Changes In Total Cholesterol Levels Research Articles

Changes in metabolic parameters and serum YKL-40 levels in Chinese rheumatoid arthritis patients during tocilizumab therapy.

To investigate the metabolic changes during therapy of tocilizumab (TCZ) and methotrexate (MTX) in non-diabetic rheumatoid arthritis (RA) patients and for the first time explore the associations between metabolic parameters and serum YKL-40 (sYKL-40) levels. We enrolled active non-diabetic RA patients who were refractory to MTX. Patients received intravenous TCZ (8mg/kg) once every 4weeks combined with MTX for 24weeks. Metabolic parameters and sYKL-40 levels were measured before TCZ infusion at baseline, week 4, week 12, and week 24. Correlations were assessed by the Spearman's rank correlation analysis. A total of 91 non-diabetic RA patients were enrolled in this study. At week 24, we observed a significant elevation in body mass index (BMI), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) levels. In contrast, there was a significant decrease in TC/HDL‑C ratio. No apparent changes in insulin resistance were found. Additionally, we detected a significant reduction in sYKL-40 levels during the study. At week 24, changes in sYKL-40 levels showed a significant negative correlation (r = -0.334, p = 0.002) with changes in TC levels. The combined therapy of TCZ and MTX resulted in a significant increase in BMI and lipid levels, while an evident decrease in the TC/HDL‑C ratio and sYKL-40 levels in RA patients. Additionally, there was a significant correlation between the decrease in sYKL-40 levels and the increase in TC levels during treatment with TCZ and MTX. Key Points • Lipid levels elevated significantly and sYKL-40 levels decreased obviously after therapy of TCZ combined with MTX in Chinese RA patients. • There was a significant correlation between the increase in TC levels and the decrease in sYKL-40 levels during treatment with TCZ and MTX in RA patients.

Improving mental health in chronic care in general practice: study protocol for a cluster-randomised controlled trial of the Healthy Mind intervention

BackgroundMental health issues are common among patients with chronic physical conditions, affecting approximately one in five patients. Poor mental health is associated with worse disease outcomes and increased mortality. Problem-solving therapy (PST) may be a suitable treatment for targeting poor mental health in these patients. This study protocol describes a randomised controlled trial of the Healthy Mind intervention, a general practice-based intervention offering PST to patients with type 2 diabetes and/or ischaemic heart disease and poor mental well-being.MethodsA stepped-wedge cluster-randomised controlled trial with 1-year follow-up will be conducted in Danish general practice. At the annual chronic care consultation, patients with type 2 diabetes and/or chronic ischaemic heart disease will be screened for poor mental well-being. Patients in the control group will be offered usual care while patients in the intervention group will be offered treatment with PST provided by general practitioners (GPs) or general practice staff, such as nurses, who will undergo a 2-day PST course before transitioning from the control to the intervention group. The primary outcome is change in depressive symptoms after 6 and 12 months. Secondary outcomes include change in mental well-being, anxiety, and diabetes distress (patients with type 2 diabetes) after 6 and 12 months as well as change in total cholesterol levels, low-density lipoprotein (LDL) levels, and blood glucose levels (patients with diabetes) after 12 months. Process outcomes include measures of implementation and mechanisms of impact. We aim to include a total of 188 patients, corresponding to approximately 14 average-sized general practices.DiscussionThe Healthy Mind trial investigates the impact of PST treatment for patients with chronic disease and poor mental well-being in general practice. This will be the first randomised controlled trial determining the effect of PST treatment for patients with chronic diseases in general practice. The results of this study will provide relevant insights to aid GPs, and general practice staff manage patients with poor mental well-being.Trial registrationClinicalTrials.gov NCT05611112. Registered on October 28, 2022.

Effectiveness and safety of the combination of sodium-glucose transport protein 2 inhibitors and glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies.

