Decrease In Total Cholesterol Research Articles

Efficacy and Safety of PCSK9 Inhibitors in Hypercholesterolemia Associated With Refractory Nephrotic Syndrome

IntroductionTreatment of hypercholesterolemia in refractory nephrotic syndrome remains a therapeutic challenge. There is not enough evidence supporting the efficacy of statins, and these drugs can be associated with an increased incidence of adverse effects. Herein we summarize our clinical experience with 12 patients suffering from refractory nephrotic syndrome with associated vascular disease and uncontrolled hypercholesterolemia despite treatment with statins who were treated with proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors.MethodsTwelve adult patients with primary nephrotic syndrome refractory to multiple lines of immunosuppressive treatment who suffered from clinical atheromatous vascular disease were treated with PCSK9 inhibitors according to the prescription guidelines for secondary prevention of cardiovascular events. Eight patients with refractory nephrotic syndrome without vascular disease treated with atorvastatin comprised the control group.ResultsFour weeks after treatment with PCSK9 inhibitors, a statistically significant decrease in total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels was observed without significant changes in serum albumin levels or proteinuria. The mean LDL-C decrease was 36.8% ± 4.9% mmol/L at 4 weeks and remained unchanged throughout the follow-up period. In the control group, there were no significant changes in the levels of total cholesterol or LDL-C during the follow-up period. At the diagnosis of nephrotic syndrome, plasma PCSK9 levels were 334 ± 40 ng/mL and correlated significantly with serum LDL-C levels (r = 0.49, P = 0.023). Six months after starting treatment with PCSK9 inhibitors, plasma PCSK9 levels were significantly reduced to values of 190 ± 36 ng/mL (P = 0.001) with a mean relative reduction of 42.3% ± 12.6%. No local adverse effects were seen at the injection site and no significant changes were seen in the levels of transaminase, creatine phosphokinase, or aldolase.ConclusionPCSK9 inhibitors may be an effective and safe alternative for the treatment of hypercholesterolemia associated with refractory nephrotic syndrome.

Sex-Specific Influence of the SCARB1 Rs5888 SNP on the Serum Lipid Response to Atorvastatin in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

BackgroundEpidemiological studies have shown that there are sex differences in blood lipid levels and lipid responses to statins. Previous studies have shown that the rs5888 single nucleotide polymorphism (SNP) in the scavenger receptor class B type 1 (SCARB1) gene is associated with serum lipid levels in a sex-specific manner. The present study was undertaken to detect the sex-specific influence of the SCARB1 rs5888 SNP on the serum lipid response to atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).MethodsA total of 158 unrelated ACS patients (108 males, 50 females) were enrolled, and all patients received atorvastatin 20 mg/daily after PCI. Genotyping of the rs5888 SNP was performed by polymerase chain reaction and direct sequencing. Serum lipid profiles were determined before treatment and after an average follow-up time of one year.ResultsThe baseline serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo)AI levels were higher in females than in males (P<0.05). After treatment with atorvastatin, serum TC, LDL-C, and ApoB were decreased, and ApoAI was increased (P<0.05). The effects of atorvastatin on serum lipid levels were different between males and females, and females had greater decreases in TC, LDL-C and ApoB levels than males (P<0.05). The genotypic frequencies of the rs5888 SNP were not different between males and females. The atorvastatin response was not associated with the rs5888 SNP in males (P > 0.05). Nonetheless, in female individuals carrying the rs5888 T-allele, we observed a greater reduction in TC, LDL-C, and ApoB levels after the use of 20 mg/day atorvastatin (P<0.05).ConclusionThis study indicates that the SCARB1 rs5888 T-allele was associated with a greater reduction in serum TC, LDL-C, and ApoB after atorvastatin treatment in female patients with ACS undergoing PCI.

Digital telemedicine interventions for patients with multimorbidity: a systematic review and meta-analysis

ObjectiveTo determine the effectiveness of digital telemedicine interventions designed to improve outcomes in patients with multimorbidity.DesignSystematic review and meta-analysis of available literature.Data sourcesMEDLINE, EMBASE, The Cochrane Central Register of Controlled...

