Decrease In LDL Levels Research Articles

Exploring the Potential Effects of Soybean By-Product (Hulls) and Enzyme (Beta-Mannanase) on Laying Hens During Peak Production.

This study determined the interaction between soybean hulls (SHs) and enzymes (β-mannanase) to improve the sustainability and efficacy of feeding programs for laying hens during peak production while ensuring the best health and efficiency. In a completely randomized design (CRD), 200 golden-brown hens were fed for four weeks (33 to 36 weeks) and randomly distributed into four groups, each containing four replicates of ten birds, with one group receiving a control diet (P0) and the others receiving diets that contained four combinations of SHs and enzymes (ENZs). e.g., 3% SHs and 0.02 g/kg ENZs (P1), 3% SHs and 0.03 g/kg ENZs (P2), 9% SHs and 0.02 g/kg ENZs (P3), and 9% SHs and 0.03 g/kg ENZs (P4). Although most egg quality measures remained similar, the P2 group showed enhanced (p = 0.630) egg weight, albumen weight, and height. Moreover, the P2 group improved gut (p < 0.05) shape by increasing villus width, height, crypt depth, and surface area throughout intestinal sections, while the P4 group markedly improved total cholesterol and LDL (p = 0.022) levels. The P1, P2, and P4 groups exhibited a significant enhancement in dry matter (p = 0.022) and crude fiber (p = 0.046) digestibility, while the P2 group demonstrated superior crude protein digestibility (p = 0.032), and the P1 and P2 groups showed increased crude fat digestibility compared to the other groups. In conclusion, adding 3% of SHs and 30 mg/kg of ENZs (β-mannanase) to the feed may help laying hens, enhance gut health and some egg quality indices, and decrease blood cholesterol and LDL levels without compromising nutrient digestibility.

Abstract 4138035: Inclisiran in Routine Clinical Practice: Results from a Nationwide Study of &gt;5,000 Patients

Introduction: Inclisiran is a small interfering RNA drug which inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9). Inclisiran was recently approved for the treatment of hypercholesterolemia and durably lowers LDL levels by around 50% with injections once every six months based on the results of large, randomized controlled trials. However, no nationwide studies have evaluated the use or effectiveness of Inclisiran in routine clinical practice. Goals/Aims: To characterize the use and effectiveness of Inclisiran in routine clinical practice in a large nationwide cohort. Methods/Approach: We used the Truveta healthcare database, a large nationwide database of electronic health records, to study patients who were administered Inclisiran up to September 2023. Patient demographic characteristics and lipid levels before and after treatment were summarized. Means and 95% confidence intervals were estimated using t-tests. Results/Data: A total of 5,256 patients (median age 71, first quartile 65, third quartile 76) were prescribed Inclisiran, of whom 2,919 (55.5%) were Female. In terms of race, most of the patients identified as White (81.0%), and a smaller proportion as African American (7.3%), Asian (2.1%), or American Indian/Alaska Native (0.5%); 7.3% of patients identified as more than one race or did not provide race data. Mean LDL and HDL levels (mg/dL) before Inclisiran were 125 (95% CI 123-127) and 51 (95% CI 51-52) respectively and after Inclisiran were 88 (95% CI 85-90) and 50 (95% CI 49-51) respectively. The mean difference in LDL after treatment was -39 (95% CI -42 to -37) mg/Dl for a mean percent change of -22% (95% CI -25% to -19%). Effects of Inclisiran on LDL levels are shown in Figure 1. At the conference, we will compare effects of Inclisiran to those of Alirocumab and Evolocumab (two older monoclonal antibodies against PCSK9) using a propensity score overlap weighting design. Conclusions: In a large cohort of patients administered Inclisiran in routine clinical practice, Inclisiran use was associated with substantial decreases in LDL levels, but those decreases were nonetheless smaller than the effects seen in randomized controlled trials of the drug.

Case Report: Effect of Ajwa Date Consumption on LDL Levels in Perimenopausal Women

During perimenopause, there can be a decrease in estrogen production, which indicates the end of a woman’s reproductive years. The production of the hormone estrogen that continues to decrease will cause hypercholesterolemia. Decrease in LDL cholesterol levels can be increased by giving antioxidant properties, which are rich in vitamin C and contain flavanoids and phenolics that function as antioxidants. The method used in this study is Literature Review with Design Narrative Review. The result from the literature it was found the effect of giving ajwa dates (Phoenix Dactylifera L) before and after administration showed a change, namely a decrease in LDL levels after giving ajwa dates. This is because ajwa dates contain flavanoids, phenolics, and plant sterols that function as antioxidant that can prevent the formation of lipid peroxidation. The conclusion based on the results of the literature review, it can be concluded that giving ajwa dates to perimenopause women decreased LDL levels where ajwa dates have antioxidant functions to prevent lipid peroxidation to reduce LDL. The suggestion from the study is necessary to conduct further research on the effect of consumption of ajwa dates on LDL levels in perimenopause women using experimental methods of pretest and posttest design.

