA, and CYP4A11), alongside contributions from lipid-handling genes (ApoB and PCSK9) and mitochondrial or smooth-muscle regulators (HSG and MFN2). GWAS conducted across diverse ancestries repeatedly mapped blood pressure variation to vascular calcium dynamics (ATP2B1 and CACN* loci), renal tubular transport mechanisms (UMOD and SLC4A7), renin-angiotensin-aldosterone system-related steroidogenesis (CYP17A1 and CYP11B2), and immune remodeling pathways (SH2B3), with several loci demonstrating sex- or ancestry-specific modulation and enrichment in resistant-hypertension cohorts, particularly within calcium-handling and steroidogenic pathways. Sequencing studies further identified rare, functional, and ancestry-specific variants, including large blood pressure-lowering alleles and signals enriched in Middle Eastern populations, that refine biological mechanisms and support population-tailored risk stratification. Overall, convergent evidence across genetic approaches highlights four translationally actionable systems, such as vascular calcium handling, renal salt and bicarbonate transport, adrenal steroidogenesis, and immune or inflammatory tone, supporting the development of ancestry-aware polygenic risk tools, genetic sub-phenotyping (including resistant hypertension), and mechanism-aligned therapeutics as key steps toward precision hypertension care. Show less

In heart failure (HF), atherogenic dyslipidemia and lipotoxicity contribute to adverse remodeling. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve HF outcomes, yet their lipid effects remain debated. This review aims to synthesize quantitative changes in lipid parameters and plausible mechanisms by which SGLT2i modulate lipoproteins in HF. Across trials and HF-focused cohorts, SGLT2i are associated with small increases in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) and small decreases in triglycerides. Beyond concentrations, emerging data suggest qualitative remodeling - a shift toward less atherogenic LDL phenotypes (small-dense LDL (sd-LDL)↓) and increases in HDL2 - although evidence is limited and heterogeneous. Mechanistically, enhanced adipose lipolysis and hepatic β-oxidation/ketogenesis may raise ketone availability for the myocardium ("thrifty substrate"), while hepatic cholesterol pool-driven LDL receptor (LDLR) downregulation could explain modest LDL-C increases. These lipid shifts coexist with consistent reductions in HF events, independent of diabetes, implying benefits not captured by traditional lipid metrics alone. In HF, SGLT2i likely exert modest quantitative lipid changes but potentially meaningful qualitative lipoprotein remodeling alongside improved metabolic flexibility. Clinically, apolipoprotein B (ApoB)-targeted therapy (e.g., statins ± ezetimibe) remains essential when LDL-C/ApoB are above goal, with SGLT2i used for cardiorenal benefit. HF-specific trials powered for ApoB, sd-LDL, low-density lipoprotein particle number (LDL-P), HDL function, and lipidomics are lacking. In conclusion, SGLT2i produce small, mixed lipid changes in HF, but mechanistic and particle-level effects may align with improved outcomes; definitive HF-centric lipid studies are a priority. Show less

To systematically evaluate the causal effects of lipoproteins on ischemic stroke (IS) through a systematic review and meta-analysis of Mendelian randomization (MR) studies. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science to identify MR studies investigating the relationship between lipoproteins and IS, covering all publications up to November 2024. Relevant data were extracted, followed by a quality assessment. Meta-analyses were performed using RevMan software, with evaluations of heterogeneity and publication bias. A total of 442 studies were evaluated, and 10 were included. Our meta-analysis showed a significant positive correlation between LDL and IS (OR 1.09, 95% CI 1.07-1.12; This meta-analysis provides evidence for a causal relationship between various lipoproteins and ischemic stroke. Most non-HDL lipoproteins (LDL, VLDL, apoB) are associated with an increased risk of IS, while HDL and apoA1 appear to confer a protective effect. The role of Lp(a) in IS remains inconclusive and warrants further investigation. https://www.crd.york.ac.uk/PROSPERO, CRD42024617825. Show less