Antidiabetic and Anti-hyperlipidemic Effects of the Crude Hydromethanol Extract of Hagenia abyssinica (Rosaceae) Leaves in Streptozotocin-Induced Diabetic Mice.

BackgroundThe leaves of Hagenia abyssinica (Rosaceae) have been used traditionally for the management of diabetes mellitus. Thus, this study aimed to evaluate the antidiabetic and anti-hyperlipidemic activity of Hagenia abyssinica leaves crude extract in streptozotocin-induced diabetic mice.MethodsAntidiabetic and anti-hyperlipidemic activity of the crude extract of Hagenia abyssinica was studied in streptozotocin-induced diabetic mice. The effects of the extract on fasting blood glucose level, body weight, and serum lipid profiles were analyzed. One-way ANOVA followed by Tukey’s post hoc test was used for data analysis and p<0.05 was considered as statistically significant.ResultsHagenia abyssinica leaves crude extract showed significant (p<0.05-p<0.001) blood-glucose-lowering activity. Moreover, the crude extract of H. abyssinica reduced the fasting blood glucose level by 23.21%, 38.20%, 43.53%, and 58.99%, respectively, for CE100, CE 200, CE 400, and GLC 5 mg/kg on the 14th day of treatment. After diabetic mice were treated with H. abyssinica (100, 200 and 400 mg/kg) for 14 days, there was a significant decrease in serum total cholesterol, very-low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and serum triglyceride and a significant increase in body weight, and HDL-cholesterol level as compared to diabetic control.ConclusionThe present findings revealed that H. abyssinica leaves could be useful for the management of diabetes mellitus and other abnormalities related to this metabolic disorder. Thus, the present study may support the traditional use of H. abyssinica for diabetes mellitus treatment.

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.

Anti-diabetic, anti-hyperlipidemic and hepatoprotective potential of shaddock (Citrus maxima) peel extract.

Diabetes is a serious public health problem which poses serious socio-economic burden at the national and global level. Most synthetic agents for treating diabetes are expensive and not devoid of adverse effect hence, the need for continuous effort in the search for affordable and natural effective treatment of diabetes. This study investigated the anti-diabetic, anti-hyperlipidemic, and hepatoprotective effects of Citrus maxima peel extract on alloxan-induced diabetic rats. Twenty-eight adult male Wistar rats were categorized into four groups of seven rats with similar body weights. Diabetes was induced using alloxan and baseline data obtained. Rats in groups A, B, and C were administered with 200 mg, 400 mg, and 600 mg of Citrus maxima peel extract per kg body weight/day, respectively for 14 days. Group D (control) received 200 mg of plain water per kg body weight/day. Biochemical analyses of blood glucose, lipid profile, and liver enzyme activities were performed afterthe feeding trial. Data were analyzed using SPSS, version 21. Citrus maxima peel extract significantly decreased (p < 0.05) the blood glucose level by 70.17%. The extract (600 mg) resulted in a percentage increase in high-density lipoprotein cholesterol (4.43%) and decrease in total cholesterol (30.86%), triglyceride (10.58%) and low-density lipoprotein cholesterol (10.20%). Liver enzyme activities of the control groups significantly increased while the treated groups showed no significant change. Citrus maxima peel extract has proven to be effective in diabetes management. However, use of standardized extract and proper laboratory tests are necessary.

New possibilities for dyslipidemia correction in patients with diffuse liver changes and gallbladder cholesterosis