Effect of feeding black soldier fly larvae meal based diet on canine skin barrier function, organic antioxidant defence and blood biochemistry

ABSTRACT Black soldier fly meal in pet diets is gaining acceptance. This study aimed to assess the use of black soldier fly larvae defatted meal (BSFL) and its impact on blood parameters, biochemical markers, organic antioxidant capacity, skin barrier function and skin and coat quality. A cross-over study involved eight beagle dogs with two periods of 50 days each and a washout period of seven days in between. Two approximately iso-nutritive extruded diets were evaluated, the first containing 29.5% BSFL meal and a control diet containing 26% poultry by-product meal (PBP) as protein source. Skin and coat evaluations and blood collections were conducted before and after each period. Skin barrier function was assessed by measurement of trans epidermal water loss (TEWL) and stratum corneum hydration (SCH) in belly and pinna of the dogs on days 0, 15, 30, and 45 of each period. A trend for higher antioxidant effect was found for BSFL diet trough malondialdehyde and Vitamin E measurement in dog’s serum. When fed PBP diet dogs exhibited reduction in serum cholesterol and LDL levels after 50 days. TEWL was significantly reduced in pinna over time when dogs were fed BSFL, and TEWL in belly was significantly lower in dogs fed BSFL in comparison to PBP. SCH was also higher for the BSFL group along the feeding period in comparison to PBP, indicating improved ability of the dogs to retain water and keep skin moisture. Improved skin barrier function could be related to fatty acids from BSFL and increased sebaceous lipids in skin. These are responsible for to avoid water loss and to improve skin protection against microbial insults. Inclusion of BSFL as protein source did not promote negative changes in blood biochemistry and had minor antioxidant effect in healthy dogs. However, it proved effective in improving skin barrier function, making BSFL a valuable alternative protein source for dogs, particularly those with sensitive skin or allergies manifesting on the skin.

Atorvastatin versus tetrahydrolipstatin in male patients with dyslipidemia: A systematic review and meta-analysis

Context: Atorvastatin is typically used in the treatment of dyslipidemia. However, the interest in using anti-obesity medications such as orlistat has grown rapidly as obesity is one of the variables associated with dyslipidemia. Aims: To synthesize the findings from previous studies published to date on the potential effects of atorvastatin and tetrahydrolipstatin (orlistat) on the levels of serum LDL. Methods: A systematic review and meta-analysis of research reports and RCTs about atorvastatin and orlistat on LDL levels from articles published in Medline, PubMed, and Scopus from 2012 to 2022 were conducted using PRISMA and RevMan 5.4 software. Results: From 9 final included articles, 6 focused on atorvastatin and 3 on orlistat. Five papers on atorvastatin reported a significant decrease in LDL level, whereas only 2 from orlistat papers. There is a significant decrease in LDL level associated with Atorvastatin treatment (p = 0.04, CI = 1.58, 56.81, I2 = 99%), but not with orlistat (p = 0.05, CI = 0.10, 17.69, I2 = 93%). Conclusions: Here, it is shown that atorvastatin instead of orlistat has a significant effect on decreasing LDL serum levels in dyslipidemia patients.

Effect of L-arginine on myocardial vascular atherosclerosis in rabbits under high mountain environment

The study assessed blood lipid metabolism indicators and myocardial vascular morphology in rabbits with atherosclerosis under long-term adaptation under high mountain environment against the background of L-arginine therapy and prophylaxis. The experiment was conducted on 30 rabbits divided into 5 groups. Using biochemical analyzers, changes in the concentrations of total cholesterol, triglycerides, low- and high-density lipoproteins were determined before and after atherosclerosis simulation; additionally, the effect of L-arginine on the dynamics of the lipid spectrum indicators under long-term adaptation to high mountain environment was assessed. The results were processed using SPSS 16.0 at a statistical significance level of p &lt;0.05. Administration of L-arginine in rabbits with high cholesterol rate under long-term adaptation under high mountain environment resulted in a significant decrease in its content related to the initial increased level. Triglyceride level decreased after L-arginine therapy under adaptation to high mountain environment; however, an increase in the level of this lipid type was observed in animals receiving cholesterol simultaneously with L-arginine (prophylaxis). The therapy and prophylaxis with L-arginine resulted in a decrease in LDL level in animals with atherosclerosis under long-term adaptation to high mountain environment that may indicate the potential efficacy of the drug in the treatment of this condition.

