Hypolipidemic Drugs Research Articles

UV filter ethylhexyl salicylate affects cardiovascular development by disrupting lipid metabolism in zebrafish embryos

Ethylhexyl salicylate (EHS) is an organic UV filter commonly used in sunscreens to protect people from the UV radiation. The widespread use of EHS will enter the aquatic environment along with human activities. EHS readily accumulates in adipose tissue as a lipophilic compound, but its toxic effects on lipid metabolism and cardiovascular system of aquatic organisms have not been studied. This study investigated the effects of EHS on lipid metabolism and cardiovascular development during zebrafish embryogenesis. The results showed that EHS caused defects such as pericardial edema, cardiovascular dysplasia, lipid deposition, ischemia, and apoptosis in zebrafish embryos. In addition, qPCR and whole-mount in situ hybridization (WISH) results indicated that EHS treatment significantly altered the expression of genes related to cardiovascular development, lipid metabolism, erythropoiesis, and apoptosis. The hypolipidemic drug rosiglitazone was able to alleviate the cardiovascular defects caused by EHS, indicating that EHS affected cardiovascular development by disrupting lipid metabolism. In addition, severe ischemia caused by cardiovascular abnormalities and apoptosis were observed in the EHS-treated embryos, which was likely to be the main cause of embryonic mortality. In conclusion, this study shows that EHS has toxic effects on lipid metabolism and cardiovascular formation. Our findings provide new evidence for assessing UV filter EHS toxicity and contribute to raising awareness of the safety risks of EHS.

Removal of pharmaceutical compounds from real urban wastewater by a continuous bio-electrochemical process at pilot scale

A coupled bio-electrochemical treatment was designed by combining a microalgae-based system with an electro-oxidation (EO) process for removing pharmaceutical compounds in real urban wastewater. First, a preliminary study was carried out at bench scale to identify the best configuration for the coupled treatment, which involved determining whether EO should be used as a pre or post-treatment of the microalgae-based system. The results showed that using EO as a post-treatment provided the best removal results for most of pharmaceuticals, with an average of 58.8% compared to 47.7% obtained with EO as a pre-treatment. Based on these results, a bio-electrochemical treatment was designed using a high rate algal pond (HRAP) followed by an EO process at pilot scale. EO process was evaluated using a Boron Doped Diamond electrode anode and cathode (BDD/BDD cell) with a current density of between 20 and 30 mA cm−2 and an electrolysis time of one hour. This coupled treatment showed removal efficiencies above 80% for hypolipidemic, analgesics and anti-inflammatory drugs. However, antiepileptic drugs showed the lowest removal rate between 36.8% and 69.1%. It is noteworthy that carbamazepine and 10,11-Dihydro-10,11-dihydroxycarbamazepine (CBZ-Diol) showed almost five times the removal rate in the coupled treatment compared to HRAP alone. Overall, the coupled bio-electrochemical treatment proved to be efficient in removing the studied pharmaceutical compounds. The HRAP pre-treatment reduced the presence of organic and inorganic load by 77.4%, allowing the EO process to remove the more recalcitrant target contaminants.

Assessment of The Risk Factors for Statin-Related Myopathy in the Indian Population

Statins are widely used hypolipidemic drugs with limitations due to myopathy. Several comorbid factors act as predisposing factors for statin-related myopathy (SRM) and are rarely studied in the Indian population. In this study, we aim to understand the various risk factors involved in the occurrence of SRM, which may give insight towards the management of statin intolerance. A cross-sectional and non-interventional clinical study with 700 subjects, both statin and non-statin users, was conducted. Subjects were enrolled after ethical approval and informed consent. Information on case report forms and blood samples for clinical chemistry investigations were collected. SPSS version 21 was used to collect and analyze data. Based on statistical analysis, we found myopathy in statin users (19%), nonstatin users (11%), and total subjects (16%), respectively. No significant association of myopathy was observed with the female sex, differences in food habits, physical activity, alcohol intake, or comorbid factors like diabetes and hypertension. Smoking is associated with myopathy in pooled subjects, whereas age (>60) is associated with myopathy in statin users. Slight differences in mean values of bilirubin and alanine transferase were observed between myopathic and non-myopathic subjects. Therefore, the study demonstrates that smoking is related to myopathy regardless of statin usage. Statin users over 60 were shown to be at a greater risk for myopathy than non-statin users.