Background . According to existing data, the decisive role in the development of gallbladder cholesterosis is played by the lipid metabolism violation of the body. In this regard, the most important stage in the complex treatment of this disease is correction of the detected lipid disorders in the patient, which contributes to regression and stopping the pathological process progression in the gallbladder wall. Materials and methods . In this work the safety and efficacy of using the drug Vazosponin (Vifitech, Russia) in the treatment of dyslipidemia in 50 patients with a verified diagnosis of non-alcoholic fatty liver disease and gallbladder cholesterosis was evaluated. The main group (n = 25) of patients received Vazosponin at a dosage of 400 mg per day in addition to dietary recommendations as a hypolipidemic therapy. The control group consisted of 25 patients, which received rosuvastatin at a dose of 10 mg per day in addition to the dietary recommendations. The total duration of observation for each patient was 84 days with three control points: before treatment, on the 28th and the 84th days of therapy. Results . The drug Vazosponin on the 84th day of therapy made it possible to achieve a significant (p < 0.05) and general decrease in total cholesterol by 38 %, LDL – by 17 %, VLDL – by 66 %, TG – by 47 %, CA – by 28 %. To the 84th day of the therapy with Vazosponin positive changes were revealed in the biochemical markers of liver function indicator as a significant (p < 0.05) decrease in levels of ALT – by 42 %, AsAT – by 46 %, GGTP – by 61 %, ALP – by 23 %, total bilirubin – by 41 %. In the main group of patients, adverse effects of therapy have not been established. Conclusion . The inclusion of Vazosponin in the treatment regimens for patients with non-alcoholic fatty liver pathology and gallbladder cholesterosis makes it possible to achieve significant and persistent lipid-lowering and mediated hepatoprotective effects.

Treatment of Thyroid Dysfunction and Serum Lipids: A Systematic Review and Meta-analysis.

Hyperthyroidism is associated with low levels of cholesterol and triglycerides, and hypothyroidism is associated with hypercholesterolemia and hypertriglyceridemia. The aim of this systematic review was to investigate the impact of therapy for overt and subclinical hyper- and hypothyroidism on serum lipids. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus from 1970 through April 5, 2018. Pairs of independent reviewers selected randomized and observational studies evaluating lipid parameters in patients undergoing treatment for hyper- or hypothyroidism. Pairs of independent reviewers extracted data and appraised studies. Treatment of overt hyperthyroidism showed a significant increase in total cholesterol (TC) by 44.50 mg/dL (95% confidence interval [CI]: 37.99, 51.02), low-density lipoprotein cholesterol (LDL-C) by 31.13 mg/dL (95% CI: 24.33, 37.93), high-density lipoprotein cholesterol (HDL-C) by 5.52 mg/dL (95% CI: 1.48, 9.56), apolipoprotein A (Apo A) by 15.6 mg/dL (95% CI: 10.38, 20.81), apolipoprotein B (apo B) by 26.12 mg/dL (95% CI: 22.67, 29.57), and lipoprotein (Lp[a]) by 4.18 mg/dL (95% CI: 1.65, 6.71). There was no significant change in triglyceride (TG) levels. Treatment of subclinical hyperthyroidism did not change any lipid parameters significantly. Levothyroxine therapy in overt hypothyroidism showed a statistically significant decrease in TC by -58.4 mg/dL (95% CI: -64.70, -52.09), LDL-C by -41.11 mg/dL (95% CI: -46.53, -35.69), HDL-C by -4.14 mg/dL (95% CI: -5.67, -2.61), TGs by -7.25 mg/dL (95% CI: -36.63, 17.87), apo A by -12.59 mg/dL (95% CI: -17.98, -7.19), apo B by -33.96 mg/dL (95% CI: 41.14, -26.77), and Lp(a) by -5.6 mg/dL (95% CI: -9.06, -2.14). Levothyroxine therapy in subclinical hypothyroidism showed similar changes but with a smaller magnitude. The studies contained varied population characteristics, severity of thyroid dysfunction, and follow-up duration. Treatment of overt but not subclinical hyperthyroidism is associated with worsening of the lipid profile. Levothyroxine therapy in both overt and subclinical hypothyroidism leads to improvement in the lipid profile, with a smaller magnitude of improvement in subclinical hypothyroidism.

PERCEPTIONS AND LIPID PROFILES OF MIXED HERBAL DRINK (GARLIC, GINGER, LEMON, HONEY, AND APPLE VINEGAR) CONSUMERS WITH HYPERCHOLESTEROLEMIA