Effect of Buffalo Curd Milk-Edamame Pudding Snack Consumption on Fasting Blood Glucose Levels and Lipid Profile in Diabetes Mellitus Patients

Background: Buffalo milk curd, a native probiotic source from Indonesia, is dominated by live indigenous Lactic Acid Bacteria known for their ability to lower blood glucose levels. Edamame contains amino acid arginine, chromium, antioxidants, and fibre, aiding in blood glucose control and lipid profile reduction. Objectives: This study aimed to assess the effects of buffalo milk curd and edamame-based pudding snacks on fasting blood glucose levels and lipid profiles in Type 2 diabetes mellitus (T2DM) patients. Methods: This study used a True Experiment Design with Pretest-Posttest Control Group Design. The study involved 32 patients divided into treatment and control groups. During the study, the treatment group received 250 g of snacks in the morning and evening for one week. Blood glucose levels and lipid profiles were measured using the enzymatic colourimetry method. Results: The results showed decreased fasting blood glucose levels before and after treatment in both control (-17.06 ± 40.17) and treatment (-48.38 ± 40.27 mg/dl) groups (p=0.036). Total cholesterol levels also decreased in control (-15.87 ± 23) and treatment (-41.4 ± 19 mg/dl) groups (p=0.001). There were decreased LDL levels in control (-6.81 ± 29.09) and treatment (-27.3 ± 25.09 mg/dl) groups (p=0.04). However, HDL and TG levels showed no differences at the end of the study. Conclusions: Buffalo curd milk-edamame pudding snacks can reduce fasting blood glucose levels and lipid profiles, particularly total cholesterol and LDL levels, in Type 2 DM patients.

EFFECTS OF PROBIOTIC SUPPLEMENTED YOGURT ON NEONATAL STREPTOZOTOCIN-INDUCED TYPE-2 DIABETIC RATS

Probiotics can be considered as biological agents that modify the intestinal microbiota as well as show several health benefits. The purpose of this study was to explore the effects of probiotics in neonatal STZ-induced type-2 diabetic rats. Following the biochemical analysis of probiotic bacteria, yogurt was prepared using cow milk and used to feed the experimental rats. Probiotic yogurt was supplemented to three rat groups, each with six rats, and the doses were 2 g in PYT1, 4 g in PYT2 and 6 g in PYT3 for 21 days. Fasting serum glucose, serum insulin, lipid profiles and liver glycogen levels were measured to investigate the probiotic effects on type 2 diabetic rats. It was observed that fasting serum glucose levels were significantly lower in case of PYT3 group (p&lt;0.05) whereas a significant (p&lt;0.05) upsurge of serum insulin levels was detected in PYT2 rat group. A significant (p&lt;0.05) decrease in LDL level in PYT2 group and significantly (p&lt;0.05) increased level of HDL was detected in PYT1 and PYT2 rat groups. However, there were no significant differences regarding triglyceride as well as total cholesterol levels among three probiotic yogurt supplemented rat groups. Hepatic glycogen content was 34.5%, 30.9% and 39.1% among the probiotic yogurt feed groups viz. PYT1, PYT2 and PYT3, respectively. Findings of this research suggest that application of probiotic yogurt can help to manage type-2 diabetes. Further study on clinical trial would be worthy to investigate for probiotic-based product improvement for treatment of type-2 diabetic patients.

Potency of Ethanol Extract Celery (Apium graveolens L.) Stalk as Anti-Cholesterol

Increasing levels of blood cholesterol is one of the risk factors for atherosclerosis. Currently, experts have been trying used herbal medicine as an alternative treatment of atherosclerosis. One of the highlights is the use of celery stalks. Celery is generally used as a flavouring dish. In addition, celery stalks are believed able to reduce cholesterol levels because they contain flavonoids, tannins, and saponins. This study was aim to determine the effect of celery stalk ethanol extract to reduce LDL an increase of HDL level in rats after fed high-fat diet. Randomized Post Test Only Control Group Design was used to measure the HDL and LDL blood serum levels of male Wistar (Rattus norvegicus) rats fed a high-fat diet. This study was used 27 male Wistar rats (Rattus norvegicus) divided into 3 groups; K1 was only given regular feed and water, K2 was given a high-fat diet and water, K3 was given a high-fat diet and celery stalk extract at a dose of 75mg/kg BW/day for 14 days. The data were analysed by ANOVA test and Tukey HSD test. The results of the ANOVA test showed a significance value of p-value of LDL = 0.000 and HDL p-value = 0.536. Celery stalk extract (Apium graviolens L) had an effect on decreasing LDL levels but not on increasing HDL blood serum levels of white Wistar rats (Rattus norvegicus) given high-fat diet.