Heterozygous familial hypercholesterolemia (HeFH) is the most prevalent inherited dyslipidemia, and it predisposes individuals to premature atherosclerotic cardiovascular disease. Genetic testing can provide a definitive diagnosis. The spectrum of causal DNA variants in Ontario patients with hypercholesterolemia is not fully defined. In Southwestern Ontario patients with a clinical diagnosis of HeFH, we performed targeted next-generation DNA sequencing and bioinformatic analysis to determine the qualitative and quantitative spectrum of pathogenic and likely pathogenic (P/LP) variants. We observed 101 unique P/LP variants in 254 patients, of which 6 were novel This study provides a comprehensive overview of the clinical and genetic spectrum of HeFH in Southwestern Ontario. The P/LP variant diversity reflects historical colonization and later migration patterns both from across the world and interprovincially from Quebec. Show less

In recent years, special attention has been paid to the role of endotoxemia in the pathogenesis of chronic inflammatory processes and vascular complications of type 1 diabetes mellitus (DM1) - increased levels of circulating bacterial lipopolysaccharide (LPS). Endotoxemia occurs due to increased permeability of the intestinal barrier ("leaky gut syndrome") and/or decreased activity of its elimination systems. Correction of endotoxemia is a promising direction in the complex therapy of DM1. Traditional approaches include strict glycemic control and the use of certain pharmacological agents, however, the search for effective non-pharmacological methods, such as the use of natural mineral waters, remains relevant. Despite the theoretical background, data on the effect of a course of mineral water intake on markers of endotoxemia and systemic inflammation in patients with DM1 are extremely limited. to evaluate the effect of mineral waters on the state of LPS-binding systems, the level of circulating lipopolysaccharide and markers of inflammation in patients with type 1 diabetes mellitus. The study included 53 patients with a verified diagnosis of type 1 diabetes mellitus. The intervention group ( In patients of group 1, after the use of mineral waters, a significant decrease in circulating LPS ( The study demonstrates that a 30-day course of taking "Krymskaya" mineral water in addition to standard insulin therapy in patients with type 1 diabetes mellitus leads to a statistically significant decrease in the level of circulating lipopolysaccharide (LPS), a key trigger of endotoxemia and chronic inflammation. The results obtained justify the expediency of further studying the use of mineral waters, in particular bicarbonate-chloride-sodium, as a component of complex non-pharmacological therapy aimed at correcting endotoxemia and improving the metabolic profile in patients with type 1 diabetes mellitus. Show less

Coronary artery calcium (CAC) scoring is widely used to screen for coronary artery disease (CAD) in asymptomatic individuals. However, it detects calcified plaques and may miss non-calcified or soft plaques. This study compared the diagnostic accuracy of CAC scoring with coronary computed tomography angiography (CCTA) for detecting CAD in asymptomatic individuals with risk factors. Eighteen asymptomatic adults with a CAC score of 0 underwent CCTA to evaluate for subclinical CAD. Clinical, biochemical, and lifestyle risk factors were assessed. Diagnostic agreement between CAC and CCTA was analyzed using the Wilcoxon signed rank test. The cohort had a mean age of 51.4 ± 10.6 years, 88.8% were male, and mean body mass index (BMI) was 27.7 ± 3.6 kg/m CCTA detected non-calcified atherosclerosis missed by CAC and demonstrated superior sensitivity for early CAD detection in asymptomatic individuals. Show less

The intestine is a multifunctional organ responsible for digestion, nutrient absorption, metabolic regulation, and innate immunity. In flatworms, recent studies have highlighted the importance of intestine-enriched genes expressed strongly in cells of the digestive tract. These genes are not only involved in digestion, nutrient uptake, transport, metabolism, and feeding behavior, but also in the modulating dynamics of stem cells (neoblasts). In Show less

Gingival crevicular fluid (GCF) reflects both local periodontal inflammation and systemic conditions. This review highlights the role of oxidative stress, oxidised low-density lipoprotein (oxLDL), and apolipoprotein B (apoB) as molecular links between periodontitis and metabolic disorders. Elevated GCF levels of oxLDL and apoB indicate enhanced vascular permeability and local oxidative modification, particularly in diabetes. Furthermore, oxLDL promotes the formation of neutrophil extracellular trap (NET) via connecting oxidative stress with immune-mediated tissue injury. These insights establish GCF as a valuable, non-invasive biomarker for understanding the interplay between periodontal and systemic diseases. Show less