Cholesterol-lowering herbal treatment made from natural ingredients are believed to be able to replace modern medicine even though it has not been scientifi cally proven. Purpose of this study was to test perceptions of customers and eff ects of mixed herbal drink on lipid profi le of consumers with hypercholesterolemia. Study was conducted using cross sectional study design consisted of three stages, that is survey, questionnaire data collection, and medical record data collection. The research subjects were selected by stratifi ed random sampling, which subjects were consumers of mixed herbal drink in total of 55 people, both men and women. Data was collected through interviews of questionnaires covering subject characteristics, subject perceptions of mixed herbal drink, and their medical record data before and after consumption of mixed herbal drinks. Paired T-test were used to observe the diff erences in subject lipid profi le before and after consumption of mixed herbal drink. Consumer perceptions toward health aspects showed that 83.7% of subjects experienced a decrease in cholesterol after consuming mixed herbal drink. Consumer emotional perception showed that 90.9% of subjects feel healthier and fi lter after consuming mixed herbal drink. Results of subject medical records on lipid profi le showed a decrease in total cholesterol, LDL, and triglycerides (p&lt;0.05). Based on perceptions and medical records, it is known that mixed herbal drink can be used as an alternative to traditional cholesterol-lowering medicines.

Revealing metabolic pathways relevant to prediabetes based on metabolomics profiling analysis

AimsDahl salt-sensitive (SS) rats develop similar prediabetes lesion characteristics, such as impaired glucose tolerance (IGT), when compared with the salt resistant rat. In this study, we evaluate the risk of high glucose intake during prediabetes and reveal the metabolic pathways relevant to the pathophysiology of prediabetes to diabetes using the SS rat model and compared this with the salt-resistant consomic SS.13BN rat model. MethodsSS rats were fed with normal chow ±10% glucose solution ad libitum for five weeks. The same experimental treatment was performed on the SS.13BN rats. Metabolites derived from the serum and liver tissue were measured through biochemical and metabolomics analyses. Multivariate, pathway enrichment, and metabolic correlation network analyses were performed based on the metabolomics data. ResultsBiochemical analysis revealed that serum triglyceride (TG) significantly increased with a significant decrease in serum total cholesterol (TC) after high glucose intake in the SS rat. Metabolic pathway analysis revealed that high glucose intake interfered with galactose, glyoxylate, and dicarboxylate metabolism, most evidently in the SS rat. Hepatic l-lactic acid content increased in the SS rat after high glucose intake, whereas the opposite was observed in SS.13BN rats. Metabolic correlation network analysis based on serum metabolites revealed that urea and l-valine had higher metabolic centrality in the SS rat. ConclusionOur findings revealed that high glucose intake can significantly stimulate hypertriglyceridemia and reduce serum TC level. The profoundly altered metabolic pathway included galactose, glyoxylate, and dicarboxylate metabolism. l-lactic acid was screened as a biomarker in liver, whereas l-valine and urea were screened as hub metabolites in serum.

Analysis of blood parameters in HIV positive patients

Human immunodeficiency virus (HIV), the causative agent in AIDS has been a challenge to medical fraternity from the time since it was first discovered in 1983. About 40 million people are living with HIV infection globally and 99% of the infected people are in South East Asia (ESA). Close monitoring of HIV infected patients is essential in reducing the morbidity and mortality of HIV patients. The monitoring HIV disease progression &amp; deciding the time to initiate anti retro viral therapy requires evaluation of T CD4 cell counts and HIV/RNA viral load at regular intervals along with monitoring of biochemical parameters and hematological parameters in HIV Seropositive patients.The objective of the study was to evaluate some biochemical parameters and hematological parameters in newly diagnosed HIV seropositive patients (primary stage).A total of 300 newly diagnosed HIV patients and 200 age and sex matched healthy individuals as control were tested for CBC, lipid profile, renal function tests, liver function tests, electrolytes and some minerals (copper, zinc, iron). Our observations were subjected to statistical analysis Mean ± standard deviation calculated. Comparison was done by student t-test.HIV positive patients had significantly (p&amp;#60;0.001) decreased mean Hb (10.22 ± 1.51) and RBC count (3.99 ± 0.75) compared with HIV negative subjects with Hb (12.52 ± 1.21), RBC count (5.08 ± 0.42). We observed a decrease in total cholesterol, HDL cholesterol and LDL cholesterol, and an increase in triglyceride and VLDL levels. HIV patients increasingly require careful monitoring and evaluation for altered renal function, to prevent co morbidities of treatment and non-treatment related nephrotoxicity. In this study patients with HIV showed significant increase in the mean serum copper level when compared with the control subjects respectively, zinc and iron levels significantly decreased compared with normal subjects.It was concluded in the present study that, hematological manifestations of the HIV infection are complication associated with the disease, anaemia being a very common finding. This complications are not related to age or the sex of the patients. The lipid profile of the patients is also seen to be altered by the disease process. Decreased Lipid levels are more pronounced in anemic groups than non-anemic group.