Randomized controlled trials and real-world studies suggest that combination therapy with sodium-glucose transport protein 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) is associated with improvement in fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), body mass index (BMI), and total cholesterol levels. However, a systematic review of available real-world evidence may facilitate clinical decision-making in the real-world scenario. This meta-analysis assessed the safety and effectiveness of combinations of SGLT2is + GLP-1RAs with a focus on their cardioprotective effects along with glucose-lowering ability in patients with type 2 diabetes mellitus (T2DM) in a real-world setting. Electronic searches were performed in the PubMed/MEDLINE, PROQuest, Scopus, CINAHL, and Google Scholar databases. Qualitative analyses and meta-analyses were performed using the Joanna Briggs Institute SUMARI software package and Review Manager v5.4, respectively. The initial database search yielded 1445 articles; of these, 13 were included in this study. The analyses indicated that SGLT2is + GLP-1RAs combinations were associated with significantly lower all-cause mortality when compared with individual therapies (odds ratio [95% confidence interval [CI] 0.49 [0.41, 0.60]; p < 0.00001). Significant reductions in BMI (- 1.71 [- 2.74, - 0.67]; p = 0.001), SBP (- 6.35 [- 10.17, - 2.53]; p = 0.001), HbA1c levels (- 1.48 [- 1.75, - 1.21]; p < 0.00001), and FPG (- 2.27 [- 2.78, - 1.76]; p < 0.00001) were associated with the simultaneous administration of the combination. Changes in total cholesterol levels and differences between simultaneous and sequential combination therapies for this outcome were not significant. This systematic review and meta-analysis based on real-world data suggests that the combination of SGLT2is + GLP-1RAs is associated with lower all-cause mortality and favorable improvements in cardiovascular, renal, and glycemic measurements. The findings drive a call-to-action to incorporate this combination early and simultaneously in managing T2DM patients and achieve potential cardiovascular benefits and renal protection.

Changes in total cholesterol level and cardiovascular disease risk among type 2 diabetes patients

Despite many diabetic patients having hypercholesterolemia, the association of total cholesterol (TC) levels with CVD risk in type 2 diabetes (T2D) patients is unclear. Diagnosis of type 2 diabetes often leads to changes in total cholesterol (TC) levels. Thus, we examined whether changes in TC levels from pre- to post-diagnosis of T2D were associated with CVD risk. From the National Health Insurance Service Cohort, 23,821 individuals diagnosed with T2D from 2003 to 2012 were followed-up for non-fatal CVD incidence through 2015. Two measurements of TC, 2 years before and after T2D diagnosis, were classified into 3 levels (low, middle, high) to define changes in cholesterol levels. Cox proportional hazards regression was performed to estimate adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs) for the associations between changes in cholesterol levels and CVD risk. Subgroup analyses were performed by use of lipid-lowering drugs. Compared with low–low, aHR of CVD was 1.31 [1.10–1.56] for low–middle and 1.80 [1.15–2.83] for low–high. Compared with middle–middle, aHR of CVD was 1.10 [0.92–1.31] for middle–high but 0.83 [0.73–0.94] for middle–low. Compared with high–high, aHR of CVD was 0.68 [0.56–0.83] for high–middle and 0.65 [0.49–0.86] for high–low. The associations were observed regardless of use of lipid-lowering drugs. For diabetic patients, management of TC levels may be important to lower CVD risk.

Uji Efektivitas Penurunan Kadar Kolesterol Total Ekstrak Etanol Kulit Batang Mangkokan Terhadap Tikus Jantan Putih

Hypercholesterolemia is a condition in which cholesterol levels in the blood are more than normal. Europe and America are the regions with the highest hypercholesterolemia in the world with prevalence values ​​of 54% and 48%, respectively. Meanwhile, Africa and Southeast Asia are regions with the lowest prevalence of hypercholesterolemia with prevalence values ​​of 23% and 30%, respectively. In Indonesia, the age group of 25 - 34 years has the highest rank with high cholesterol levels. The purpose of this study was to determine the effect of lowering total cholesterol in male white rats (Rattus norvegicus) induced with Propylthiouracil (PTU). In this study, we used 25 rats which were divided into 5 groups equally. The groups were a negative control group (Na-CMC), a positive control group (Simvastatin), and three extract groups with doses of 500 mg/kgBW, 750 mg/kgBW, and 900 mg/kgBW. We made the ethanol extract of the bark of the Mangkokan stem by maceration. We induced all mice used in the study orally using a high-fat diet and PTU. In this study, the parameters that we studied were total cholesterol levels before induction, after induction, and after treatment. From this study, we found that all groups showed significant changes in total cholesterol levels (P value = 0.000). The group that was given ethanol extract at doses of 500 and 750 mg/kgBW showed a significant difference between the negative control group and the positive control group. Only the 900 mg/kgBW dose group showed no significant difference in total cholesterol levels with the positive control group. Thus, we can conclude that the ethanolic extract of the bark of the Mangkokan stem has the potential to reduce total cholesterol levels but is not as good as the positive control.&#x0D; Kata kunci : Kadar kolesterol total, Kulit batang mangkokan, PTU

Effect of Vitamin E on Clinical Outcomes in Patients With Non-alcoholic Fatty Liver Disease: A Meta-Analysis.

