High HDL-C Levels Linked to Increased Risk of Osteosarcopenia in Older Adults: Study Finds

China: New research in adults aged 50 and older found that those with osteosarcopenia had higher serum high-density lipoprotein cholesterol (HDL-c) levels (1.65 ± 0.30 mmol/L) compared to individuals without the condition (1.49 ± 0.34 mmol/L). 

“Additionally, individuals in higher HDL-c quartiles exhibited a significantly greater incidence of osteosarcopenia, with odds ratios ranging from 2.72 to 3.66. This trend was consistent in both men and women,” the researchers reported in BMC Musculoskeletal Disorders. 

Osteoporosis and sarcopenia, common age-related conditions, significantly impact the health and quality of life in older adults. Osteosarcopenia, the coexistence of both, increases the risk of falls, fractures, and disability. Dyslipidemia, often seen in older adults, has been linked to both osteoporosis and sarcopenia, with conflicting results regarding HDL-c levels and bone mass. While some studies suggest that HDL-c is positively associated with bone density, others report conflicting findings. Additionally, recent research indicates that high HDL-c may not always protect against cardiovascular disease. However, studies exploring the relationship between HDL-c and osteosarcopenia remain scarce.

To fill this knowledge gap, Xiao Chen, Nanjing University of Chinese Medicine, Nanjing, China, and colleagues examined the relationship between serum high-density lipoprotein cholesterol (HDL-c) levels and osteosarcopenia.

For this purpose, the researchers included 1,995 participants aged 50 and older who underwent chest CT physical examinations between 2016 and 2019. Data collected from medical records included demographic details such as age, sex, body mass index, and laboratory results on liver and kidney function, blood lipids (HDL-c, LDL-c, triglycerides, total cholesterol), blood glucose, and serum albumin.

Osteosarcopenia was defined by low bone mass (bone CT values < 110 HU) and low muscle mass of the bilateral erector spinae (< 25.0 cm² in men and < 20.0 cm² in women). The relationships between HDL-c levels and osteosarcopenia were analyzed using multivariable logistic regression and restricted cubic spline analysis.

The study revealed the following findings:

  • 7.7% of patients were diagnosed with osteosarcopenia.
  • Patients with osteosarcopenia had significantly higher HDL-c levels than those without the condition (1.65 ± 0.30 versus 1.49 ± 0.34 mmol/L).
  • Multivariate logistic regression showed that HDL-c was associated with osteosarcopenia (OR = 2.72).
  • The third and fourth HDL-c quartiles were significantly associated with a higher incidence of osteosarcopenia than the first (OR = 3.36; OR = 3.66).
  • A similar trend was observed in males.
  • In females, the fourth HDL-c quartile was significantly associated with a higher incidence of osteosarcopenia compared to the first quartile (OR = 2.73).
  • Restricted cubic spline analysis showed similar relationships between HDL-c levels and osteosarcopenia.

“Our study found that individuals with osteosarcopenia had elevated levels of HDL-c and that HDL-c was positively associated with reduced muscle mass and osteosarcopenia, even after adjusting for factors like age, diabetes, BMI, and other potential confounders. Further research is required to determine a causal link and explore the underlying mechanisms through which HDL-c influences osteosarcopenia,” the researchers wrote.

Reference:

Wang, R., Wang, Y., Wei, Z. et al. The association between HDL-c levels and computed tomography-based osteosarcopenia in older adults. BMC Musculoskelet Disord 25, 932 (2024). https://doi.org/10.1186/s12891-024-08059-9

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Genetic Study Links Anterior Uveitis to Autoimmune Diseases

An international study led by the University of Oulu and Oulu University Hospital has identified six genetic regions associated with inflammation of the eye’s iris, known as anterior uveitis. The research also revealed a genetic correlation between anterior uveitis and inflammatory bowel diseases (IBD). These findings enhance our understanding of the mechanisms behind anterior uveitis and its connection to common autoimmune diseases.These findings contribute to a better understanding of the mechanisms behind anterior uveitis and its connection to common autoimmune diseases.

Each year, approximately 600 Finns are diagnosed with anterior uveitis. This is an intraocular inflammation that can occur at any age but is most common in individuals aged 20-50. Anterior uveitis is known to be associated with several autoimmune diseases, and certain tissue types may also predispose individuals to it. However, the precise mechanisms underlying the disease remain largely unknown, and the root cause often remains unclear.

The aim of the study was to investigate the genetic background of anterior uveitis, a field in which knowledge has been limited. This extensive international collaboration utilized biobank data from Finland, Estonia, and the United Kingdom, enabling comparisons between over 12,000 patients with anterior uveitis and nearly one million controls.

