Comparison of fasting and non-fasting lipid profiles in a large cohort of patients presenting at a community hospital

Objective: To compare the fasting and non-fasting lipid profile including ApoB in a cohort of patients from a community setting. Our purpose was to determine the proportion of results that could be explained by the known biological variation in the fasting state and to examine the additional impact of non-fasting on these same lipid parameters. Methods: 1093 adult outpatients with fasting lipid requests were recruited from February to September 2016 at the blood collection sites of the Moncton Hospital. Participants were asked to come back in the next 3–4 days after having eaten a regular breakfast to have their blood drawn for a non-fasting lipid profile. Results: 91.6% of patients in this study had a change in total cholesterol that fell within the biological variation expected for this parameter. Similar results were seen for HDL-C (94.3%) non-HDL-C (88.8%) and ApoB (93.0%). A smaller number of patients fell within the biological variation expected for TG (78.8%) and LDL-C (74.6%). An average TG increase of 0.3 mmol/L was observed in fed patients no matter the level of fasting TG. A gradual widening in the range of change in TG concentration was observed as fasting TG increased. Similar results were seen in diabetic patients. Conclusion: Outside of LDL-C and TG, little changes were seen in lipid parameters in the postprandial state. A large part of these changes could be explained by the biological variation. We observed a gradual widening in the range of increase in TG for patients with higher fasting TG. Non-HDL-C and ApoB should be the treatment target of choice for patients in the non-fasting state

The Effect of triglyceride concentration on attainment of lipid targets in patients with diabetes

Objectives: To evaluate the effects of triglyceride (TG) and glycated hemoglobin (A1C) concentrations in the percentage of patients with diabetes who are within target (WT) for low-density lipoprotein-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C) and apolipoprotein B (ApoB), as defined by the Canadian Lipid Guidelines, in a cohort of outpatients presenting at a 350-bed community hospital. Methods: Laboratory samples from 1919 patients, 18 years or older, who had A1C levels of 6.5% or above were used. Fasting lipid profiles were retrieved, and ApoB was measured. Results: We found no significant difference in the percentage of those WT for LDL-C as TG increased from normal to intermediate and high levels. For non-HDL-C, we saw a substantial decrease in the percentage of patients WT as TG levels increased from normal (61%) to intermediate (30.4%) and high levels (14.0%). ApoB showed a similar pattern to non-HDL-C: decreasing from normal (68.8%) to intermediate (40.7%) and high levels (21.0%). No significant difference was seen in the percentage of patients WT for the 3 lipid parameters studied with the increase in A1C levels. Conclusions: As TG increases, we saw discordance in the percentage of patients WT for LDL-C in relation to non-HDL-C and ApoB. Alternative targets to LDL-C should preferentially be used when the TG concentration is elevated.Objectifs : Évaluer les effets des concentrations de triglycérides (TG) et d’hémoglobine glyquée (A1C) dans le pourcentage des patients diabétiques qui sont à l’intérieur des cibles (IC) pour le cholestérol des lipoprotéines de faible densité (cholestérol LDL), le cholestérol non–HDL et l’apolipoprotéine B (ApoB), selon les lignes directrices canadiennes sur les lipides, chez une cohorte de patients en consultation externe qui se présentent dans un hôpital communautaire de 350 lits. Méthodes : Des échantillons sanguins de 1919 patients de 18 ans et plus qui avaient des concentrations d’A1C de 6,5 % ou plus ont été utilisés. Les profils lipidiques à jeun ont été récupérés et l’ApoB a été mesurée. Résultats : Nous n’avons observé aucune différence significative dans le pourcentage de ceux IC quant au cholestérol LDL alors que les TG passaient de concentrations normales à des concentrations intermédiaires et élevées. Quant au cholestérol non–HDL, nous avons constaté une diminution substantielle dans le pourcentage de patients IC alors que les concentrations de TG passaient de concentrations normales (61 %) à des concentrations intermédiaires (30,4 %) et élevées (14,0 %). L’ApoB a montré des profils similaires à ceux du cholesterol non-HDL: diminution des patients IC alors que les concentrations de TG passaient de normales (68.8%) à intermédiaire (40.7%) et élevées (21.0%). Aucune différence significative dans les 3 paramètres du bilan lipidique étudiés n’a été observée dans le pourcentage de patients IC lors de l’augmentation des concentrations de l’A1C

Learning Atmosphere and Ethical Behavior, Does It Make Sense?

In the wake of corporate ethical scandals that have harmed millions of employees and investors, there has been an increase in the number of works written in the last decade, which aim to answer one apparently simple question: what causes unethical behavior, and what can we do, if anything, to prevent similar transgressions in the future? The extensive research around this question is the best proof of its real complexity as the challenge of disentangling the background of ethical behavior has obvious academic and practical interest. This study aims to take a further step toward that goal. Much research has noted the impact of multiple aspects of organizational contexts on individuals’ ethical behavior. However, studies that analyze the impact of organizational learning capability (OLC) on employees’ ethical behavior are few and far between. This was the first aim of this study. The second centered on gaining a deeper understanding of the relationship between OLC and ethical behavior by analyzing the mediating role of employability and organizational commitment. We tested our hypotheses through a structural equation methodology applied to a sample of 641 workers from 166 Spanish consultancy firms and found a positive, direct relationship between OLC and employability, OLC and organizational commitment, employability and organizational commitment, and organizational commitment and ethical behavior