The aim of the current meta-analysis was to assess the effects of vitamin E on clinical outcomes in individuals with non-alcoholic fatty liver disease (NAFLD). The current meta-analysis was planned, reported, and conducted per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two authors systematically searched for all papers using PubMed,Cochrane Central Register, and Embase from inception to October 15, 2022. Outcomes assessed in the current meta-analysis included changes in alanine transaminase (ALT) and aspartate transaminase (AST) from baseline in IU/L. Other outcomes included a change in BMI (kg/cm2), a change in total cholesterol level from baseline (mg/l), and a fibrosis score. Total articles were included in the current meta-analysis, enrolling 569 patients (274 patients in the vitamin E group and 295 in the placebo group). The study found that reduction in ALT levels, AST levels, and BMI was significantly greater in patients in the vitamin E group compared to the placebo group. However, no significant differences were reported in terms of change in fibrosis score and total cholesterol.

Yoghurt Kacang Merah (phaseolus vulgaris l.) Efektif Menurunkan Kadar Kolesterol Total Penderita Hiperkolesterolemia

Cardiovascular disease is the number one cause of death in the world, one of the factors is hypercholesterolemia which causes thickening of artery walls, resulting in atherosclerosis. The management of hypercholesterolemia is done non-pharmacologically, namely medical nutritional therapy using functional food ingredients, red beans and probiotics containing isoflavones and BAL compounds that can reduce total cholesterol levels. This research aims the effectiveness of giving red bean yoghurt of total cholesterol levels in patients with hypercholesterolemia. This study used a Quasy experiment with pre-post test design, from February 2019 to May 2020 in all patients with hypercholesterolemia in the working area of ​​Nanggalo Public Health Center. The number of samples were 15 cases given red bean yoghurt and 15 controls given 225 mL of probiotic yoghurt for 14 days and were taken by purposive sampling. The data taken is the results of initial and final cholesterol examination of hypercholesterolemia patients, analyzed by T-Test Dependent and Mann Whitney. The results showed an average decrease in total cholesterol levels of respondents given red bean yogurt 40.87 mg/dL and probiotic yogurt 15.47 mg/dL. Statistical test results showed there were significant differences between changes in total cholesterol levels of respondents who were given red bean yoghurt and probiotic yoghurt (p = 0.00). Red bean yoghurt is effective in reducing cholesterol levels so that red bean yogurt can be used as an alternative treatment for cholesterol-lowering.

Quercetin supplementation alters adipose tissue and hepatic transcriptomes and ameliorates adiposity, dyslipidemia, and glucose intolerance in adult male rats.

Quercetin, a flavonoid present in many fruits and vegetables, exhibits beneficial effects toward abnormalities related to metabolic syndrome. In this study, to further investigate metabolic and transcriptomic responses to quercetin supplementation, we used a genetic model of metabolic syndrome. Adult male rats of the PD/Cub strain were fed either a high-sucrose diet (HSD; control PD rats) or HSD fortified with quercetin (10 g quercetin/kg diet; PD-Q rats). Morphometric and metabolic parameters, along with transcriptomic profiles of the liver and retroperitoneal fat, were assessed. The relative weights of epididymal and retroperitoneal fat were significantly decreased in quercetin-treated animals. Furthermore, a smaller area under the glycemic curve along with a decreased level of fasting insulin were detected in PD-Q rats. While no changes in total cholesterol levels were observed, the overall level of triglycerides decreased in the serum and the liver of the PD-Q rats. The transcriptomic profile of the liver and the adipose tissue corroborated the metabolic and morphometric findings, revealing the pattern consistent with insulin-sensitizing changes, with major regulator nodes being Pparg, Adipoq, Nos2, and Mir378. In conclusion, quercetin supplementation improves abnormalities related to metabolic syndrome, namely adiposity, dyslipidemia and glucose intolerance.

Replacing saturated fatty acids with polyunsaturated fatty acids increases the abundance of Lachnospiraceae and is associated with reduced total cholesterol levels-a randomized controlled trial in healthy individuals.