Impact of Physician-Pharmacist Collaboration on Diabetes Outcomes and Health Care Use.

To evaluate the impact of physician-pharmacist collaboration for disease-state management on diabetes outcomes in primary care by comparing outcomes between physician-managed care and pharmacist collaborative care. A retrospective, observational cohort study was conducted at Ascension Medical Group Via Christi, P.A. from January 1, 2016 to June 30, 2018. Health outcomes were analyzed in 385 patients with diabetes mellitus collaboratively managed by a physician and pharmacist (collaborative care group). Similar patients managed by physician only (usual care group) were matched to the collaborative care group using nearest neighbor matching. The primary outcome compared glycosylated hemoglobin (HbA1c) change between collaborative care and usual care groups at 12 months. The mean change in HbA1c decreased by 1.75% in the collaborative care group and 0.16% in the usual care group (P < .0001). The usual care group had a larger number of patients with HbA1c less than 8% at follow-up (P = .0049). Additional outcomes included decrease in total cholesterol (P = .0023), triglycerides (P = .0016), and an increase in PPSV23 pneumococcal vaccinations (P = .0255) in the collaborative care group. The usual care group had an increase in PCV13 pneumococcal vaccinations (P = .0075). Both emergency department visits (P = .0162) and hospitalizations (P = .0225) decreased significantly in the collaborative care group, estimating total savings of $633,015. The collaboration of pharmacists and physicians in the primary care setting is associated with improved diabetes outcomes and substantially reduces costs related to decreased health care use.

Effect of Fasting Therapy and Low-Calorie Diet on Anthropometric and Serum Lipids in Obese Females

Background: Preclinical and clinical studies have shown the importance of calorie restriction diet in weight reduction and cardiovascular risk factors. In this study, our objective is to compare the naturopathic-based short-term fasting therapy with low-calorie diet (LCD) on anthropometric and lipid profile among obese and overweight persons. A total number of subjects (n = 100) with body mass index (BMI) ≥25 were randomly allocated into either fasting therapy intervention (n = 48) or a LCD (n = 52). Materials and Methods: Participants underwent very LCD (288–904 kcal) in fasting therapy and a LCD (1234 kcal) in the other group respectively for 10 days. Individuals in both the groups were assessed with anthropometric parameters such as BMI, weight, waist circumference, hip circumference and waist-hip ratio, serum lipid profile, and serum leptin levels at the baseline and after 10 days. Results: The anthropometric measurements were decreased significantly in the fasting group when compared with the LCD group (P &lt; 0.05). The decrease in mean serum total cholesterol (TC) (−27.43%), triglycerides (TGs) (−13.05%), and low-density lipoprotein (LDL) (−20.9%) in the treated group were statistically significant (P &lt; 0.001), whereas serum high density lipoprotein (2.32%) was increased but insignificantly (P &gt; 0.001) when compared with the nontreated group. Conclusions: Our findings support that short-term fasting therapy is beneficial in anthropometric measures and reducing leptin level among obese or overweight person compared to LCD. However, long-term adherence of weight loss with these interventions should be tested in future studies with bigger sample size.

Effects of phytoestrogen supplementation on intermediate cardiovascular disease risk factors among postmenopausal women: a meta-analysis of randomized controlled trials.