Lipid overaccumulation in the liver predisposes ducks to metabolic disorders. The molecular mechanism of oleic acid (OA)-induced hepatic steatosis in ducks is not fully elucidated. A cellular model of steatosis was established by treating primary duck hepatocytes with OA. Transcriptome sequencing was performed to identify key signaling pathways and candidate genes. The role of Apolipoprotein A1 (APOA1) was investigated through overexpression and knockdown experiments. Intracellular triglycerides (TGs) were quantified commercially; lipid droplets were visualized by Oil Red O staining. Intracellular TG accumulation was induced by OA treatment in a dose-dependent manner. Through transcriptome analysis, 1045 differentially expressed genes (DEGs) were identified, with APOA1 being recognized as a key candidate within the peroxisome proliferator-activated receptor (PPAR) signaling pathway. The content of TGs and lipid droplets was increased by APOA1 overexpression, whereas these effects were suppressed by APOA1 knockdown. The expression of acetyl-CoA carboxylase alpha (ACACA) and fatty acid synthase (FASN) was upregulated by APOA1. Conversely, the expression of carnitine O-palmitoyltransferase 1 (CPT1), acyl-CoA oxidase 1 (ACOX1), and apolipoprotein B (APOB) was downregulated. This study demonstrates that OA upregulates APOA1, suggesting the involvement of the PPAR pathway and providing a theoretical basis for modulating hepatic fat deposition. Show less

Chronic hyperglycemia inflicts serious cellular damage by inducing oxidative stress through the excessive production of free radicals. This oxidative milieu may impair the cellular redox capacity and disrupt the insulin-like growth factor (IGF) system, thereby increasing the risk of cardiovascular complications. This study aimed to investigate plasma levels of components of the IGF system and antioxidant biomarkers in young adults with type 1 diabetes mellitus (T1DM) compared to age-matched healthy controls in Brazil. This study included 129 patients with T1DM (76 female, 53 male; mean age 26.97 ± 0.6 years) and 95 healthy controls (61 female, 34 male; mean age 27.35 ± 0.68 years). Young Brazilian adults with T1DM had significantly lower mean IGF-I and higher mean IGFBP-1 levels compared to healthy controls. The T1DM group showed a more atherogenic profile, characterized by a significantly elevated ApoB/ApoA1 ratio and increased oxidized LDL levels. However, a subset of patients with significantly better glycemic control exhibited serum IGF-I and IGFBP-1 levels within the normal range observed in controls, which may indicate the presence of residual functional beta-cell activity or reflect better glycemic control in this subgroup. Antioxidant components and oxidative stress biomarkers were significantly upregulated in the T1DM group compared to the control group, suggesting a compensatory adaptive response. No significant correlation was observed between biomarkers of oxidative stress and the IGF-system. Show less

To analyze the potential therapeutic value and mechanism of luteolin in age-related macular degeneration (AMD) using network pharmacology and cellular experiments. SHD-compound targets were retrieved from the TCMSP database, while AMD-related targets were extracted from OMIM and DisGeNET databases. Overlapping targets were identified via Venny 2.1. A PPI network was constructed using the STRING database, followed by functional enrichment analysis of overlapping targets via Metascape. Pharmacological networks were mapped using Cytoscape. For cellular experiments, the optimal concentration of luteolin was determined by CCK-8 assay. Human umbilical vein endothelial cells (HUVECs) were divided into: Control group (Without any intervention), Model group (VEGF165-induced model), and Treatment group (VEGF165-induced + luteolin). Angiogenesis was evaluated via scratch, transwell migration, invasion, and tube formation assays. VEGFA protein expression was assessed by Western blot. We identified 157 SHD-compound targets and 87 AMD-related targets, yielding 6 overlapping targets (ESR1, PON1, SOD1, APOB, VEGFA, IL6). PPI networks and enrichment analysis revealed that luteolin in SHD may inhibit AMD neovascularization via VEGFA signaling pathways. The concentration of luteolin (25 µmol/L) used in the experiments was selected based on the dose-response results. In vitro assays showed the Treatment group exhibited: significantly reduced horizontal migration (scratch assay, p < 0.05), decreased vertical migration (transwell assay, p < 0.05), suppressed invasion (p < 0.05), and inhibited tube formation (p < 0.05). Western blot confirmed reduced VEGFA expression in the treatment group (p < 0.05). Luteolin alleviates angiogenesis in HUVECs by inhibiting VEGFA expression, highlighting its potential as a therapeutic candidate for neovascular AMD. Show less