BackgroundImproving dietary fat quality strongly affects serum cholesterol levels and hence the risk of cardiovascular diseases (CVDs). Recent studies have identified dietary fat as a potential modulator of the gut microbiota, a central regulator of host metabolism including lipid metabolism. We have previously shown a significant reduction in total cholesterol levels after replacing saturated fatty acids (SFAs) with polyunsaturated fatty acids (PUFAs). The aim of the present study was to investigate the effect of dietary fat quality on gut microbiota, short-chain fatty acids (SCFAs), and bile acids in healthy individuals. In addition, to investigate how changes in gut microbiota correlate with blood lipids, bile acids, and fatty acids.MethodsSeventeen participants completed a randomized, controlled dietary crossover study. The participants received products with SFAs (control) or PUFAs in random order for three days. Fecal samples for gut microbiota analyses and fasting blood samples (lipids, fatty acids, and bile acids) were measured before and after the three-day intervention.ResultsOf a panel of 40 bacteria, Lachnospiraceae and Bifidobacterium spp. were significantly increased after intervention with PUFAs compared with SFAs. Interestingly, changes in Lachnospiraceae, as well as Phascolarlactobacterium sp. and Eubacterium hallii, was also found to be negatively correlated with changes in total cholesterol levels after replacing the intake of SFAs with PUFAs for three days. No significant differences in SCFAs or bile acids were found after the intervention.ConclusionReplacing SFAs with PUFAs increased the abundance of the gut microbiota family of Lachnospiraceae and Bifidobacterium spp. Furthermore, the reduction in total cholesterol after improving dietary fat quality correlated with changes in the gut microbiota family Lachnospiraceae. Future studies are needed to reveal whether Lachnospiraceae may be targeted to reduce total cholesterol levels.Trial registrationThe study was registered at Clinical Trials (https://clinicaltrials.gov/, registration identification number: NCT03658681).

Identification of Factors Influencing Cholesterol Changes in Elementary-School Children: A Longitudinal Study.

Changes in serum cholesterol levels during childhood may affect the risk of cardiovascular disease in adulthood. However, cholesterol level changes in Japanese children and adolescents and the factors that influence them have not been completely elucidated. This study aimed to determine whether cholesterol levels changed due to the effects of growth and identify factors. This cohort study included elementary-school children in the fourth grade (9–10-year-old) who underwent assessments of cholesterol levels and demographic and lifestyle characteristics. The participants were followed up in their first year of junior high school with the same laboratory, demographic, and lifestyle assessments. From the fourth year of elementary school to the first year of junior high school, children’s cholesterol levels decreased (p < 0.0001). Regarding bowel movements, cholesterol level reduction was significant in individuals with regular bowel movements but not significant in those with infrequent bowel movements. Weight was the factor that most strongly negatively predicted cholesterol level reduction (p < 0.001). The study demonstrated the significance of lifestyle factors for growth-related changes of total cholesterol levels and identified weight as the factor that most strongly influenced total cholesterol level changes. Guidance regarding lifestyle improvements should be imparted to children from the fourth grade of elementary school.

IDF21-0546 Impact of alpha lipoic acid supplementation in metabolic parameters of patients with prediabetes