By analyzing genetic data, researchers identified six genetic regions associated with anterior uveitis, three of which had not been previously linked to the condition.

One intriguing finding was the genetic correlation between anterior uveitis and inflammatory bowel diseases (IBD). IBD includes ulcerative colitis, Crohn’s disease, and microscopic colitis. In Finland, more than 56,000 people live with IBD.

Another significant discovery was that all of the identified genetic regions associated with anterior uveitis had biologically relevant genes involved in immunity.

“For the first time, we were able to demonstrate that certain genetic regions are linked to anterior uveitis. This research enhances our understanding of the biological mechanisms contributing to anterior uveitis and its connection to autoimmune diseases. The findings may also open new perspectives for the development of treatments for anterior uveitis,” says lead researcher Fredrika Koskimäki from the University of Oulu.

Reference:

Koskimäki F, Ahokas O, Kajanne R, et alGenome-wide association study of anterior uveitisBritish Journal of Ophthalmology Published Online First: 27 December 2024. doi: 10.1136/bjo-2024-326037

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Acetaminophen with ibuprofen therapy effective in febrile children: Study

A new study published in the journal of Pediatrics showed that when treating children with fever, combination therapy may be more effective than monotherapy. Since fever is a common early clinical sign of acute infections, it has long been a symptom of great worry to parents and clinicians. Parents frequently experience worry and anxiety when their child has refractory fever, which is characterized by a poor response to an antipyretic medication or a fever return prior to the next pharmacological dose.

Despite worries about possible medication toxicity and negative interactions, children with refractory fever have been treated in practice using a regimen of alternating acetaminophen and ibuprofen at various doses and intervals. Also, the safety of alternating antipyretic treatment has not yet been shown, and the risk of improper and excessive administration is increased by the probability that parents may not comprehend dosage recommendations. It is unclear if the effects and safety of acetaminophen and ibuprofen as single or dual (alternating or combination) therapy are comparable. Thus, using a systematic review and network meta-analysis, Juan and his colleagues carried out this study to evaluate the relative effectiveness of acetaminophen, ibuprofen alone, alternating, or in combination.

From the beginning until September 20, 2023, Embase, Medline and CENTRAL were examined for this investigation. Randomized studies comparing the use of acetaminophen, ibuprofen, both alternating and both combined, to treat fever in children were carefully validated. The study used the random-effects model for both pairwise and network meta-analysis.

There were 31 trials (5009 children) in this research. In terms of the percentage of afebrile children in the 4th hour, this study discovered that ibuprofen at a high dose may be equivalent to acetaminophen (OR, 0.98; CI, 0.63–1.59), while combined and alternating therapy (OR, 0.20; CI, 0.06–0.63) may be preferable. At the 6th hour, these outcomes were comparable. Regarding adverse events, there were no differences between ibuprofen (low or high dosage), alternating, or coupled with acetaminophen.

When it came to managing fever in children, dual therapy could be better than solo ones. And in the case of treating afebrile kids between four and six hours, acetaminophen might not be as effective as alternate or combination therapy. Acetaminophen performed similarly to ibuprofen at 6 hours but worse than ibuprofen alone at 4 hours.

Reference:

De la Cruz-Mena, J. E., Veroniki, A.-A., Acosta-Reyes, J., Estupiñán-Bohorquez, A., Ibarra, J. A., Pana, M. C., Sierra, J. M., & Florez, I. D. (2024). Short-term Dual Therapy or Mono Therapy With Acetaminophen and Ibuprofen for Fever: A Network Meta-Analysis. In Pediatrics (Vol. 154, Issue 4). American Academy of Pediatrics (AAP). https://doi.org/10.1542/peds.2023-065390

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Regular dental flossing may lower risk of ischemic and cardioembolic stroke, reveals research

Flossing your teeth at least once a week may be linked to a lower risk of stroke caused by a blood clot blocking brain blood flow and irregular heartbeats, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2025. The meeting is in Los Angeles, Feb. 5-7, 2025, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“A recent global health report revealed that oral diseases-such as untreated tooth decay and gum disease-affected 3.5 billion people in 2022, making them the most widespread health conditions,” said study lead author Souvik Sen, M.D., M. S., M.P.H, chair of the Department of Neurology, Prisma Health Richland Hospital and the University of South Carolina School of Medicine in Columbia, South Carolina. “We aimed to determine which oral hygiene behavior-dental flossing, brushing or regular dentist visits-has the greatest impact on stroke prevention.”