Familial hypercholesterolaemia (FH) is an autosomal dominant genetic disorder, characterised by markedly elevated levels of low-density lipoprotein cholesterol (LDL-C) from birth, which confers a substantially increased risk of premature atherosclerotic cardiovascular disease (ASCVD). Pathogenic variants primarily occur in the genes encoding the low-density lipoprotein receptor (LDLR), apolipoprotein B (ApoB), low-density lipoprotein receptor adaptor protein 1 (LDLRAP1), or proprotein convertase subtilisin/kexin type 9 (PCSK9). Early diagnosis, based on clinical criteria, family history, and genetic testing, is imperative to promptly initiate aggressive therapeutic strategies. Standard treatment involves lifestyle modifications and high-intensity pharmacotherapy, primarily with statins, often in combination with ezetimibe. For patients who do not achieve their therapeutic goals or are intolerant, PCSK9 inhibitors represent a significant evolution in the treatment paradigm. In this article, we present a case of homozygous familial hypercholesterolaemia. Show less

Mercury (Hg) is a widespread environmental pollutant with known neurotoxic and cardiometabolic effects, and its influence on lipid metabolism during childhood remains insufficiently understood. Mitochondrial dysfunction is proposed as a potential mechanism linking Hg exposure to metabolic disruption. Mitochondrial DNA copy number (mtDNA-CN) is regarded as an indicator of mitochondrial biogenesis and functional capacity, where lower levels generally suggest mitochondrial damage or dysfunction. In contrast, ribosomal DNA (rDNA) and relative telomere length (RTL) reflect genomic stability and cellular aging. This study investigated the associations between blood Hg levels and serum lipid profiles in children and adolescents and assessed the mediating roles of mtDNA-CN, rDNA, and RTL. A cross-sectional study was performed among 352 children and adolescents aged 6–17 years in eastern China. Blood Hg levels were determined using inductively coupled plasma mass spectrometry (ICP-MS), and serum lipid markers, namely total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and lipoprotein(a), were assessed along with the genomic indicators such as mtDNA-CN, rDNA, and RTL. Multivariable linear regression and mediation analyses were conducted. Higher Hg levels were significantly related with increased TC (β = 0.144, Hg exposure in children and adolescents is linked to an atherogenic lipid profile, potentially through mitochondrial dysfunction. MtDNA-CN appears to be a sensitive molecular mediator of Hg-induced lipid disturbances, which highlights the relevance of mitochondrial health in early-life environmental epidemiology and cardiovascular risk prevention. The findings support early prevention strategies and environmentally focused health policies that reduce toxicant exposure and thus promote long-term cardiometabolic health in young populations. Show less