Background: Prediabetes, defined as IFG and/or IGT and/or HbA1c levels within 5.7–6.4% (39–47 mmol/mol), usually precedes the diagnosis of diabetes mellitus in adults and the in latest years its prevalence has been rising in numbers compared to the previous years, due to various factors. The importance of prediabetes diagnosis lies in the fact that if untreated it shows an increased rate of new onset diabetes mellitus type 2 and may also lead to the development of diabetes’ complications. Prediabetes, according to ADA, can and should be prevented through a series of diagnostic tests that have proven to be cost-effective and the use of the ADA Risk Test, and if developed there have been various treatment methods proposed, such as lifestyle modifications, use of metformin and certain dietary supplements that may take part in reducing insulin resistance, including chromium, alpha-lipoic acid (ALA), etc. Aim: Main aim of this study is to define whether alpha-lipoic acid (ALA) supplementation in adults with glucose metabolism abnormalities, defined as “prediabetes”, has an impact on their metabolic factors. The study was sponsored by “Medical Pharmaquality” Company. Method: This study included people aged 18–65, presenting at least one of ADA’s criteria for prediabetes diagnosis, leading a sedentary lifestyle, presenting with a BMI > 25 kg/m2 and showing no symptoms of depressive disorders. All subjects received a 600 mg ALA supplement daily for 90 days and they were tested for total blood count, Hba1C, fasting blood sugar and insulin levels, total cholesterol, HDL, LDL, triglycerides, fasting c-peptide, HOMA-IR, Matsuda index, AUC for glucose and insulin curves, body weight, BMI, fat percentage and visceral fat rating, before and after the intervention. Results: ALA supplementation seems to have a strong correlation with changes in total cholesterol levels (p = 0.005), HDL (p = 0.049) and c-peptide (p = 0.013). Furthermore, a statistically significant reduction in body weight was observed (p < 0.001), as well as in BMI (p < 0.001), fat percentage (p < 0.001) and visceral fat rating (p < 0.001). The rest of the tested variables did not exhibit statistically significant changes, following ALA supplementation. Discussion: The results of this study are in complete agreement with ALA’s perceived actions on the adipose tissue, although the strong correlation between ALA supplementation and visceral fat rating reduction has not been reported before. Additionally, the observed reduction in fasting c-peptide levels is a finding that supports the assumption that ALA can lead to reduction in resting hyperinsulinemia levels in prediabetes.

Change in cholesterol level during pregnancy and risk of postpartum depressive symptoms: the Japan Environment and Children's Study (JECS).

ObjectiveWomen with postpartum depressive symptoms (PDS) are at higher risk of postpartum depression (PPD) and require further assessment. Emerging evidence indicates a relationship between the total cholesterol (TC) level of blood and PPD but the results are inconsistent. In this study, we investigated the possible association of change in serum TC levels during pregnancy with the risk of PDS in a Japanese population.MethodsWe analyzed complete data on questionnaire responses and serum lipid profiles of pregnant women from 12 datasets obtained from the Japan Environment and Children's Study (n = 61,585 to n = 72,406; 103,063 pregnancies in total). TC was measured at 3 time points—during early pregnancy, during mid‐late pregnancy, and after delivery—and we calculated changes in TC in 3 ways: by subtracting early pregnancy from mid‐late pregnancy, subtracting mid‐late pregnancy from delivery, and subtracting early pregnancy from delivery. These 6 factors were used as predictors to estimate the risk of PDS at 1 and 6 months after delivery.ResultsIn multivariable logistic regression analysis, point serum cholesterol level did not predict PDS at any time point except for during mid‐late pregnancy in the second quintile, indicating an increased risk at 6 months. As for change in TC levels, subtracting mid‐late pregnancy from delivery and early pregnancy from delivery showed significant risk reduction for PDS at 1 month. A significant risk reduction was also found for subtracting early pregnancy from mid‐late pregnancy and early pregnancy from delivery at 6 months.ConclusionsIncreased cholesterol level during pregnancy is associated with reduced risk of PDS.

Evaluation of a 10-week lifestyle and weight management programme on cardiovascular disease risk factors in a group of people living with obesity referred from a specialist bariatric clinic

