Improvement In High-density Lipoprotein Research Articles

Effect of a Weight Management Program on the Determinants and Prevalence of Metabolic Syndrome

As prevalence of obesity and metabolic syndrome (met synd) rises, establishing effective, community-based treatments is imperative. Our investigation sought to evaluate and report the effect of a weight management program on the prevalence and determinants of met synd, and the effect of participation level. Between 10 July 2001 and 17 November 2005, 339 of 574 individuals enrolled in and completed our 6-month weight management program at the McConnell Heart Health Center in Columbus, Ohio. One hundred and sixty completers met our inclusion criteria for our retrospective analysis: (i) non diabetic, (ii) complete outcomes, (iii) no program participation in the previous 6 months. Met synd status was determined using AHA/NHLBI criteria. Blood pressure criterion was modified to a history of hypertension or current antihypertension medication use. Participation level was dichotomized as high participators (HP) and low participators (LP) using the number of center visits. The entire cohort showed significant reductions in BMI, waist circumference and met synd prevalence (51-39%). The met synd group had significant improvements in high-density lipoprotein (HDL), triglycerides, and glucose. Compared with LP, HP had a significant reduction in the prevalence of met synd and significantly greater improvement in the anthropometric, HDL and triglyceride determinants of met synd. This weight management program had a positive effect on determinants and prevalence of met synd. High participation levels were associated with significantly greater improvements in the anthropometric variables, HDL, triglycerides, met synd determinants, and reduction of met synd prevalence.

Cardiac Rehabilitation Programs Markedly Improve High-Risk Profiles in Coronary Patients with High Psychological Distress

Adverse behavioral profiles, particularly depression and hostility, increase the risk of coronary artery disease (CAD) and affect recovery after CAD events. We sought to determine the effects of outpatient phase II cardiac rehabilitation and exercise training (CRET) programs in CAD patients with high levels of psychological distress. We studied 500 consecutive patients both before and after phase II CRET programs and compared 109 patients with the highest quintile of psychological distress (HD) with 115 patients with the lowest quintile of psychological distress (LD). At baseline, patients with HD were younger (P < 0.001), had higher weight (+11%; P < 0.001), body mass indices (BMI) (+9%; P < 0.01), triglycerides (+66%; P < 0.0001), and glycosylated hemoglobin (+9%; P = 0.03), and had higher scores for depression, hostility, anxiety, and somatization (all P < 0.0001), but had lower values for exercise capacity (-15%; P = 0.02), high-density lipoprotein (HDL) cholesterol (-10%; P < 0.01), and total quality of life (QoL) (-26%; P < 0.0001), and all 6 major components of QoL compared with LD. After CRET, patients with HD had significant reductions in weight (-2%; P < 0.01), % fat (-6%; P < 0.001), BMI (-2%, P < 0.01), and scores for anxiety (-49%), depression (-47%), somatization (-34%) and hostility (-38%) (all P < 0.0001), and increases in exercise capacity (+54%; P < 0.0001), HDL cholesterol (+10%; P < 0.0001), and total QoL (+23%; P < 0.0001), and the 6 components of QoL studied. Compared with patients with LD, those with HD had statistically greater improvements in HDL (P = 0.03), triglycerides (P = 0.03), BMI (P = 0.02), as well as all behavioral characteristics and QoL (P < 0.0001), and had similar improvements in all other factors assessed. These data support the routine assessment of high-risk behavioral characteristics in patients with CAD and demonstrate the marked improvements that occur after phase II CRET programs in CAD patients with high psychological distress.

Inactivity, exercise training and detraining, and plasma lipoproteins. STRRIDE: a randomized, controlled study of exercise intensity and amount