Statins and highly sensitive cardiac troponins: cardiotoxicity or cross-reactivity?

To date, hypolipidemic drugs of the statin group are among the most popular therapeutic agents used for the prevention and treatment of the most common worldwide atherosclerotic cardiovascular diseases (CVD). Therefore, considerable attention of researchers is focused on statins to study the additional effects of these drugs, which is accompanied by the discovery of new mechanisms of action and properties that should be taken into account to optimize the tactics of managing patients with CVD. In addition to the key lipid-lowering effect of statins associated with the inhibition of the ratelimiting enzyme (3-hydroxy-3-methylglutaryl-coenzyme A reductase), researchers report a variety of other properties of these drugs. Important circumstances contributing to the disclosure of new effects of statins are: improvement of research methods, and first of all, their sensitivity and specificity; the discovery of new molecules and molecular pathways that may be affected by statins. In general, the currently established numerous non-lipid effects of statin drugs can be divided into two groups: favorable and side effects, which must be taken into account when managing patients with CVD and comorbid diseases. Thanks to recent studies using modern clinical diagnostic cardiomarkers (highly sensitive cardiac troponins (CT)), molecular genetic and morphological methods, potential cardiotoxic properties of statin group drugs have been identified. Of particular concern are the data on a statininduced increase in the concentration of highly sensitive CT, which are a key and generally recognized criterion for myocardial damage. In this article we discuss possible mechanisms of increasing the concentration of CT and cardiotoxic effects when using statins.

A Cost Variation Analysis of Hypolipidemic Drugs Available in the Indian Market

Background: Cardiovascular diseases are amongst the prime reasons of increasing morbidity as well as mortality worldwide. Dyslipidemia is an important and modifiable risk factor of CVD and statins are extremely endorsed in its treatment. Method: Data was acquired from the online edition of “Current Index of Medical Specialties” (CIMS), 1mg, netmeds. The percentage cost variation as well as cost ratio were calculated. Result: Percentage cost variation was recorded highest in atorvastatin 10mg (3668.50%) whereas, the least percentage cost variation was recorded for pravastatin 10mg (3.61%). Conclusion: To reduce the burden on patients, the government should cover as many as possible drugs under the drug price control order (DPCO) and develop uniformity in the pricing of the drugs. Keywords: Hypolipidemic drugs, cardiovascular diseases, cost variation, statins, brands

LDL and Fasting Blood Sugar Can Be Normalized by Doing Exercise and Consumption of Fruits or Herbs

The effect physical activity has on blood glucose will vary depending on how long someone is active and many other factors. Physical activity can lower blood glucose up to 24 hours or more after workout by making body more sensitive to insulin. Become familiar with how blood glucose responds to exercise. Checking blood glucose level more often before and after exercise can help someone see the benefits of activity. Someone also can use the results of blood glucose checks to see how the body reacts to different activities. Understanding these patterns can help prevent blood glucose from going too high or too low. Hyperglycemia and hyperlipidemia are main risk factors for coronary artery disease like syndrome leading to morbidity, and mortality. This syndrome may be prevented by allopathic as well as herbal medicines like Nigella sativa and fibrates. Conventional allopathy related drugs have unwanted effects. Herbal therapy for hyperlipidemia well as diabetes mellitus type-2 [DMT2] is getting attention due to their less frequent side effects. In this study we have compared hypolipidemic effects of Fenofibrate 40 mg with Nigella sativa. Sample Size and Study Area: Seventy-five hyperlipidemic and DM type-2 patients from National Hospital Lahore were enrolled for study. Consent, Grouping in Sample Size and Advise to Patients: After getting consent all patients were divided in three groups comprising 25 patients in each group. Group 1 was on Nigella sativa, group 2 was on Gemfibrozil 600 mg BD plus Glibenclamide 5 mg BD and third group was on placebo therapy. They were advised to take drugs for two months. Results: After completion of study pretreatment and post treatment values of LDL cholesterol were analyzed statistically. In Nigella sativa group LDL cholesterol decreased from 191.14±3.45 to 159.40±2.98 mg/dl, means 31.7 mg/dl LDL reduction was observed when compared with placebo group. Fasting Blood Sugar [FBS] in this group decreased from 210 mg/dl to 180 mg/dl in two months which is significant change in this parameter. In Fenofibrate group of patient’s LDL cholesterol decreased from 197.77±3.91 mg/dl to 159.62±2.20 mg/dl, means LDL reduction in mean values was 38.2 mg/dl, when compared with placebo group. These changes are highly significant with p-values of <0.001. FBS in this group decreased from 219.65±1.10 to 171.76±2.04 mg/dl which is highly significant change in the parameter. Conclusion: We concluded from this study that herbal medicine Nigella sativa is as effective hypoglycemic/hypolipidemic agent as traditionally used hypolipidemic drug Fenofibrate, and hypoglycemic drug Glibenclamide.