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Service Executive Health and Wellbeing, Saolta University Healthcare Group OnBehalf Croí the West of Ireland Cardiac Foundation, Galway, Ireland and the National Institute for Prevention and Cardiovascular Health Introduction People living with obesity are at an increased risk of cardiovascular disease (CVD). While development of obesity is multifactorial, lifestyle modification is fundamental to obesity treatment and risk factor reduction. We sought to measure the effects of a structured lifestyle modification programme on the physical and mental health of people living with obesity. Purpose This study investigated the impact of a 10-week, community based, lifestyle modification programme on CVD risk factors in people living with obesity (BMI ≥35kg/m2 with a co-morbidity or BMI ≥40kg/m2) who were referred from a specialist bariatric service. Methods Delivered by an interdisciplinary team (Nurse, Dietitian &amp; Physiotherapist) the programme included weekly group-based exercise sessions and health promotion workshops. A wide range of topics were addressed in workshops, including nutrition, food labels, emotional eating, physical activity, sedentary behaviour, stress management and CVD risk factor reduction. Outcomes were measured at initial and end of programme assessments. Results 1122 people participated in the intervention between 2013 and 2019 with 78% (n = 877) completing the programme. At initial assessment 26.7% of participants had a diagnosis of type 2 diabetes; 37.3% were at high or very high risk of CVD; 44.7% were hypertensive and 31.4% had a history of depression. Mean BMI was 47.0kg/m2 with 56.4% of participants having a BMI &amp;gt;45kg/m2. The intervention had significant positive impacts on key outcomes such as psychosocial health, lipid profiles, blood pressure, adiposity and cardiovascular fitness. One of the most significant outcomes observed was the improvement in psycho-social health. Scores of anxiety and depression, assessed using the HADS, decreased by 1.5 and 2.2 points respectively (p &amp;lt;0.001). Mean EQ-VAS score increased by 11 points (p &amp;lt;0.001). There were significant changes in total cholesterol levels with a mean reduction in total cholesterol from 4.69mmol/l to 4.54mmol/l (p &amp;lt;0.001) and LDL cholesterol from 2.79mmol/l to 2.64mmol/l (p &amp;lt;0.001). There were also significant improvements in blood pressure with mean systolic blood pressure reducing by 15.7mmHg (p &amp;lt;0.001) and diastolic blood pressure reducing by 1.4mmHg (p &amp;lt;0.001). For people with type 2 diabetes, there was an increase in those achieving the recommended HbA1c target (&amp;lt;53mmol/l) from 47.6% to 57.4% (p &amp;lt;0.001). Mean reduction in bodyweight was 2.0kg (p &amp;lt;0.001), with 27.2% achieving a weight loss of &amp;gt;3% of initial bodyweight. The percentage of participants achieving the recommended physical activity guidelines increased by 31% (p &amp;lt;0.001). Conclusions A lifestyle modification programme delivered by an interdisciplinary team, aimed at individuals living with obesity, is not only acceptable to participants but also significantly reduces CVD risk factors. These findings should influence the design of future programmes and healthcare policies in Ireland and abroad.

Lipid intensive drug therapy for sepsis pilot: A Bayesian phase I clinical trial.

ObjectivesCholesterol may be protective in sepsis. Patients with early sepsis may have critically low cholesterol levels that are associated with poor outcomes. The study objective was to test the safety of a fish oil–containing lipid injectable emulsion for stabilizing early cholesterol levels in sepsis.MethodsPhase I Bayesian optimal interval design trial of adult patients with septic shock (Sequential Organ Failure Assessment score ≥4 or vasopressor dependence). Using sequential dose escalation, participants received 2 doses of 1.0 to 1.6 g/kg of lipid emulsion (Smoflipid 20% lipid emulsion) within 48 hours of enrollment. Cholesterol levels, function, and organ failure were assessed serially during the first 7 days of hospital admission.Measurements and Main ResultsA total of 10 patients with septic shock were enrolled. One patient withdrew for social reasons. Another patient had an unrelated medical complication and received 1 drug dose. Of 9 patients, mean age was 58 years (SD 16), median Sequential Organ Failure Assessment was 8, and 28‐day mortality was 30%. No serious adverse events related to lipid infusion occurred. The six occurrences of non‐serious adverse events possibly related to lipid infusion included hyperglycemia (1), elevated triglycerides (3), anemia (1), and vascular access redness/pain (1) for all doses. The mean change in total cholesterol levels from enrollment was −7 (SD 16.6) at 48 hours and 14 (SD 25.2) at 7 days.ConclusionsFish oil–containing lipid emulsion administration during early septic shock was safe. Further studies are needed to assess effects on cholesterol levels, function, and organ failure.Clinical Trial RegistrationNCT03405870.

Developing Herbal Medicine, The Role of β-1,3/1,6-D-Glucan Forms of Polysaccharide Peptide (PsP) from Mycelia Ganoderma lucidum Extracts for Lowering Elevated Total Cholesterol Level in Patients with Heart Failure in Ischaemic Heart Disease