Phytoestrogens are becoming popular constituents of human diets and are increasingly used by postmenopausal women. Our study aims to determine the effects of phytoestrogen supplementation on intermediate cardiovascular disease (CVD) risk factors in postmenopausal women. Five electronic databases (Medline, EMBASE, Web of Science, Cochrane CENTRAL, Google Scholar) were systematically searched to identify eligible studies, that is, randomized controlled trials (RCTs) that assessed the association of phytoestrogen supplementation with CVD risk factors (serum lipids, homocysteine, fibrinogen, markers of inflammation, oxidative stress and endothelial function, carotid intima-media thickness [CIMT]) in postmenopausal women. Data were extracted by two independent reviewers using a predefined data collection form. In total, 56 RCTs were identified, including 4,039 individual postmenopausal women. There was substantial heterogeneity in quality across studies. Twenty-six (46%) RCTs showed poor quality and there was an indication of publication bias presence for some of the biomarkers. Results are reported in pooled mean difference (95% CI) of changes. Use of phytoestrogens was associated with a decrease in serum total cholesterol (-0.27 mmol/L [-0.41 to -0.13]), low-density lipoprotein (-0.25 mmol/L [-0.37 to -0.13]), triglycerides (-0.20 mmol/L [-0.28 to -0.11]), and apolipoprotein B (-0.13 g/L [-0.23 to -0.03]) and with an increase in serum apolipoprotein A-1 (0.04 g/L [0.02-0.07]. Also, phytoestrogen supplementation was associated with a decrease in serum intercellular adhesion molecule 1 (-18.86 ng/mL [-30.06 to -7.65]) and E-selectin (-2.32 ng/mL [-4.05 to -0.59]). There was no association observed between phytoestrogen supplementation and inflammatory markers, fibrinogen, homocysteine, or other endothelial function markers. In contrast, use of phytoestrogens was associated with an increase in CIMT (9.34 μm [95% CI, 0.39-18.29]). Effect estimates of phytoestrogen supplementation on oxidative stress could not be pooled. Phytoestrogen supplementation seems to modestly improve the CVD risk profile of postmenopausal women by influencing blood lipids and parameters of endothelial function. In women with an increased risk of atherosclerosis, although modest, a harmful effect on CIMT progression may be present. Because of limited quality and the heterogeneous nature of the current evidence, additional rigorous studies are needed to explore the role of phytoestrogens in menopausal cardiovascular health. : Video Summary: http://links.lww.com/MENO/A593.

HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome.

BackgroundIt is unclear whether HIV infection affects the long‐term prognosis after an acute coronary syndrome (ACS). The objective of the current study was to compare rates of major adverse cardiac and cerebrovascular events after a first ACS between people living with HIV (PLHIV) and HIV‐uninfected (HIV−) patients, and to identify determinants of cardiovascular prognosis.Methods and ResultsConsecutive PLHIV and matched HIV− patients with a first episode of ACS were enrolled in 23 coronary intensive care units in France. Patients were matched for age, sex, and ACS type. The primary end point was major adverse cardiac and cerebrovascular events (cardiac death, recurrent ACS, recurrent coronary revascularization, and stroke) at 36‐month follow‐up. A total of 103 PLHIV and 195 HIV− patients (mean age, 49 years [SD, 9 years]; 94.0% men) were included. After a mean of 36.6 months (SD, 6.1 months) of follow‐up, the risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− patients (17.8% and 15.1%, P=0.22; multivariable hazard ratio [HR], 1.60; 95% CI, 0.67–3.82 [P=0.29]). Recurrence of ACS was more frequent among PLHIV (multivariable HR, 6.31; 95% CI, 1.32–30.21 [P=0.02]). Stratified multivariable Cox models showed that HIV infection was the only independent predictor for ACS recurrence. PLHIV were less likely to stop smoking (47% versus 75%; P=0.01) and had smaller total cholesterol decreases (–22.3 versus –35.0 mg/dL; P=0.04).ConclusionsAlthough the overall risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− individuals, PLHIV had a higher rate of recurrent ACS.RegistrationURL: https://www.clini​caltr​ials.gov; Unique identifier: NCT00139958.