Patients with chronic kidney disease frequently exhibit abnormalities in their lipid metabolism. Confounding factors in observational studies often obscure the causal relationship between these 2 diseases. This study investigated the causal relationships between genetically predicted levels of 6 key lipid parameters (total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB)) and circulating kidney injury molecule 1 (KIM-1) levels, using a comprehensive bidirectional Mendelian randomization (MR) analysis. Using genome-wide association study data, the primary analysis used the inverse-variance weighted (IVW) method, supported by MR-Egger regression and a weighted median estimator. Sensitivity analyses including heterogeneity, pleiotropy tests, leave-one-out, and reverse causality analyses were conducted. The IVW model revealed the following: TG (odds ratio (OR): 1.1843, 95% confidence interval (CI): 1.1178-1.2547, P = 9.5894e-09), TC (OR: 1.1096, 95% CI: 1.0178-1.2095, P = .0182), and ApoA1 (OR: 1.1820, 95% CI: 1.0741-1.3007, P = .0007) were found to have significant causal relationships with KIM-1, a biomarker of kidney tubular injury, and may be risk factors for renal tubular injury; No significant causal associations were observed between high-density lipoprotein cholesterol (HDL-C), (P = .2929), LDL-C (P = .2178), ApoB (P = .1836), and KIM-1; Horizontal pleiotropy was detected for ApoA1 (P = .0208). However, sensitivity analyses confirmed the robustness of the results after the removal of outliers; significant heterogeneity was observed across all lipid parameters (Cochran Q P < .05), which necessitated the use of random-effects IVW models; and reverse causality analyses (MR-Egger intercept P > .05, Steiger filtering) confirmed no evidence of reverse causation between lipid profiles and KIM-1. TG, HDL-C, and ApoA1 levels may be risk factors for renal tubular injury. However, no significant causal relationships were observed between HDL-C, LDL-C, and ApoB levels and renal tubular injury. To further explore the underlying mechanisms of the associations between TG, HDL-C, ApoA1, and KIM-1 and to inform lipid management strategies in tubulopathy-related conditions. Show less

Despite widespread use of high-intensity statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors, substantial atherosclerotic cardiovascular disease risk persists, especially in people with heterozygous familial hypercholesterolemia or elevated lipoprotein(a) [Lp(a)] levels. Cholesteryl ester transfer protein (CETP) inhibitors block the transfer of hydrophobic cholesteryl esters from high-density lipoprotein to apolipoprotein B (apoB)-containing particles. This process raises high-density lipoprotein-C and lowers low-density lipoprotein-C, apoB, and Lp(a) levels. The first-generation of CETP inhibitors was limited by toxicity, neutral outcomes, or unfavorable pharmacokinetics. Obicetrapib is a next-generation amphipathic CETP inhibitor that selectively targets both CETP's hydrophobic and hydrophilic tunnels. It reduces low-density lipoprotein-C by about 30-51%, apoB by 20-33%, and Lp(a) by 30-57% without causing tissue accumulation or toxicity. Phase 3 trials (BROOKLYN, BROADWAY, TANDEM) show that obicetrapib is effective when added to maximized therapy, with a safety profile similar to placebo. Its consistent reduction of Lp(a) addresses an important unmet need. In addition to lowering atherogenic lipoproteins, early data suggest potential for neuroprotection, such as reductions in p-tau217 seen among APOE4 carriers. A 2025 pooled analysis offers initial evidence that major adverse cardiovascular events are reduced, as studied in the ongoing PREVAIL outcomes trial. This review covers CETP biology and tunnel mechanics, outcomes from earlier CETP inhibitor studies, obicetrapib's pharmacology, and current efficacy and safety data, and will clarify its potential place in lipid management today. Show less

Ischemic stroke is frequently associated with symptomatic intracranial atherosclerotic stenosis (sICAS), is a leading cause of global disability and mortality. Current guidelines recommend dual antiplatelet and intensive statin therapies. Proprotein convertase subtilisin 9/kexin type 9 (PCSK9) inhibitors have emerged as a potent lipid-lowering therapy, potentially influenced by genetic variations, particularly in the CYP2C19 gene. This study at Xuzhou Central Hospital from January 2021 to December 2023 included 151 patients divided into a statin group (n = 73) and a PCSK9 inhibitor (PCSK9i) group (n = 78). It evaluated lipid profiles, inflammatory markers, neurological function, and clinical outcomes over a 180-day follow-up period, with additional analysis stratified by CYP2C19 genotype. The PCSK9i group demonstrated significant improvements in lipid parameters compared to the statin group, including greater reductions in low-density lipoprotein cholesterol (LDL-C) (p = 0.008), total cholesterol (TC) (p < 0.001), and triacylglycerols (TAG) (p = 0.041), along with apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) (both p < 0.001). Inflammatory markers, particularly interleukin-6 (IL-6), significantly reduced in the PCSK9i group (p < 0.001). In the PCSK9i group, CYP2C19 rapid metabolizers achieved greater reductions in LDL-C (p = 0.021), ApoB (p = 0.003), and IL-6 levels (p = 0.041) compared to slow metabolizers. Post-treatment modified Rankin Scale (mRS) scores were significantly lower in rapid metabolizers compared to slow metabolizers (p = 0.018), though clinical events occurred infrequently in both subgroups. This study demonstrates that PCSK9 inhibitor therapy combined with statins provides enhanced lipid-lowering and anti-inflammatory effects compared to statin monotherapy in sICAS patients. While the CYP2C19 genotype may influence specific treatment responses, particularly lipid parameters, its impact on clinical outcomes requires further investigation. Show less