High levels of total cholesterol can worsen the condition of ischemic heart failure. Polysaccharide peptide (PsP) is a capsule of Ganoderma lucidum extract. This study aims to measure changes in total cholesterol levels in patients with ischemic heart failure before and after the administration of PSP and Placebo and to analyze differences in decreases in total cholesterol levels between PSP and Placebo group. This research is a true experiment with a prospective double-blind randomized control method through pre-post test design. The sample consisted of 26 patients, divided into 2 groups and given PSP or placebo capsules per oral interventions carried out every day for 90 days. Venipuncture blood was taken before and after the intervention to measure total cholesterol levels by spectrophotometry methods. Paired T Test was used to determine the average reduction in total cholesterol levels for each group. Independent T Test was used to determine the difference of reduction in total cholesterol average between the two groups. The decrease of total cholesterol average level in PsP group was 24.3 mg/dl (p value 0.001) and an increase of Placebo group was 8.3 mg/dl (p value 0.099). Comparison of the average reduction in total cholesterol levels in PsP : Placebo group was 24.31: -8.31 mg/dl (p value 0.000). There was significant decrease total cholesterol levels in PsP group and neither was of the Placebo group. In addition, there was significant difference in the reduction of total cholesterol levels between PSP and Placebo group.

Research of relationship between thyroid-stimulating hormone level after surgery and hypercholesterolemia in female patients with differentiated thyroid cancer

Objective:To evaluate changes of postoperative thyroid-stimulating hormone（TSH） and total cholesterol（TC） levels in serum, and to analyze the risk of hypercholesterolemia in female patients with differentiated thyroid cancer（DTC） receiving levothyroxine after total thyroidectomy. Method:Female patients with DTC in the first affiliated hospital of hebei north university, who underwent total thyroidectomy, were analyzed retrospectively. All patients were divided into four groups according to follow-up TSH levels:<0.03 mIU/L, 0.03-0.29 mIU/L, 0.30-4.20 mIU/L and>4.20 mIU/L. Changes in TC levels before and after surgery were compared and the occurrence of hypercholesterolemia was analyzed. Result:The lower postoperative TSH level groups had higher preoperative TC levels than the higher TSH level groups. Compared with preoperative level, the TC levels remained unchanged in 0.03-0.29 mIU/L group, but decreased in <0.03 mIU/L group, and markedly increased in greater than 0.3 mIU/Lgroups with TSH levels after surgery. The preoperative-to-follow-up change in TC levels had positive correlation with follow-up TSH level. Compared with those with TSH levels of 0.03-0.29 mIU/L, the risk of TC marginal elevation and hypercholesterolemia in the patients with TSH of 0.30-4.20 mIU/L was found to be 1.16 times and 1.91 times higher, respectively. For patients with TSH levels of >4.2 mIU/L, the risk of TC marginal elevation and hypercholesterolemia was 1.29 times and 3 times, respectively. The increase in TSH was consistent with the increase in the incidence of hypercholesterolemia （P for trend=0.003）. Conclusion:Women with DTC who are using levothyroxine to maintain TSH after surgery should be aware of the risk of hypercholesterolemia due to inadequate replacement.

A Study on Effect of Melatonin in Dyslipidemia Caused by Experimentally Diabetes

In this study, it was aimed to determine the effects of melatonin application on lipid profile in streptozotocin-induced diabetic rats . Animals in control group were not any treatment. Melatonin group animals received 50 mg/kg melatonin intraperitoneally in daily for eight weeks. Diabetes was induced by subcutaneous injections of streptozotocin at dose of 40 mg/kg for two days as a single dose per day in diabetes group animals. Animals in Diabetes+Melatonin group were made diabetic by streptozotocin in the same way and then these animals received 50 mg/kg melatonin intraperitoneally in daily for eight weeks. In blood samples taken from all animals, TNF-α, triglyceride, total cholesterol, LDL and HDL were determined. In diabetes group, TNF-α level were high (p<0.05). The changes in TNF-α level with melatonin application to diabetic rats were important (p<0.05). In diabetic rats, triglyceride and LDL levels were found to be enhanced compared to control group (p<0.05), HDL level was significantly low (p<0.05), while the change in total cholesterol level was not important. With the melatonin application to diabetic rats, HDL level was found to be higher (p<0.05) and LDL level was lower than diabetes group (p<0.05). It was concluded that the administration of melatonin to streptozotocin-induced diabetic rats may have positive effects on lipid profile.