The Atherosclerosis Risk in Communities (ARIC) study, one of the first large-scale investigations of this kind in the U.S., assessed the home use of dental floss through a structured questionnaire of more than 6,000 people. Among those who reported flossing, 4,092 had not experienced a stroke, and 4,050 had not been diagnosed with an irregular heartbeat known as atrial fibrillation (AFib).

Participants were asked about their status regarding high blood pressure, diabetes, high cholesterol, smoking, body mass index, education, regular brushing and dentist visits. During the 25 years of follow-up, 434 participants were identified as having strokes, of which 147 were larger artery brain clots, 97 were heart-driven clots and 95 were hardening of the smaller arteries. Additionally, 1,291 participants were noted to have experienced AFib.

The analysis found:

  • Flossing was associated with a 22% lower risk of ischemic stroke, 44% lower risk of cardioembolic stroke (blood clots traveling from the heart) and 12% lower risk of AFib.
  • The associated lower risk was independent of regular brushing and routine dental visits or other oral hygiene behaviors.
  • Increasing the frequency of flossing had a greater chance of stroke risk reduction.
  • Flossing was also associated with a lower chance of cavities and periodontal disease.

Researchers were surprised by the reduction of irregular heartbeats, or AFib. AFib is the most common form of irregular heartbeat. It can lead to stroke, heart failure or other cardiovascular complications. More than 12 million people are projected to have AFib in the United States by 2030, according to the American Heart Association’s 2025 Heart Disease and Stroke Statistics.

“Oral health behaviors are linked to inflammation and artery hardening. Flossing may reduce stroke risk by lowering oral infections and inflammation and encouraging other healthy habits,” Sen said. “Many people have expressed that dental care is costly. Flossing is a healthy habit that is easy to adopt, affordable and accessible everywhere.”

Study limitations include that data were based on answers to a questionnaire, and the 25-year follow-up appears to have focused on stroke and heart outcomes only. There was no follow-up concerning flossing or other oral behaviors over the years, Sen said.

“This study offers more insights into the specific dental health behaviors that may be linked to stroke risks and potential risk reduction. With further research, dental health practices could possibly be incorporated into the “Life’s Essential 8” risk factors, which include diet, physical activity, nicotine exposure, sleep, body mass index, blood pressure, blood glucose and blood lipids,” said Daniel T. Lackland, Dr.P.H., FAHA, American Heart Association EPI and Stroke Council member and professor of epidemiology and director of the Division of Translational Neurosciences and Population Studies in the department of neurology at the Medical University of South Carolina in Charleston. Lackland was not involved in this study.

Study background, and details:

  • The study began in 1987 and is ongoing.
  • Of the 6,258 participants, 82% were self-reported white adults and 18% Black adults. Their average age was 62 years and 55% were women.
  • Potential participants were excluded if they had total tooth loss, dental implants, heart disease, organ transplant, artificial joints, implanted heart valve or stent or major surgery.

Reference:

Regular dental flossing may lower risk of stroke from blood clots, irregular heartbeats, American Heart Association, Meeting: ASA International Stroke Conference 2025

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First Month and Fifth Year: Critical Time Points for Long-Term Sleeve Gastrectomy Outcomes, 13-Year Study Reveals

Greece: A recent retrospective study of patients who underwent sleeve gastrectomy (SG) has revealed two crucial time points in assessing the long-term clinical outcomes of this popular weight loss surgery: the first postoperative month and the fifth postoperative year. This study, which followed patients for up to 13 years after surgery, provides valuable insights into the timing and effectiveness of monitoring clinical responses to SG over an extended period. 

“We found that those with the best responses showed the highest percentage of excess body weight loss (%EWL) within the first month. After the fifth postoperative year, %EWL declined in partial responders, while it remained relatively stable in good responders,” the researchers reported in the journal Obesity Surgery.

The researchers note that weight loss after sleeve gastrectomy shows considerable long-term variation, with the mechanisms behind suboptimal clinical response (SCR) and recurrent weight gain (RWG) requiring further investigation. Dimitrios Kehagias, Department of Surgery, University General Hospital of Patras, Patras, Greece, and colleagues retrospectively analyzed weight-loss trajectories to identify key time points, aiming to optimize follow-up strategies and inform future prospective research.

For this purpose, the researchers conducted a single-center, retrospective study involving 104 patients who underwent sleeve gastrectomy (SG). Excess body weight loss was measured at multiple time points: 1, 3, 6, 12, 24, 60 months, and 160.4 ± 16 months. Recurrent weight gain was defined as the difference between the current body mass index (BMI) and the minimum BMI achieved postoperatively. Based on clinical response, patients were categorized into three groups: good responders (Group A: %EWL ≥ 50 and RWG < 5 kg/m²), partial responders (Group B: %EWL ≥ 50 and RWG ≥ 5 kg/m²), and weak responders (Group C: %EWL < 50).