The Effect of Atorvastatin on Lipid Profile and Inflammatory Marker in patient with Diabetes Dyslipidemia

Inflammation is the underlying cause of several comorbid diseases, including macrovascular complications that cause the highest mortality in diabetes patients. One of the pro-inflammatory cytokines used to assess inflammatory conditions in diabetes and its complications is IL-6. This study intends to analyze the effect of atorvastatin administration on lipid profile and inflammatory markers after 30 days and the correlation between lipid profile and IL-6. An observational prospective cohort study was conducted from November 2017 to January 2018 and approved by the ethical committee of General Hajj Hospital, Surabaya. Nineteen patients who met the inclusion criteria and signed the informed consent enrolled in this study. The measurement of lipid profile and IL-6 level were done twice, before and after 30 days of atorvastatin therapy. After atorvastatin administration, there was a 40.55% decrease in LDL level, a 15.34% decrease in TG level, a 30.70% decrease in total cholesterol level, which was statistically significant (p&lt;0.05), and a 6.06% increase in HDL level. There was a 5.76% decrease in the IL-6 level (p&gt;0.05). In conclusion, atorvastatin administration can improve lipid profile in diabetes patients with dyslipidemia. There was a decrease in IL-6 but not statistically different. From statistical analysis, there is no correlation found between lipid profile and IL-6

A STUDY ON FASTING LIPID PROFILE IN NONADIABETIC STROKE PATIENTS

Objectives: To study serum fasting lipid profile in patients with acute ischaemic stroke &amp; to determine the significant correlation between them. To assess the role of aggressive control of dyslipidemia on recovery of stroke. Design: Prospective study. Setting: Patients admitted with Ischemic stroke into the Acute Medical Care Unit and Medical Wards in the department of General Medicine, SAIMS Hospital Indore, from December 2019 to November 2021, were taken for the study. Patients were subjected to a Fasting lipid profile at presentation and followed- up at 12 weeks and rechecked the fasting lipid profile and correlated with the recovery of stroke. Participants: A total of 50 Ischaemic stroke patients- 33 males and 17 females, participated. All subjects were above 50 years. Patients with suspected emboli of cardiac origin, haemorrhagic stroke, diabetes and h/o of head injury/usage of anticoagulant drugs were excluded from the study. None of the patients was on diet (or) other modifications to lower plasma lipid levels. Results: S.T.C was abnormal in 11 patients at onset and 8 pts after three months of statin therapy. TG was abnormal in 34 patients at the beginning and 35 pts after three months of treatment. LDL was abnormal in 32 patients at the beginning and 20 pts after three months of statin therapy. HDL was abnormal in 38 patients at onset and 35 pts after three months of treatment. VLDL was abnormal in 34 pts at the beginning &amp; 35 pts after three months of statin therapy. After three months, the MRS score of most of the patients was 0 -1(21 pts), followed by a score of 0 (15 pts). Correlation between mNIHSS score and lipid profile showed a significant clinical improvement with reduction in the LDL levels &amp; the corresponding p- value is .000, which is highly effective. Correlation between MRS score and lipid profile showed a good clinical outcome with a reduction in LDL levels &amp; the corresponding p-value is 0.26, which is substantial. Conclusion: This study shows that higher levels of S.T.C, TG, LDL, VLDL is not the only significant risk factor for the occurrence of ischaemic CVD. A decrease in LDL levels shows significant improvement in clinical outcomes.