Difference of changes in total and triglyseride cholesterol levels of insulin monotherapy use with combination insulin and metformin therapy in type II diabetes mellitus patients

Backround: Diabetes mellitus (DM) is a degenerative disease predicted by WHO to increase in Indonesia from 8.4 million in 2000 to around 21.3 million in 2030. Diabetes mellitus is closely related to dyslipidemia which can increase the risk of coronary artery disease (CAD). Current DM treatment is using oral hypoglycemic drugs, insulin, or a combination of both. Many previous studies have not examined the effect of these therapies on lipid profiles, specifically total cholesterol and triglyceride levels. Objective: To determine the differences in changes in total cholesterol and triglyceride levels between the use of insulin monotherapy and combination therapy of insulin and metformin in patients with type II diabetes mellitus in Sleman Yogyakarta Hospital from January 2010 toJune 2012. Methods: This study was an observational analytic study using a retrospective cohort study method with samples (n = 64). Samples were taken by non-probability consecutive sampling, carried out in DM patients inpatient or outpatient at Sleman Yogyakarta Hospital for the period of January 2010 - June 2012. The samples were divided into two groups, insulin monotherapy group and insulin and metformin combination therapy group. The data taken was the total cholesterol and the first triglyceride level, then the second total cholesterol and triglyceride data were made after four months of getting therapy. Result: Analysis of statistical data using the Mann Whitney test for changes in total cholesterol levels in the two treatment groups showed p = 0.166, whereas for changes in triglyceride levels in the two treatment groups it was found that p = 0.840. Conclusion: There were no significant differences in changes in total cholesterol and triglyceride levels between the two treatment groups.

Evaluation of Oral Anti-HCV Therapy (OAT) Effects on Serum Lipids Profile in Diabetic Patients

to down regulation of cholesterol level. Interferon (INF) therapy has been shown to decrease cholesterol even further during treatment .With the availability of direct acting antiviral agents (DAAs) the effect of suppressing HCV on lipid metabolism warrantes re-evaluation. Aim of the work : goal of our study was evaluation the changes in lipid profile after treatment of chronic HCV infection with oral antiviral medications in diabetic patients. Methods: this prospective study conducted on 90 HCV infected patients, all patients received Sofosbuvir (SOF) & Daclatasvir (DCV) as a dual therapy for 3 months. They were divided according to the presence or absence of diabetes mellitus (DM) and hyperlipidemia into three main groups; Group I: included 30 diabetic hyperlipidemic patients, Group II: included 30 non-diabetic hyperlipidemic patients, Group III: included 30 non-diabetic non- dyslipidemia patients.Changes of lipid profile on treatment with DAAs were assessed by checking fasting lipid profile at base line, then at end of treatment, and finally 3 months after treatment. Results: there was a statistically significant increase in total cholesterol level (TCHOL) which was maintained after the end of therapy. Changes in TCHOL were driven by changes in low-density lipo-protein (LDL) cholesterol, whereas high-density lipo-protien (HDL) cholesterol and very low-density lipo-protein (VLDL) cholesterol showed no significant changes. There were also no significant changes in tryglyceride (TG) level on treatment. Conclusion: eliminating HCV with DAAs increased TCHOL but had no effect on TG level.

Evaluation of Oral Anti-HCV Therapy (OAT) Effects on Serum Lipids Profile in Diabetic Patients

to down regulation of cholesterol level. Interferon (INF) therapy has been shown to decrease cholesterol even further during treatment .With the availability of direct acting antiviral agents (DAAs) the effect of suppressing HCV on lipid metabolism warrantes re-evaluation. Aim of the work : goal of our study was evaluation the changes in lipid profile after treatment of chronic HCV infection with oral antiviral medications in diabetic patients. Methods: this prospective study conducted on 90 HCV infected patients, all patients received Sofosbuvir (SOF) & Daclatasvir (DCV) as a dual therapy for 3 months. They were divided according to the presence or absence of diabetes mellitus (DM) and hyperlipidemia into three main groups; Group I: included 30 diabetic hyperlipidemic patients, Group II: included 30 non-diabetic hyperlipidemic patients, Group III: included 30 non-diabetic non- dyslipidemia patients.Changes of lipid profile on treatment with DAAs were assessed by checking fasting lipid profile at base line, then at end of treatment, and finally 3 months after treatment. Results: there was a statistically significant increase in total cholesterol level (TCHOL) which was maintained after the end of therapy. Changes in TCHOL were driven by changes in low-density lipo-protein (LDL) cholesterol, whereas high-density lipo-protien (HDL) cholesterol and very low-density lipo-protein (VLDL) cholesterol showed no significant changes. There were also no significant changes in tryglyceride (TG) level on treatment. Conclusion: eliminating HCV with DAAs increased TCHOL but had no effect on TG level.