Cost-effectiveness analysis of using atorvastatin, simvastatin, ezetimibe, alirocumab, evolocumab, inclisiran in adults with very high cardiovascular risk under the preferential drug provision program

Objective: to evaluate the clinical and economic feasibility of expanding the preferential drug provision (PDP) program for adult patients at very high cardiovascular (CV) risk, including those who have not reached lipid targets on statin therapy, by increasing the frequency of use of ezetimibe, alirocumab, evolocumab and inclisiran used in combination with statins, compared with current PDP practice (use of atorvastatin, simvastatin and minimal use of other drugs).Material and methods. A Markov model was constructed to characterize the development of atherosclerotic heart disease in patients with very high CV risk and to suggest a consistent change in hypolipidemic therapy if it is ineffective. The model considered patients' compliance to drug therapy over time and the factor of non-prescription of any treatment. The modeling horizon was 30 years, and the model cycle was 1 year. The outcomes used were quality-adjusted life years (QALY), life years gained (LYG), and probabilities of various individual and combined CV events. The baseline modeling scenario was to increase the frequency of рroprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors’ prescriptions. In addition, alternative scenarios were modeled that included prescription of highly effective lipid-lowering therapy for all patients who had not reached target low-density lipoprotein cholesterol (LDL-C) on statin therapy, and the scenario with 100% compliance to statin therapy.Results. In comparison with current practice of treatment of patients with very high CV risk, clinical and economic modeling showed a decrease in the incidence of combined outcomes (combined CV events – by 8%, extended combined CV events – by 9%) and individual CV events (heart attack – by 4%, stroke – by 3%, unstable angina – by 2%, revascularization – by 3%) in the baseline scenario. In scenarios of prescribing PCSK9 inhibitors and inclisiran to all patients who have not reached target values of LDL-C on statin therapy, the frequency of individual events ranged from 4% to 8%. In the scenario, which also implies 100% drug compliance, the reduction was from 8% to 17% compared with current patient management practices, characterized by lower frequency of hypolipidemic drugs, including PCSK9 inhibitors and inclisiran. The incremental cost-effectiveness ratio (ICER) for QALY in the baseline scenario was 3,598,156 rubles, the ICER for LYG was 1,949,393 rubles. When comparing the ICER with willingness-to-pay (WTP) threshold in the Russian Federation (calculated as three times the gross domestic product per capita and in 2022 amounting to 2.8 million rubles per effect unit) the ICER for LYG did not exceed the WTP in all scenarios, while the ICER for QALY exceeded the WTP by 29–44%, depending on the realized scenario.Conclusion. Expanding the PDP program for high CV risk patients will have a positive impact on their quality of life and life expectancy, as well as significantly reduce the likelihood of acute CV events. Comparison of ICER with estimated WTP suggests that expansion of the PBP program is a cost-effective organizational technology according to LYG criterion, but not according to the QALY criterion.

Effects of atorvastatin on the Sirtuin/PXR signaling pathway in Mugilogobius chulae.