A STUDY ON FASTING LIPID PROFILE IN NON-DIABETIC STROKE PATIENTS

Objectives: To study serum fasting lipid profile in patients with acute ischaemic stroke &amp; to determine the significant correlation between them. To assess the role of aggressive control of dyslipidemia on recovery of stroke. Setting: Patients admitted with Ischemic stroke into the Acute Medical Care Unit and Medical Wards in the department of General Medicine, SAIMS Medical Indore, from December 2019 to November 2021, were taken for the study. Patients were subjected to a Fasting lipid profile at presentation and followed– up at 12 weeks and rechecked the fasting lipid profile and correlated with the recovery of stroke. Participants: A total of 50 Ischaemic stroke patients- 33 males and 17 females, participated. All subjects were above 50 years. Patients with suspected emboli of cardiac origin, haemorrhagic stroke, diabetes and h/o of head injury/usage of anticoagulant drugs were excluded from the study. None of the patients was on diet (or) other modifications to lower plasma lipid levels. Results: S.T.C was abnormal in 11 patients at onset and 8 pts after three months of statin therapy. TG was abnormal in 34 patients at the beginning and 35 pts after three months of treatment. LDL was abnormal in 32 patients at the beginning and 20 pts after three months of statin therapy. HDL was abnormal in 38 patients at onset and 35 pts after three months of treatment. VLDL was abnormal in 34 pts at the beginning &amp; 35 pts after three months of statin therapy. After three months, the MRS score of most of the patients was 0 -1(21 pts), followed by a score of 0 (15 pts). Correlation between mNIHSS score and lipid profile showed a significant clinical improvement with reduction in the LDL levels &amp; the corresponding p- value is .000, which is highly effective. Correlation between MRS score and lipid profile showed a good clinical outcome with a reduction in LDL levels &amp; the corresponding p-value is 0.26, which is substantial. Conclusion: This study shows that higher levels of S.T.C, TG, LDL, VLDL is not the only significant risk factor for the occurrence of ischaemic CVD. A decrease in LDL levels shows significant improvement in clinical outcomes.

Hydroxychloroquine increased cholesterol transfer to high-density lipoprotein in systemic lupus erythematosus: A possible mechanism for the reversal of atherosclerosis in the disease.

The beneficial effect of hydroxychloroquine (HCQ) in decreasing LDL levels on Systemic Lupus Erythematosus (SLE) is well defined. The influence of this drug on HDL levels is still under debate and information about its effect on cholesterol reverse transport is lacking. To evaluate the effects of HCQ on HDL levels and the transfer of lipids to this lipoprotein in SLE. Nineteen SLE patients using only HCQ (SLE WITH HCQ), 19 SLE patients without any therapy (SLE WITHOUT THERAPY), and 19 healthy controls (CONTROL) were included. All three groups were premenopausal women age- and gender-matched. Serum lipids and apolipoproteins were determined by commercial kits. An in vitro transfer of four lipids (14C-Phospolipid, 3H-Cholesteryl ester, 3H-Triglyceride, and 14C-Unesterified cholesterol) from a radioactively labeled nanoemulsion donor to HDL was performed in all participants. Groups had comparable mean age, weight, height, BMI(body mass index), and waist circumference (p > .05). Mean HDL levels were higher in SLE WITH HCQ group compared to SLE WITHOUT THERAPY(58.37 ± 14.04 vs 49.79 ± 8.0mg/dL; p < .05) but lower than CONTROL (58.37 ± 14.04 vs 68.58 ± 9.99mg/dL; p < .05). Total cholesterol (TC) and LDL levels were also significantly lower in SLE WITH HCQ compared SLE WITHOUT THERAPY(148.16 ± 16.43 vs 167.11 ± 30.18mg/dL; p < .05, 75.05 ± 22.52 vs 96.05 ± 25.63mg/dL; p < .05) and CONTROL (148.16 ± 16.43 vs 174.11 ± 23.70mg/dL; p < .05, 75.05 ± 22.52 vs 88.53 ± 20.24mg/dL; p < .05). The in vitro lipid transfer to HDL study revealed a significant difference among the three groups (p = .002) with a higher transfer of unesterified cholesterol(UC) in SLE WITH HCQ compared to SLE WITHOUT THERAPY(5.40 ± 1.05% vs. 4.44 ± 1.05%; p < .05). The latter was significantly decreased compared to CONTROL (5.40 ± 1.05% vs. 5.99 ± 1.71%; p < .05).The percentages of transfer of triacylglycerol (4.93 ± 0.69% vs. 4.50 ± 0.69% vs. 5.14 ± 1.01%; p = .054), esterified cholesterol (5.24 ± 0.70% vs. 4.96 ± 0.89% vs. 5.69 ± 1.27%; p = .079), and phospholipid (15.67 ± 1.03% vs. 15.34 ± 1.44% vs. 16.47 ± 1.89%; p = .066) were similar among groups. The present study is the first to demonstrate that HCQ promoted a higher transfer of unesterified cholesterol which may account for the increased HDL levels in lupus patients under HCQ. This desirable effect may underlie the reported reduced atherosclerosis in SLE.