Diabetes mellitus and dyslipidemia are major risk factors for atherosclerosis. Hypoechoic plaques, which indicate vulnerable or unstable plaques, may rupture and lead to ischemic stroke, cognitive impairment, increased adverse cardiac events, and even death. This study aimed to investigate the correlation between plasma lipid levels and the characteristics of atherosclerotic plaques in adult patients with type 2 diabetes mellitus. A retrospective analysis was conducted on adult patients with type 2 mellitus who were hospitalized in the Department of Endocrinology at Affiliated Hospital of Hebei University between January 2017 and December 2021.Patients were categorized into two groups based on arterial ultrasound results. Statistical analyses were performed to compare plasma lipid levels and plaque characteristics across the groups. 1) Statistically significant differences were observed among the two groups in terms of gender, hypertension, age, duration of diabetes mellitus, plaque location, triglycerides (TG),total cholesterol (TC), Apolipoprotein A1 (Apo A1),very-low-density lipoprotein (VLDL), VLDL/apolipoprotein B(ApoB), high-density lipoprotein cholesterol (HDL)/ApoA1 ( In clinical practice, the characteristics of atherosclerotic plaques and lipid profiles should be jointly evaluated to guide targeted treatment and effectively reduce the risk of atherosclerotic cardiovascular disease. Show less

Familial dyslipidemia (FD), particularly familial hypercholesterolemia (FH), is a major contributor to premature cardiovascular disease (CVD), especially in regions with high consanguinity and underutilized genetic screening, such as Egypt. This study aimed to assess clinical, biochemical, and genetic factors that differentiate FD patients with and without CVD, and to develop a composite risk score for individualized stratification. A cross-sectional study was conducted on 60 Egyptian patients aged 15-25 years with genetically confirmed FD, equally divided based on CVD status. All participants underwent detailed clinical assessment, lipid profiling, and targeted next-generation sequencing of LDLR, APOB, and PCSK9 genes. Missense variants were evaluated using SIFT, PolyPhen-2, CADD, and ΔΔG stability scores, and classified according to ACMG criteria. Compared to non-CVD patients, those with CVD had significantly higher triglyceride levels (median: 356.5 vs. 236.5 mg/dL; p < 0.001) and a higher frequency of heterozygous pathogenic LDLR variants (30.0% vs. 3.3%; p = 0.006), while homozygous variants were more common in non-CVD patients (26.7% vs. 0%; p = 0.002). Deleterious missense variants were notably more frequent in the CVD group (56.7% vs. 10.0%; p < 0.001). A 10-variable composite risk score integrating clinical, lipid, and bioinformatic predictors effectively distinguished high- and moderate-risk cases (AUC = 0.742; p = 0.022), with 89.5% sensitivity and 81.8% negative predictive value. The study highlights the importance of combining clinical and genomic data for early risk stratification and introduces a pragmatic tool for identifying high-risk youth in resource-limited, consanguineous populations. Show less