Atorvastatin (ATV) is a hypolipidemic drug widely detected in the aquatic environment. Nevertheless, limited information is provided about the toxic effects of ATV on estuary or coastal species and the underlying mechanisms. In the present study, the responses of genes expression in pregnane X receptor (PXR) signaling pathway and enzymatic activities in the liver of the estuarine benthic fish (Mugilogobius chulae) were investigated under acute and sub-chronic ATV exposure. Results showed that PXR was significantly inhibited in the highest exposure concentration of ATV for a shorter time (24h, 500μg L-1) but induced in a lower concentration (72h, 5μg L-1). The downstream genes in PXR signaling pathway such as CYP3A, SULT, UGT, and GST showed similar trends to PXR. P-gp and MRP1 were repressed in most treatments. GCLC associated with GSH synthesis was mostly induced under ATV exposure for a long time (168h), suggesting that reactive oxygen species (ROS) were generated under ATV exposure. Similarly, GST and SOD enzymatic activities significantly increased in most exposure treatments. Under ATV exposure, SIRT1 and SIRT2 displayed induction to some extent in most treatments, suggesting that SIRTs may affect PXR expression by regulating the acetylation levels of PXR. The investigation demonstrated that ATV exposure affected the expression of the Sirtuin/PXR signaling pathway, thus further interfered adaption of M. chulae to the environment.

Persisting Delirium as a Presenting Feature of an Underlying Myeloproliferative Neoplasm in Elderly

A 71 year old female presented with an unusually long course of persisting delirium and a rapid downhill functional decline. She presented with progressive symptoms over a course of year with confused behaviour, sleep disturbances, irrelevant talk and restlessness followed by difficulty in walking, falls, speech disturbances, generalized weakness of six months duration and decreased appetite with urinary and stool incontinence of 2 week duration. Her lab reports had shown consistently abnormal blood counts for 4 years before hospitalisation. The abnormalities from peripheral blood smear and GBP (general blood picture) showed elevated platelet count, total leucocyte count and decreased red blood cell count and haemoglobin level. Investigations for myeloproliferative neoplasm (MPN) included the Reflex profile (JAK mutations on qualitative RT-PCR), and bone marrow biopsy (increased megakaryocytes suggestive of Essential thrombocythemia). Patient was started on Oral Hydroxyurea along with oral anti platelet and hypolipidemic drugs. Six months post chemotherapy initiation remained asymptomatic.
 
 Keywords: elderly, delirium, myeloproliferative, neoplasia.

Altered Functional State and Medicinal Therapeutics

Coronary Artery Disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. This process is called atherosclerosis. Coronary artery disease (CAD), when get worst, it is known as coronary artery syndrome (CAS). There are many allopathic medications which can stop, even at starting points of the disease (CAD). Hypolipidemic drugs like statins, fibrates, resins and niacin are well known agents used for prevention of CAD. There are ethnic-based medicinal herbs which can be used to treat or prevent CAD with narrow to moderate range of statistical significance. We compared Rosuvastatin 10 mg with Indian dates (Jujubes) as hypolipidemic agents. This research was conducted at Ghurki Trust Teaching Hospital, jalo park, Lahore, Pakistan. Duration of study was two months. Twenty to seventy years old 60 hyperlipidemic patients of both gender were included in research work with written consent. We divided these patients in two equal groups. Group-I was advised to take Tablet Rosuvastatin 10 mg, twice daily for two months. Group-II was advised to take 500 grams Indian dates for two months. Their baseline parameters like LDL-cholesterol, HDL-cholesterol, systolic/diastolic blood pressure was determined in the hospital laboratory. Separate file was maintained for their name, age, sex, occupation, and address. After two months therapy we compiled data related to tested parameters. Paired t-test was applied to compare changes in all parameters. Their mean values with ± SD before and after treatment were compared and analyzed statistically. It was observed that Rosuvastatin significantly decreased systolic/diastolic blood pressure, LDL-cholesterol, and increased HDL-cholesterol in 27 hyperlipidemic/hypertensive patients. Indian dates used in 30 hyperlipidemic patients significantly decreased systolic blood pressure, and LDL-cholesterol, but insignificant changes were seen in diastolic blood pressure, and HDL-cholesterol. We concluded from the research work that Rosuvastatin is potent hypolipidemic and hypotensive medicine as compared to indian dates.