Exercise has beneficial effects on lipoproteins. Little is known about how long the effects persist with detraining or whether the duration of benefit is effected by training intensity or amount. Sedentary, overweight subjects (n = 240) were randomized to 6-mo control or one of three exercise groups: 1) high-amount/vigorous-intensity exercise; 2) low-amount/vigorous-intensity exercise; or 3) low-amount/moderate-intensity exercise. Training consisted of a gradual increase in amount of exercise followed by 6 mo of exercise at the prescribed level. Exercise included treadmill, elliptical trainer, and stationary bicycle. The number of minutes necessary to expend the prescribed kilocalories per week (14 kcal x kg body wt(-1) x wk(-1) for both low-amount groups; 23 kcal x kg body wt(-1) x wk(-1) for high-amount group) was calculated for each subject. Average adherence was 83-92% for the three groups; minutes per week were 207, 125, and 203 and sessions per week were 3.6, 2.9, and 3.5 for high-amount/vigorous-intensity, low-amount/vigorous intensity, and low-amount/moderate-intensity groups, respectively. Plasma was obtained at baseline, 24 h, 5 days, and 15 days after exercise cessation. Continued inactivity resulted in significant increases in low-density lipoprotein (LDL) particle number, small dense LDL, and LDL-cholesterol. A modest amount of exercise training prevented this deterioration. Moderate-intensity but not vigorous-intensity exercise resulted in a sustained reduction in very-low-density lipoprotein (VLDL)-triglycerides over 15 days of detraining (P < 0.05). The high-amount group had significant improvements in high-density lipoprotein (HDL)-cholesterol, HDL particle size, and large HDL levels that were sustained for 15 days after exercise stopped. In conclusion, physical inactivity has profound negative effects on lipoprotein metabolism. Modest exercise prevented this. Moderate-intensity but not vigorous-intensity exercise resulted in sustained VLDL-triglyceride lowering. Thirty minutes per day of vigorous exercise, like jogging, has sustained beneficial effects on HDL metabolism.

Pistachio Intake Increases High Density Lipoprotein Levels and Inhibits Low-Density Lipoprotein Oxidation in Rats

There is increasing evidence that nuts have protective effects against coronary artery disease by improving lipid profile and inhibiting lipid oxidation. However, data about pistachio nuts are limited, and to our knowledge, there is no study investigating the effects of pistachio intake on lipid oxidation and serum antioxidant levels. This study, therefore, sought to determine the effects of pistachio intake on serum lipids and determine whether consumption of pistachio would alter serum antioxidant levels. Rats were randomly divided into three groups (n=12 for each): control group fed basic diet for 10 weeks and treated groups fed basic diet plus pistachio which constituted 20% and 40% of daily caloric intake, respectively. Consumption of pistachio as 20% of daily caloric intake increased high-density lipoprotein (HDL) levels and decreased total cholesterol (TC)/HDL ratio, compared with those not taking pistachio. However, TC, low-density lipoprotein (LDL) cholesterol and triglyceride levels were unaffected by pistachio consumption. Consumption of pistachio as 20% of daily caloric intake increased serum paraoxonase activity by 35% and arylesterase activity by 60%, which are known to inhibit LDL cholesterol oxidation, compared with the control group. However, increased antioxidant activity was blunted when pistachio intake was increased to 40% of daily caloric intake. In conclusion, the present results show that consumption of pistachio as 20% of daily caloric intake leads to significant improvement in HDL and TC/HDL ratio and inhibits LDL cholesterol oxidation. These results suggest that pistachio may be beneficial for both prevention and treatment of coronary artery disease.

Effects of pravastatin with niacin or magnesium on lipid levels and postprandial lipemia

This study was designed to evaluate the therapeutic effectiveness of 3 different pharmacologic lipid-lowering regimens in the treatment of patients with clustered lipid risk factors. Sixty-five patients with low high-density lipoprotein (HDL) levels and hypertriglyceridemia were randomized to 1 of 3 treatment arms: pravastatin/ niacin, pravastatin/magnesium, or pravastatin/placebo. After 18 weeks, patients in the pravastafin/niacin group had a −41% change in the total cholesterol/HDL ratio compared with −13% in the pravastatin/magnesium arm and −16% in the pravastatin/placebo group. The HDL 2 and HDL 3 subfractions, as well as the apolipoprotein A-l levels, were increased significantly only in the pravastatin/niacin arm. The levels of small dense low-density lipoprotein (LDL) cholesterol (LDL 3) were decreased to a greater extent in the pravastatin/niacin arm (−43%) than in either the pravastatin/magnesium (−13%) or the pravastatin/placebo (−20%) arm. Only the pravastatin/ niacin regimen significantly diminished postprandial lipemia (−32% change in the remnant particle triglyceride concentration and decreased very-low-density lipoprotein remnant levels). Thus, in this group of patients with clustered risk factors, the combination of pravastatin and niacin resulted in significant improvements in HDL and triglyceride levels, total cholesterol to HDL ratio, small dense LDL levels, and postprandial lipemia. Pravastatin alone or in combination with magnesium resulted in less significant changes that were largely limited to LDL cholesterol reduction.