To assess the predictive ability of baseline serum apolipoprotein B (ApoB) and the ratio of ApoB to apolipoprotein A1 (ApoB/ApoA1 ratio) for dyslipidemia risk in patients receiving second-generation antipsychotics (SGAs). Medical records of patients hospitalized between March 2019 and March 2025 were retrospectively reviewed. The optimal cut-off points for baseline serum ApoB levels and the ApoB/ApoA1 ratio were identified using a maximally selected log-rank statistic analysis. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs). The Kaplan-Meier method with Log rank testing was used to compare the cumulative incidence of dyslipidemia between groups defined by these cut-off points. Of 311 enrolled patients, 33 (10.6%) lacking baseline ApoA1 measurements were excluded from ApoB/ApoA1 ratio analyses. The optimal cut-off points were 0.70 g/L for baseline ApoB and 0.45 for the ApoB/ApoA1 ratio. Multivariable Cox proportional hazards models, fully adjusted for covariates, demonstrated significantly elevated dyslipidemia risk for patients exceeding these thresholds vs low-risk groups: adjusted HR 2.98 (95% CI: 2.05-4.32, p < 0.001) for high ApoB and 3.17 (95% CI: 1.62-6.22, p = 0.001) for high ApoB/ApoA1 ratio. Continuous analysis showed each 0.1 g/L ApoB increase conferred a 34% higher risk (adjusted HR 1.34, 95% CI: 1.21-1.48, p < 0.001), while each 0.1-unit ApoB/ApoA1 ratio increase conferred a 20% higher risk (adjusted HR 1.20, 95% CI: 1.10-1.30, p < 0.001). Kaplan-Meier curves confirmed significantly higher cumulative dyslipidemia incidence in high vs low groups for both markers (Log rank test, both p < 0.001). Baseline serum ApoB levels and the ApoB/ApoA1 ratio are valuable risk markers for dyslipidemia in patients treated with SGAs. Show less

Olezarsen (Tryngolza) is a next-generation, N-acetylgalactosamine (GalNAc)-conjugated antisense oligonucleotide that selectively inhibits hepatic ApoC-III, a key regulator of triglyceride metabolism. By inhibiting ApoC-III, olezarsen increases triglyceride clearance through both lipoprotein lipase (LPL)-dependent and -independent pathways. In the Phase 3 BALANCE trial, olezarsen reduced fasting triglycerides by approximately 60% at 12 months in patients with familial chylomicronemia syndrome (FCS), with a marked decrease in pancreatitis events versus placebo. Consistent triglyceride reductions (around 50%) were also observed in moderate and severe hypertriglyceridemia, along with improvements in ApoB-containing lipoproteins and high-density lipoprotein (HDL) profiles. In completed trials, olezarsen demonstrated a favorable safety profile, with most adverse events limited to mild injection-site reactions and no clinically significant thrombocytopenia. Ongoing Phase 3 trials (ESSENCE, CORE, and CORE2) will further define its role in cardiovascular risk reduction and pancreatitis prevention in broader hypertriglyceridemic populations. Olezarsen represents a precision medicine advance, offering effective triglyceride lowering with improved tolerability compared with earlier antisense therapies. Show less

Traditional lipid parameters like low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC) are commonly used in evaluating cardiovascular risk. Recently, emerging biomarkers such as apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) are proposed to provide improved accuracy in assessing atherosclerotic risk. This study examined the association between conventional and novel lipid parameters and plaque burden in statin-naïve acute coronary syndrome (ACS) patients. We enrolled 81 statin-naïve patients with ACS. Each underwent both standard and extended lipid profiling. Coronary angiograms were evaluated using the Gensini score to quantify plaque burden. All participants were followed for 28 days to monitor for major adverse cardiac events (MACE). The average age was 51 years, with males comprising 77%. The ST-segment elevation myocardial infarction (STEMI) was observed in 58% of cases, non-ST-segment elevation myocardial infarction (NSTEMI) in 31%, and unstable angina in 11%. There was a significant correlation between the Gensini score and TC/HDL ratio ( The ratios of TC/HDL, LDL/HDL, and ApoB levels were positively associated with coronary plaque burden. While conventional lipid parameters continue to serve well in cardiovascular risk assessment (CRA), ApoB presents a promising standalone marker for identifying atherogenic risk and may serve as a practical alternative in clinical practice. Show less