HPTLC-Bioluminescent Bioautography Screening of Herbal Teas for Adulteration with Hypolipidemic Drugs.

Teas based on nutraceutical herbs are an effective tool against hyperlipidemia. However, the adulteration with chemical drugs is frequently detected. By coupling bioluminescent bioautography with high performance thin-layer chromatography (HPTLC), we developed a facile method suitable for screening hypolipidemic drugs (ciprofibrate and bezafibrate) adulteration in five different herbal teas (lotus leaf, Apocynum, Ginkgo biloba, Gynostemia and chrysanthemum). First, the sensitivity of a bioluminescent bacteria to the analyte was evaluated on different HPTLC layer materials, revealing that the best performance was achieved on the silica gel layer. On this basis, sample extracts were separated on silica gel plates via a standardized HPTLC procedure, forming a selective detection window for the targeted compound. Then, the separation results were rapidly visualized by the bioluminescence inhibition of bacteria cells within 6 min after dipping. The observed inhibition displayed an acceptable limit of detection (<20 ng/zone or 2 mg/kg) and linearity (R2 ≥ 0.9279) within a wide concentration range (50-1000 ng/zone). Furthermore, the optimized method was performed with artificially adulterated samples and the recovery rates were determined to be within the range of 71% to 91%, bracing its practical reliability. Showing superiorly high simplicity, throughput and specificity, this work demonstrated that the analytical method jointly based on HPTLC and bioautography was an ideal tool for screening bioactive compounds in complex biological matrix.

An Overview of Triphala Guggulu and its Ingredients

Triphala Guggulu, a polyherbal Ayurvedic formulation, is among the most significant and frequently used Guggulu Kalpana. Numerous references for preparing this formulation have been mentioned in various classical texts. It has been discussed under ‘Vranashotha’ and ‘Vidradhi’ rogadhikar in Chakradutt and Yogratnakar respectively. ‘Triphala Guggulu’ presnted in this article is mentioned in the Sharangdhara Samhita under ‘Vati Kalpana’. As the name itself suggests, this preparation contains Triphala and Guggulu as the main ingredient along with Pippali. It contains Guggulu in greater proportion than the other ingredients, much like any other Guggulu Kalpas. Triphala Guggulu is frequently used in the treatment of Shotha, Arsha, Bhagandara, Gulma, Vrana, and other ailments. It can also be used as a hypolipidemic drug on its own or in conjunction with other formulations. Several studies and experiments have also demonstrated its efficacy in atherosclerosis, coronary and arterial plaque, and elevated cholesterol levels in the blood. Thus, this article takes the approach of reviewing the experimental research work done on Triphala Guggulu as well as covers the pharmacological action of its ingredients.

Prolongation of Professional Longevity of Patients with Arterial Hypertension in Military Personnel Participating in Modern Armed Conflicts

Arterial hypertension (AH) without proper treatment can lead to heart attack, stroke, kidney or heart failure, vision impairment and other complications. The determination of effective preventive measures to prolong siutability for military service based on the health status of experienced military persons with existing comorbid pathology is an urgent issue today and a component of national security. The objective: to analyze the effective measures that influence on the prolongation of the suitability for military service of military personnel with AH – the participants in the anti terrorist operation / operation of the United Forces (ATO/OUF), taking into account the existing comorbid pathology. Materials and methods. 213 servicemen – the participants of the ATO/OUF with AH and comorbid pathology were examined, who were divided into two statistically homogeneous groups according to the age. The first group included 126 patients with AH stage I, the second group – 87 persons who were diagnosed with AH stage II. CIRS cumulative disease scale was used to assess comorbidity. Results. It has been established that the most important prognostic factors (predictors) that influence on the prolongation of the professional longevity of servicemen with AH – the participants of ATO/OUF with comorbid pathology are timely diagnosis and secondary prevention of atherosclerotic cardiovascular diseases, reduction of total cholesterol and triglyceride levels, the prescribtion of hypolipidemic and antiplatelet drugs therapy, normalization of carbohydrate metabolism disorders, body weight and smoking cessation. Conclusion. The «Algorithm for determination of preventive measures for prolonging suitability for military service based on the health status of servicemen with AH – the participants in ATO/OUF with comorbid pathology was developed».