Interplay between oxidative damage, the redox status, and metabolic biomarkers during long-term fasting

Obesity and its related metabolic disorders, as well as infectious diseases like covid-19, are important health risks nowadays. It was recently documented that long-term fasting improves metabolic health and enhanced the total antioxidant capacity. The present study investigated the influence of a 10-day fasting on markers of the redox status in 109 subjects. Reducing power, 2,2’-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt radical cation(ABTS) radical scavenging capacity, and hydroxyl radical scavenging capacity increased significantly, and indicated an increase of circulating antioxidant levels. No differences were detected in superoxide scavenging capacity, protein carbonyls, and superoxide dismutase when measured at baseline and after 10 days of fasting. These findings were concomitant to a decrease in blood glucose, insulin, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) and triglycerides as well as an increase in total cholesterol/high-density lipoprotein (HDL) ratio. In addition, the well-being index as well as the subjective energy levels increased, documenting a good tolerability. There was an interplay between redox and metabolic parameters since lipid peroxidation baseline levels (thiobarbituric acid reactive substances [TBARS]) affected the ability of long-term fasting to normalize lipid levels. A machine learning model showed that a combination of antioxidant parameters measured at baseline predicted the efficiency of the fasting regimen to decrease LDL levels. In conclusion, it was demonstrated that long-term fasting enhanced the endogenous production of antioxidant molecules, that act protectively against free radicals, and in parallel improved the metabolic health status. Our results suggest that the outcome of long-term fasting strategies could be depending on the baseline values of the antioxidative and metabolic status of subjects.

The effect of lipid disturbance and vitamin D on the fertility in male albino rats

ABSTRACT Background: Vitamin D has multiple biological effects on male reproductive system. Vitamin D deficiency (VD−) and disturbance of lipid metabolism can induce changes in testicular hormone production and seminal parameters that relate to male infertility. Objective: To investigate the role of vitamin D and lipid metabolism on fertility in male albino rats. Methods: The study was performed on 60 male rats, divided into 6 groups; GI: control group, GII: orlistat group, GIII: orlistat and vitamin D group, GIV: hyperlipidemic group, GV: hyperlipidemic orlistat group and GVI: hyperlipidemic orlistat and vitamin D group. Serum total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-c) and high density lipoprotein cholesterol (HDL-c), 25-hydroxyvitamin D (25(OHD), testosterone (T), inhibin B, follicle-stimulating hormone (FSH) and estradiol (E) levels were determined. Sperm count and viability were also analyzed. Results: Administration of orlistat in GII caused significant alterations of the serum lipid profile, compared to control group. There was interaction between dietary fat and VD− on serum 25 (OHD). A significant VD− was occurred in both GII and GIV, compared to GI. VD− in these groups consequently caused significant decrease in serum T, inhibin B, sperm count and viability and significant increase in FSH and E levels. Administration of orlistat in GV caused significant changes in serum lipid profile, a decrease in E, increase in 25(OHD) and inhibin B, compared to IV. On the other hand, administration of vitamin D with orlistat in GIII and GVI caused significant increase in HDL-c, 25(OHD), T, sperm count and viability and significant decrease in TC, TG, LDL-c, FSH and E. Conclusion: Both hyperlipidemia and hypolipidemia were associated with vitamin D deficiency. Moreover, vitamin D has a positive potential effect on male fertility in either hyperlipidemic or hypolipidemic rats.

Nutritional and Antioxidant Properties of Mango Juice and Aloe Vera Gel and their Effect on Diabetic Rats

Aloe vera gel contains several vitamins and minerals, which make it rich in antioxidants and aid in managing different chronic conditions. Aloe vera, along with other fruits, is used to produce many fruit beverages. Therefore, the present work was designed to investigate effects on the sensory, nutritional, and antioxidant properties of the juice from various combinations of Aloe gel (7.5, 15, and 25 percent) with mango juice. Some biochemical parameters of streptozotocin-induced diabetic rats were also recorded for the effects of aloe gel, mango juice, and their combination. Sensory tests showed lower acceptability for juices with a content of 25 percent Aloe vera, while other scores obtained were good and deemed satisfactory. Calcium and chromium content in 25 percent aloe vera gel treatment was significantly (p&lt;0.05) highest for mineral content, while phosphorus, potassium, and magnesium content were lower compared to other treatments. Results also showed that mango juice content of the antioxidant activity, phenols, and flavonoids increased with rising gel concentration in the blends. The administration of aloe-mango juice has resulted in a significant decrease in serum glucose and total cholesterol compared with other diabetic groups. A significant decrease in serum levels of AST, ALT, and ALP in animals receiving Aloe-mango juice relative to mango juice group was observed. Furthermore, Aloe-mango juice treatment ameliorated the oxidative stress as demonstrated by a substantial decrease in the serum MDA level in the treated group as opposed to the diabetic mango juice group. These findings of the present investigation support the use of Aloe gel for elevating the nutritional properties of the supplemented juices; it can be recommended to consume these juices as part of a healthy diet, especially for diabetic persons.