The study revealed the following findings:

  • In the first postoperative month, good responders achieved the highest %EWL of 24.4 ± 6.5, significantly higher than the other two groups.
  • After 24 months, all patients exhibited a decrease in %EWL.
  • Good and partial responders followed a similar pattern of weight loss until the fifth year.
  • After the fifth year, %EWL significantly decreased in partial responders.
  • In contrast, %EWL remained relatively stable in good responders.

The study showed the importance of targeted follow-up and intervention during these key time points to maximize the long-term success of sleeve gastrectomy.

The findings highlight that the first postoperative month and the fifth postoperative year are critical time points for evaluating long-term clinical outcomes following sleeve gastrectomy.

“Healthcare providers can improve patient outcomes and support sustained weight management by focusing on these critical periods,” the researchers concluded.

Reference:

Lampropoulos, C., Kehagias, D., Bellou, A. et al. Critical Time Points for Assessing Long-Term Clinical Response After Sleeve Gastrectomy—A Retrospective Study of Patients with 13-Year Follow-Up. OBES SURG (2025). https://doi.org/10.1007/s11695-024-07659-7

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Medical colleges accused of forcing PG residents to opt for hostels, doctors seek Minister’s help

Pointing out that staying in the medical college hostels is not mandatory for the resident doctors, the doctors have alleged that many medical colleges across the country are forcing the resident doctors to opt for hostel stay.

Raising this issue, the doctors under the Indian Medical Association Junior Doctors’ Network IMA JDN recently wrote to the Union Health Minister Shri J P Nadda urging him to take cognisance of the issue and intervene immediately to enforce uniform compliance with NMC regulations across all medical institutes in India.

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HC Imposes Rs 1 Lakh Fine on Medical College, Principal for Illegal Cancellation of MBBS Admission

Taking action against the illegal cancellation of admission of an MBBS aspirant, the Punjab and Haryana High Court slapped a fine of Rs 1 lakh on the Government Medical College, Amritsar and its principal.

Apart from this, the HC bench of Chief Justice Sheel Nagu and Sumeet Goel also directed the Punjab Government to pay Rs 50,000 compensation to the petitioner student, while clarifying that the amount can be recovered from the officials who made the mistake.

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Glenmark Pharmaceutical Gets CDSCO Panel Nod To Import and Market Anti-cancer Drug Tislelizumab

New Delhi: Drug major Glenmark Pharmaceutical has got the go-ahead from the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) to import and market the anti-cancer drug Tislelizumab Injection 100mg (10ml)/Vial with waiver of local clinical trials.

This came after the firm presented the safety and efficacy data of 28 Indian patients with non-small cell lung cancer (NSCLC) and head neck squamous cell cancer (HNSCC) participated in the Global Clinical Trial (GCT).

However, this approval is subject to a condition to conduct a Phase IV clinical trial in India for both the proposed indications.

Tislelizumab is an IgG4 variant monoclonal antibody against PD-1 indicated for the treatment of unresectable, locally advanced or metastatic esophageal squamous cell carcinoma.

Tislelizumab is a humanized monoclonal IgG4 antibody against programmed death receptor-1 (PD-1). It was engineered to have a nullified Fc portion, thus minimizing binding to FcγR on macrophages and limiting treatment resistance via antibody-dependent phagocytosis. By blocking PD-L1/PD-L2–mediated cell signaling, tislelizumab restores T-cell function through cytokine production, resulting in immune-mediated antitumor responses. Tislelizumab is generally well tolerated with manageable and mild-to-moderate adverse effects.

At the recent SEC meeting for oncology held on January 16, 2025, the expert panel reviewed the safety and efficacy data of 28 Indian patients in non-small cell lung cancer (NSCLC) and head neck squamous cell cancer (HNSCC) participated in the Global Clinical Trial (GCT).

The Committee noted that the drug is approved in the USA, Europe, the United Kingdom, Australia, China, and other countries. The expert panel further noted that the proposed indications come under the category of orphan drugs, and there is an unmet medical need in the country.

After detailed deliberation, the committee recommended the grant of permission to import and market the drug with waiver of local clinical trials with the condition to conduct Phase IV clinical trials in India for both the proposed indications.

Accordingly, the expert panel suggested that the firm submit the Phase IV Clinical Trial protocol to CDSCO within 3 months of the grant of marketing authorization.

Also Read: Sanofi Healthcare India gets CDSCO Panel nod to study Nirsevimab

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