Utilization of Hypolipidemic Drugs, Patterns, and Factors Affecting Dyslipidemia Among Type 2 Diabetes Mellitus at a Tertiary Care Teaching Hospital in South India.

Background The prevalence of dyslipidemia is higher in type 2 diabetes mellitus (T2DM) and hypolipidemic drugs like statins are effective for the primary and secondary prevention of cardiovascular events. Most of the patients with type 2 diabetes have a mixed type of dyslipidemia. This study aimed to evaluate the utilization of hypolipidemic drugs, patterns, and factors affecting dyslipidemia in T2DM participants. Methods This cross-sectional observational study was approved by the institutional ethics committee (IEC) of the Vydehi Institute of Medical Sciences and Research Center. It was conducted for a period of one year from July 2021 to June 2022. Participants with T2DM visiting the Department of General Medicine and Endocrinology were enrolled after obtaining informed consent. Demographic details, medication history, and laboratory data were recorded in case report form and statistical measures were applied. Results Out of 237 participants enrolled in the study,the predominance (n=133, 56%) was males. The mean age of the study population was 47.92±9.17 years, and the mean duration of diabetes was 6.8±5.3 years. Out of the total participants, 164 (69%) had deranged lipid profiles. Out of them, 129 (78.65%) were on hypolipidemic drugs. Regarding drug utilization, 122 (94.6%) received statins either rosuvastatin (54%) or atorvastatin (40%). In the deranged lipid profilespattern, 24% (58) participants had oneabnormal lipid parameter and the majority 70% (166) had combined lipid profile abnormality. Factors like increased BMI were significantly associated with dyslipidemia(p=0.004). Utilization of hypolipidemic drugs was also significantly associated with the control of dyslipidemia (p<0.001). It was observed that participants who were not on lipid-lowering drugs had 5.38 times more chance ofdyslipidemia (OR=5.38; CI=2.82-10.28; p<0.001). Conclusion A high prevalence of dyslipidemia was observed among diabetic patients. Statins were the most prescribed drug in the study.BMI and lack of pharmacotherapy were found to have a statistically significant association with dyslipidemia in diabetic patients.

Promotion of colorectal cancer cell death by ezetimibe via mTOR signaling-dependent mitochondrial dysfunction.

Introduction: Colorectal cancer (CRC) is the fourth most common cancer worldwide, with high morbidity and mortality rates. In recent years, high-fat diet has been shown to increase CRC morbidity, highlighting the possibility of the application of hypolipidemic drugs for CRC treatment. In this study, we preliminarily evaluated the effects and mechnisms of ezetimibe against CRC through the blockage of lipid absorption in small intesine. Methods: In this study, CRC cell proliferation, invasion, apoptosis, and autophagy were evaluated using cellular and molecular assays. Fluorescent microscopy, and a flow cytometric assay were used to assess mitochondrial activity in vitro. A subcutaneous xenograft mouse model was used to evaluate the effects of ezetimibe in vivo. Results: We found that ezetimibe inhibited CRC cell proliferation, and migration, and facilitated autophage-associated apoptosis in HCT116 and Caco2 cells. Ezetimibe-induced mitochondrial dysfunction in CRC cells was found to be correlated with mTOR signaling activity. Discussion: Ezetimibe exhibits effects against CRC through the promotion of cancer cell death via mTOR signaling-dependent mitochondrial dysfunction, highlighting its potential value in CRC therapy.

Formulation and Evaluation of Pravastatin Sodium-Loaded PLGA Nanoparticles: In vitro-in vivo Studies Assessment.