Extracellular and Intracellular Polysaccharide Extracts of Trametes versicolor Improve Lipid Profiles Via Serum Regulation of Lipid-Regulating Enzymes in Hyperlipidemic Mice.

Trametes versicolor extracts have been shown to have health-promoting benefits in hypercholesterolemia, obesity, hepatic steatosis, and cardiovascular disease. However, hypolipidemic or the anti-hyperlipidemic effects of polysaccharide extracts of T. versicolor (PTVs) are not yet clear. In present work, the structural characterization of intracellular (IPTV) and the extracellular polysaccharide extracts of T. versicolor (EPTV) were partially clarified, and their effects on serum lipid metabolism and regulation of lipid-regulating enzymes in high-fat diet-induced hyperlipidemic mice were also investigated. Results indicated that IPTV and EPTV are α-pyran polysaccharide with an average molecular weight of 127 and 68.4kDa, respectively, and were mainly composed of mannose, glucose and galactose. In vivo study, EPTV treatment (200mg/kg/d) significantly decreased serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), and atherosclerosis index (AI) of hyperlipidemic mice by 20.97%, 57.85%, 27.72%, and 20.35%, respectively (P < 0.01), while IPTV treatment (100mg/kg/d) showed a significant (P < 0.01) decrease in serum TC (17.05%), TG (43.80%), LDL-C (25.61%) levels, and AI value (13.32%). A significant increase in serum lipoprotein lipase (LPL) activity and decrease in protein expression of hepatic 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) were observed following EPTV administration, while IPTV remarkably promoted LPL activity. These results suggest that IPTV and EPTV which improve serum lipid profiles in high-fat diet-induced hyperlipidemic mice via mechanisms regulated by serum LPL and hepatic HMGR have potential for further development as novel therapeutic dietary supplements for the prevention and treatment of hyperlipidemia.

Abstract 472: Liver X Receptor Ligands Suppress Intestinal Soat2 and Reduce Cholesterol in Mice Fed a High Cholesterol Diet

The nuclear receptors, liver X receptor-alpha and -beta (LXRa and LXRb), were originally identified as orphan members of the nuclear receptor (NR) superfamily that function as heterodimers with the retinoid X receptor (RXR). Both LXRa and LXRb play important roles in cholesterol homeostasis and lipid metabolism and have been implicated in the pathology of several diseases including atherosclerosis, cancer, and obesity. Detailed examination of mice deficient in LXRa have revealed significant information regarding its role in regulating lipid metabolism while pharmacological roles of LXR in metabolism and inflammation have been identified using synthetic agonists. We have identified novel synthetic LXR Inverse Agonists that display the ability to suppress lipogenesis and significantly improve the phenotype of fatty liver diseases in several mouse models. During our previous investigation of LXR inverse agonists and fatty liver, we observed a substantial decrease in LDL and total cholesterol, as well as a significant decrease in soat2 gene expression. Recent basic and clinical studies indicate that soat2 may be a potential therapeutic target for cholesterol regulation and atherosclerosis treatment. Based on our observations, we investigated the effects of tissue-selective LXR inverse agonists on cholesterol regulation with greater intensity. We hypothesized that soat2 may be a novel target of LXR and that selectively suppressing LXR in the liver and/or intestine may lead to lowered cholesterol levels in hyperlipidemic models (n = 12). While our research is currently ongoing, we have validated soat2 as a potential LXR target gene by ChIP in hepatocytes, RNA-Seq experiments, fecal cholesterol excretion experiments, as well as expression assays in LXRa/b double knockout mouse tissues (n = 3). Additional studies in LDLr KO mice indicate that selectively targeting LXR in the gut with inverse agonists significantly decrease total and LDL cholesterol (n=12). We believe that this is an innovative method of targeting hypercholesterolemia and may lead to a new class of atherosclerosis therapeutics.