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Lipid biomarkers, including direct low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1), are essential tools for cardiovascular risk assessment. Monitoring patient-derived median values over time may provide insights into population health and analytical performance. This study provides a descriptive analysis of population-level lipid results spanning nearly two decades. While trends in patient medians may support quality assurance, these data do not constitute a validated approach to risk prediction or definitive analytical monitoring due to the absence of outcome and treatment information. We retrospectively analyzed routine clinical laboratory data from Uppsala University Hospital, Sweden, covering January 2006-December 2024. A total of 890,948 LDL-C, 867,446 HDL-C, 64,787 ApoB, and 65,500 ApoA1 results were included. Measurements were performed on Abbott Architect systems until 2021, after which assays were transferred to Roche Cobas Pro platforms. Statistical analyses included trend evaluation, variability assessment, and seasonal pattern analysis. Women had modestly higher LDL-C and HDL-C levels compared to men, while ApoB values were similar between sexes. ApoA1 was notably higher in women. Over the 19-year period, median LDL-C declined from 3.18 to 2.62 mmol/L, consistent with improved lipid management. HDL-C remained stable (1.36-1.45 mmol/L), while ApoB and ApoA1 concentrations showed minimal change. Variability was highest for LDL-C (median CV 6.4%) and lowest for ApoA1 (median CV 2.6%). Seasonal variation was negligible across all analytes. Testing volumes increased substantially for LDL-C and HDL-C, whereas ApoB and ApoA1 requests peaked around 2010 and later declined. Long-term monitoring of median patient values demonstrates declining LDL-C, stable HDL-C, and consistent ApoB/ApoA1 ratios with minimal seasonal effects. These findings highlight the potential utility of patient medians as supplementary quality indicators and for population-level lipid surveillance. Show less

Cardiovascular disease (CVD) remains the leading cause of death worldwide, according to global statistics from the WHO and GBD, with the incidence of acute coronary syndromes (ACS) continuing to rise annually. This study aims to develop a nomogram model to predict the risk in ACS patients with hypertension, providing clinicians with a tool for early diagnosis, personalized treatment, and prognostic evaluation. Data were collected from ACS patients at Huangshi Aikang Hospital between 2018 and 2023. Patient characteristics, including age, sex, hypertension history, initial blood test results, and cardiac doppler ultrasonography findings, were recorded. ACS diagnosis followed the 2019 revised Guidelines for the Diagnosis and Treatment of Acute ST-Segment Elevation Myocardial Infarction (STEMI) by the Chinese Society of Cardiology. The 2024 Revised Guidelines for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes from the Chinese Journal of Cardiovascular Diseases were used for NSTEMI and unstable angina (UA) diagnoses. Statistical analyses were performed using SPSS (version 27.0.1) and R software (version 4.3.2), with statistical significance at P < 0.05. A total of 980 ACS patients were included in the study. Among the three clinical subtypes, 592 patients (60.4%) had UA, which was the most prevalent. The hypertensive group comprised 682 ACS patients (69.59%), with a mean age of 64.93 ± 9.51 years. Significant differences between hypertensive and non-hypertensive groups were found in sex (P = 0.001), age (P < 0.001), clinical subtype (P < 0.001), and several clinical and laboratory parameters, including creatinine (Cr) (P < 0.001), left ventricular ejection fraction (LVEF) (P = 0.049), left ventricular posterior wall thickness (LVPW) (P = 0.003), CK-MB (P = 0.019), AST (P = 0.028), total cholesterol (TC) (P = 0.035), LDL-C (P = 0.007), and APOB (P = 0.005). Using LASSO regression, nine variables were selected for multivariate logistic regression analysis, leading to the construction of the nomogram model. The calibration curve, Hosmer-Lemeshow test, ROC curve, decision curve, and clinical impact curve all demonstrated the model's high quality. A high-quality predictive nomogram model for assessing the risk of ACS in patients with hypertension has been developed. This model can assist clinicians in early diagnosis, personalized treatment, and prognostic evaluation. Show less