Activity Of Ethanol Extracts 70%, Extract Nanoparticles And Nanoparticles Tablet Of Okra Fruit Extract(Abelmoschus esculentus (L) Moench.) As Anti-Dislipidemia In Rats Feeded On High Fat Diet

Dyslipidemia is a condition caused by disruption of lipid metabolism due to the interaction of genetic factors and environmental factors. There is strong evidence of an association between LDL cholesterol and cardiovascular events based on clinical outcome studies, so LDL cholesterol is the main target in the management of dyslipidemia. In addition to using synthetic drugs, dyslipidemia can be treated by consuming natural ingredients, one of which is okra (Abelmoschus esculentus (L) Moench). The form of nanoparticles and nanoparticle tablets of okra fruit extract is an effort to increase antidyslipidemic activity and to make it easier to use. This study aims to obtain nanoparticle extracts and nanoparticle tablets of okra fruit extract which have antidyslipidemic activity in vivo against mice given the High Fat Diet (HFD). The research used 24 rats divided into 6 treatment groups, namely group I as normal control, group II as positive control using simvastatin as the control control, group III as a negative control, group IV as a control treatment of ethanol extract 70% okra fruit, group V as a control treatment of okra fruit extract nanoparticles, and group VI as a treatment of okra fruit extract nanoparticles tablets. All test substances are given for 14 days. Blood sampling was carried out on days 0, 14, and 28, with the parameters measured were lipid profiles including total cholesterol (KT), LDL, Triglycerides (TG) and HDL. 70% ethanol extract, extract nanoparticles, and okra fruit extract nanoparticle tablets can decrease KT levels by 33.14%, 46.31%, 45.42%, decrease TG levels by 39.46%, 43.56%, 41, 62%, decrease LDL levels by 45.22%, 68.76%, 59.94%, and can increase HDL levels by 103.80%, 119.20%, 114.39%. Based on the lipid profile of mice given HFD, 70% ethanol extract, nanoparticles, and okra fruit extract nanoparticle tablets had antidyslipidemic activity.

Adherence to Treatment and Glycemic Control in Patients with Type 2 Diabetes Mellitus: A 4-Year Follow-up PTM Bogor Cohort Study, Indonesia.

PurposeLarge-scale evaluation of the treatment adherence in patients with type 2 diabetes mellitus (DM) in Indonesian is limited. We aim to evaluate the treatment adherence of Indonesian type 2 DM patients using national “big data” and investigate its association with glycemic parameters.Patients and MethodsWe analyzed baseline and fourth-year data sets from 2011 to 2018 obtained from the Indonesian Ministry of Health Cohort Study of Non-Communicable Disease Risk Factors in Bogor, West Java (the PTM Bogor Cohort Study). This was a retrospective cohort study in which the sample was divided into two groups. One group adhered to treatment from primary health centers and followed the prescribed medicine/treatment regimen (treated group), while the other did not follow the treatment (untreated group). We evaluated changes in fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) by controlling for other variables.ResultsFrom 5690 subjects, 593 were type 2 DM diagnosed and 342 were eligible at the baseline. At 4-year observation, 212 eligible patients remained, consisting of 62 subjects who adhered to treatment, and more than double that number who were untreated (150 subjects). More significant decreases in FBG and PPBG were found in the treated group (FBG 80.6%, PPBG 90.3%) than in the untreated group (FBG 42.0%, PPBG 67.3%). The results of the multivariate analysis showed that after 4 years observation, treated patients have reduced FBG 3.304 times more and PPBG 3.064 times more than untreated patients, with control factors such as decrease in LDL levels and use of oral drugs.ConclusionThere were less than half as many treated patients as untreated patients involved in the PTM Bogor Study Group. At the fourth-year follow-up, treated patients experienced three times more significant decreases in FBG and PPBG than those who were untreated, even after being controlled by several confounding factors. Given the importance of these findings, it is suggested that immediate strategic action be taken to improve Indonesian patients’ adherence to treatment.

Control of cardiovascular risk factors in a vascular retinopathy population and its long-term impact