Pravastatin sodium (PVS) is a hypolipidemic drug which suffers from extensive first-pass metabolism and short half-life. Poly(d,l-lactide-co-glycolide) (PLGA) is considered a promising carrier to improve its hypolipidemic and hepatoprotective activities. PVS-loaded PLGA nanoparticles (PVS-PLGA-NPs) were prepared by double emulsion method using a full 32 factorial design. The in vitro release and the physical stability studies of the optimized PVS-PLGA-NPs (F5) were performed. Finally, both hypolipidemic and hepatoprotective activities of the optimized F5 NPs were studied and compared to PVS solution. All the studied physical parameters of the prepared NPs were found in the accepted range. The particle size (PS) ranged from 90 ± 0.125 nm to 179.33 ± 4.509 nm, the poly dispersity index (PDI) ranged from 0.121 ± 0.018 to 0.158 ± 0.014. The optimized NPs (F5) have the highest entrapment efficiency (EE%) (51.7 ± 5%), reasonable PS (168.4 ± 2.506 nm) as well as reasonable zeta potential (ZP) (-28.3 ± 1.18mv). Solid-state characterization indicated that PVS is well entrapped into NPs. All NPs have distinct spherical shape with smooth surface. The prepared NPs showed a controlled release profile. F5 showed good stability at 4 ± 2°C during the whole storage period of 3 months. In vivo study and histopathological examination indicated that F5 NPs showed significant increase in PVS hypolipidemic as well as hepatoprotective activity compared to PVS solution. The PVS-PLGA-NPs could be considered a promising model to evade the first-pass effect and showed improvement in the hypolipidemic and hepatoprotective activities compared to PVS solution.

A Population-Based Scoring System to Assess the Impact of Individual Risk Factors on Vascular Health.

Arterial stiffness is an indicator of vascular health, influenced by both pathological conditions and physiological determinants, noticeably age. Augmentation index (AI) and pulse wave velocity (PWV) are used among others to assess arterial stiffness. Several risk factors may contribute to pathologically increase arterial stiffness and produce early vascular aging. Our study aims to assess the impact of individual risk factors on vascular health, evaluating the distribution of PWV and AI values in a cohort of adult people without modifiable cardiovascular risk factors while analyzing their role in accelerating vascular ageing. We performed a secondary analysis of a Swiss population-based research project, which took place in 2017 and 2018. Of the 1202 participants originally enrolled, 1097 were included in the final sample. The population was divided into without (n=388) and with risk factors (n=709), based on the presence of the following: smoking, diabetes, previous cardiovascular disease (CVD), chronic kidney disease stage 3 or more, LDL cholesterol ≥ 4.11 or treatment with hypolipidemic drugs, hypertension or treatment with antihypertensive drugs, and metabolic syndrome. Tonometric and oscillometric devices were employed to assess PWV, and the 75th percentiles of PWV and AI in the population without risk factors were calculated to identify cut-offs for the logistic regression analysis. We developed nomograms by assigning a numerical score to each independent prognostic factor; the total score estimating the probability of PWVs and AIs being over the defined cut-offs. Patients with hypertension, diabetes, and obesity showed higher PWV values (p < 0.001). In the univariate logistic regression, factors predictive for higher PWV values were diabetes, CVDs, hypercholesterolemia, and hypertension, while CVDs, antihyperlipidemic treatment, hypertension, and increased BMI were predictive in the multivariate logistic regression. Smoking did not significantly influence arterial stiffness parameters. The present study provides reference values for PWV and AI in subjects without modifiable cardiovascular risk factors and, through nomograms, a risk score stratification to assess the impact of individual risk factors on vascular health.

Lipodystrophies in non-insulin-dependent children: Treatment options and results from recombinant human leptin therapy

Lipodystrophy is a general definition containing different pathologies which, except for those observed in insulin-treated subjects falling outside the scope of this paper, are characterized by total or partial lack of body fat, that, according to the amount of missing adipose tissue, are divided in generalized or partial lipodystrophy. These diseases are characterized by leptin deficiency, which often leads to metabolic derangement, causing insulin resistance, dyslipidemia, and increasing cardiovascular risk. In this narrative review, we presentend the clinical presentation of different types of lipodystrophies and metabolic unbalances related to disease in children and adolescents, focusing on the main treatment options and the novel results from recombinant human leptin (metreleptin) therapy. Milestones in the management of lipodystrophy include lifestyle modification as diet and physical activity, paired with hypoglycemic drugs, insulin, hypolipidemic drugs, and other drugs with the aim of treating lipodystrophy complications. Metreleptin has been recently approved for pediatric patients with general lipodystrophy (GL)> 2 years of age and for children with partial lipodystrophy (PL)> 12 years of age not controlled with conventional therapies. New therapeutic strategies are currently being investigated, especially for patients with PL forms, specifically, liver-targeted therapies. Further studies are needed to achieve the most specific and precise treatment possible.

THE RELATIONSHIP BETWEEN SKIPPING BREAKFAST AND DEMENTIA: A RETROSPECTIVE COHORT STUDY IN OSAKA

Abstract In Japan, annual medical checkups are carried out to prevent lifestyle diseases. Studies have found that skipping breakfast is a risk factor for diabetes, and potentially also dementia. This retrospective cohort study aimed to evaluate the relationship between skipping breakfast and dementia in people with diabetes. The eligible cohort was anyone on the National Health Insurance Database of Osaka who had a checkup in FY 2013 and had diabetes (N = 283,410). The cohort was divided into two groups, those who skipped breakfast more than three times a week (7.38%) and those who did not. The database does not allow individuals to be identified. People with diabetes were defined as those prescribed diabetes drugs in the year before the checkup or with HbA1c of 6.5% or higher at the checkup. People with dementia were defined as those prescribed anti-dementia drugs between April 2014 and December 2017. Data also included body mass index (BMI), smoking, sex , age, and prescription of hypolipidemic or blood pressure drugs. Logistic regression analysis was used, with odds ratio (OR) and 95％ confidence interval . Being male, younger, smoking, having lower BMI or HbA1c levels, and drug prescriptions were associated with skipping breakfast. Skipping breakfast was associated with dementia (OR 1.26, 1.14–1.41), as was lower BMI and being older. For people with diabetes, skipping breakfast is a risk factor for obesity and dyslipidemia, which are associated with dementia. This study therefore provides evidence for a health behavior approach to eating breakfast in people with diabetes.

Ethanol Extracts of Eriobotrya japonica (Loquat) Seeds, Leaves, and Fruits Have Anti-obesity and Hypolipidemic Effects in Rats

Background: Obesity is a serious public health problem contributing to development of several diseases, including hyperlipidemia, hyperglycemia, and hypertension. The plant Eriobotrya japonica (loquat) has been used in traditional Chinese medicine to treat many ailments and traditional healers used it to reduce weight. Objectives: To examine the potential anti-obesity and hypolipidemic effects of ethanol extract of loquat in rats. Materials and Methods: Loquat leaves, fruits, or seeds were extracted with ethanol. About 96 Wistar male rats were fed either a normal rat diet (normal control group; group 1) or a high-fat diet (HFD) for 12 weeks (obese; groups 2−12). Obese rats were divided into11 groups as follows: (obese control: group 2) (obese positive control which received the hypolipidemic reference drug atorvastatin: group 3). Groups (4−6), (7−9), and (10−12) were given seed, leaf, or fruit extract, respectively, at 40,100, and 400 mg/kg. Body weight, serum glucose, lipid profile, creatinine, liver enzymes, albumin, and total protein were measured weekly. Results: HFD consumption significantly increased body weight and serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very-low density lipoprotein (VLDL), and glucose and decreased HDL compared to rats fed the normal diet. HFD also increased serum glutamic-oxaloacetic transaminase (GOT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and creatinine but decreased serum albumin and total protein. Administration of E. japonica seed, leaf, or fruit extract significantly decreased body weight, TC, TGs, LDL, VLDL, glucose, liver, and renal enzymes but increased HDL, albumin, and total protein levels. Conclusion: E. japonica seed, leaf, and fruit ethanol extract regulates body weight gain, has hypolipidemic properties, and positively affects liver and kidney enzymes.