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Control of cardiovascular risk factors is the cornerstone of secondary prevention. However, in patients with retinopathy of vascular etiology (hypertensive, diabetic or atherosclerotic) the benefit of stricter control of lipid in the long term has been little studied. Methods Prospective study of a cohort of 107 patients who underwent fundus and coronary angiography, of which 42 (39.3%) required percutaneous revascularization. During the follow-up, new cardiovascular events and analytical control of cardiovascular risk factors were recorded. Results Mean age was 75.19 ± 11.53 years. 60.7% were men, 78.5% were hypertensive, 32.7% were diabetic, and dyslipidemia was observed in 57%. Initially, 28% had 1-vessel disease, 14% 2-vessel, 8.4% 3-vessel, and 3.8% left common trunk. 0.9% had diabetic retinopathy, 3.7% had hypertensive retinopathy, 1.9% atherosclerotic, 70.1% had a combination of hypertensive and atherosclerotic retinopathy, and 7.5% signs compatible with all types. Initial and final mean values of LDL-c and HDL-c by type of retinopathy are in Table 1. During follow-up, a significant improvement in LDL-c and HDL-c levels was observed in total patients and in patients with hypertensive and atherosclerotic retinopathy, however globally lipid control was poor and only 18.9% of the total of the sample reached the recommended levels for very high-risk people (&amp;lt;55 LDL-C). Advanced hypertensive retinopathy patients with a greater reduction in LDL-C during follow-up, recorded lower mortality (p = 0.004). Besides, patients with previous percutaneous revascularization showed a greater decrease in LDL levels at the end of follow-up (69.5 ± 26.1 vs 103 ± 41.47; p &amp;lt;0.001); without significant changes in the rest of parameters. Conclusions In patients with vascular etiology retinopathy, long-term lipid control is poor. However, patients with hypertensive retinopathy and a greater reduction in LDL-c had lower long-term mortality. Hypertensive retinopathy Initial Final Sig. LDL-Cholesterol (mg / dl) 102,8+/-35,5 75,65+/-28,9 &amp;lt;0,001 HDL-Cholesterol (mg / dl) 42,1+/-10,3 43,46+/-13,1 0,04 Atherosclerotic retinopathy LDL-Cholesterol (mg / dl) 101,2+/-36,8 79,8+/-32,98 &amp;lt;0,001 HDL-Cholesterol (mg / dl) 42,8+/-11,6 45,73+/-13,9 0,03 Diabetic retinopathy LDL-Cholesterol (mg / dl) 89,1+/-35,8 69,8+/-18 0,73 HDL-Cholesterol (mg / dl) 35,2+/-8,7 31,51+/-12,7 0,73

The Effect of Proton Pump Inhibitors on Insulin-Glucose Homeostasis in Patients With Type 2 Diabetes Mellitus

Introduction: Gastrin release from G cells stimulates cholecystokinin (CCK2) receptors throughout the body, most of which promote gastric acid secretion. However, gastrin also stimulates CCK2 receptors located elsewhere, including the islet of the pancreas. In turn, gastrin increases insulin secretion1. Gastrin also promotes pancreatic β cell neogenesis and replication. Proton pump inhibitors (PPIs) decrease the pH of the stomach and stimulate gastrin secretion, which may indirectly promote insulin secretion and improve hemoglobin A1c (HbA1c). Objective: To understand the effect of PPIs on insulin-glucose homeostasis (c-peptide, HbA1c, and glucose) in patients with type 2 diabetes mellitus (T2DM). Methodology: We retrospectively reviewed the charts of patients with T2DM at least 18 years of age who received care at AnMed Health facilities from Jan. 1, 2018 through Dec. 31, 2018 to compare HbA1c, C‐peptide, and glucose levels in patients with and without active PPI therapy. Slicer-dicer software was used to identify study population with diagnosis of T2DM and labs including both HbA1c and C-peptide. Out of total 215 patients satisfying inclusion criteria, 71 patients were on PPI. Statistical analyses were performed using SPSS version 20.0 (SPSS, Armonk, NY: IBM Corp). All values are presented as means ± SD. A p value of < 0.05 was considered to be significant. Independent T-test and chi-square test were performed to compare parameters in between groups. Results: The PPI and non‐PPI groups had no statistical difference regarding age, sex, race and BMI. There was no significant difference in HbA1c levels between PPI and non‐PPI groups (8.6% ± 2.1 vs 8.3% ± 2.0, respectively; p value = 0.37). However, we found a significant increase in C‐peptide levels (3.1 ng/mL ± 2.4 vs 2.4 ng/mL ± 2.3; p value = 0.037) and decrease in LDL levels (79.6 mg/dL ± 34.0 vs 89.73 mg/dL ± 32.9; p value = 0.046) in the PPI group compared to non-PPI group. In addition, there was a significantly greater prevalence of coronary artery disease in the PPI group (p = 0.01). Conclusion: PPI therapy in patients with T2DM was not associated with improved glycemic control. However, C-peptide levels were significantly higher in patients with T2DM who were on PPI therapy suggesting higher insulin secretion. The lack of difference in HbA1c levels may be a result of aggressive diabetic management by treating clinicians to achieve similar goal HbA1c in both groups. Further research is needed to understand the gastrin pathway as a potential option for improving glycemic control.

Spectroscopic Signature of Red Blood Cells in a D-Galactose-Induced Accelerated Aging Model.

This work presents a semi-quantitative spectroscopic approach, including FTIR–ATR and Raman spectroscopies, for the biochemical analysis of red blood cells (RBCs) supported by the biochemical, morphological and rheological reference techniques. This multi-modal approach provided the description of the RBC alterations at the molecular level in a model of accelerated aging induced by administration of D-galactose (D-gal), in comparison to natural aging. Such an approach allowed to conclude that most age-related biochemical RBC membrane changes (a decrease in lipid unsaturation and the level of phospholipids, or an increase in acyl chain shortening) as well as alterations in the morphological parameters and RBC deformability are well reflected in the D-gal model of accelerated aging. Similarly, as in natural aging, a decrease in LDL level in blood plasma and no changes in the fraction of glucose, creatinine, total cholesterol, HDL, iron, or triglycerides were observed during the course of accelerated aging. Contrary to natural aging, the D-gal model led to an increase in cholesterol esters and the fraction of total esterified lipids in RBC membranes, and evoked significant changes in the secondary structure of the membrane proteins. Moreover, a significant decrease in the phosphorous level of blood plasma was specific for the D-gal model. On the other hand, natural aging induced stronger changes in the secondary structures of the proteins of the RBCs’ interior. This work proves that research on the aging mechanism, especially in circulation-related diseases, should employ the D-gal model with caution. Nonetheless, the D-gal model enables to imitate age-related rheological alterations in RBCs, although they are partially derived from different changes observed in the RBC membrane at the molecular level.

The Effect of Elastic Resistance Bands Training on Vascular Aging Related Serum microRNA-146 Expression and Atherosclerosis Risk Factors in Elderly Women with Osteosarcopenic Obesity: A Randomized Clinical Trial

Objective: Vascular aging and osteosarcopenic obesity (OSO) refers to age-related endothelial cells and body composition disorders. The purpose of this study was to investigate the effect of 12 weeks resistance training with elastic bands on vascular aging-related serum miR-146 expression level and atherosclerosis risk factors in elderly women with OSO. Materials and Methods: In the present single-blind randomized clinical trial, 48 elderly women with OSO (according to Dual energy X-ray absorptiometry (DEXA) method results), were divided randomly into two groups of control (n=22) and experimental (n=26). The experimental group performed resistance training with elastic bands for 12 weeks and three sessions per week for all major muscle groups. Statistical analyses were carried out using SPSS statistical software version 22. Results: Between-group comparisons showed a significant decrease in serum miR-146 expression (P-value= 0.005) and total cholesterol (P-value= 0.034) in the experimental group compared to the control group. There was no significant difference in body weight (P-value= 0.440), BMI (P-value= 0.553), total fat (P-value= 0.093), BMC (P-value= 0.862), BMD (P-value= 0.564), Hs-CRP (P-value= 0.065), HDL-C (P-value= 0.515) and LDL-C (P-value= 0.889). Conclusion: Resistance trainings decrease miR-146 expression in elderly women with OSO, which was associated with decreased LDL levels and increased HDL levels, though BMI, body fat percentage, total cholesterol and HS-CRP were not significantly different probably due to the type and intensity of the exercises that require further investigation.

Therapeutic efficacy of Trifolium pratense L. on letrozole induced polycystic ovary syndrome in rats

Polycystic ovary syndrome (PCOS) is considered as one of the leading endocrine disorders during reproductive age in women. This study designed to determine the therapeutic effects of red clover (Trifolium pratense) on letrozole-induced PCOS in vivo. Forty female Sprague–Dawley rats were equally divided into five groups. Control group with a regular sexual cycle received normal saline (letrozole vehicle). Letrozole (1 mg/kg) was used to induce the PCOS to the rats in the treatment groups. After induction of PCOS, four treatment groups received the normal saline, or clomiphene citrate (1 mg/kg), or red clover extracts (500 or 750 mg/kg) for 30-days. After treatment, ovary and uterus were removed, weighed, and the ovaries were subjected to histopathological studies. Serum testosterone and estradiol levels, antioxidant activities, and lipid profiles were evaluated. Red clover extracts and clomiphene citrate decreased testosterone levels and showed a significant increase in estradiol levels in comparison to PCOS induced group (p&lt;0.05). Red clover administration restored the GSH, SOD and CAT levels (p&lt;0.05) and decreased the NO and MDA levels (p&lt;0.05). Treatments caused no significant change in levels of TG, TC, and FBG factors when compared to PCOS induced group (P&gt;0.05). However, red clover (750 mg/kg) significantly increased HDL and decreased LDL levels when compared to PCOS induced group (P&lt;0.05). Treatment with red clover reduced ovarian weight, volumes of ovarian, medulla, cortex and number of cysts and increased number of oocytes compared to PCOS group. Both red clover and clomiphene citrate could treat the letrozole induced PCOS in rats; however, red clover indicated antioxidant activities more than clomiphene citrate. Red clover may be used for discovering anti-PCOS drugs with lower side effects.