Improvement In High-density Lipoprotein Research Articles

Building Healthy Families: Outcomes of an Adapted Family Healthy Weight Program Among Children in a Rural Mid-Western Community.

Background: This study aimed to evaluate the effectiveness of implementing an adapted, evidence-based 12-week Family Healthy Weight Program (FHWP), Building Healthy Families, on reducing BMI metrics and clinical health indicators in a real-world community setting. Methods: Ninety child participants with a BMI percentile greater or equal to the 95th percentile for gender and age and their parents/guardians (n = 137) enrolled in the program. Families attended 12 weekly group-based sessions of nutrition education, family lifestyle physical activity, and behavior modification. A pre-post study design with a 6-month follow-up was used. Results: Nine cohorts of families between 2009 and 2016 completed the program with 82.1% retention at 12 weeks and 53.6% at 6 months. Participants had statistically significant improvements at 12 weeks in BMI z-score, %BMIp95, body mass, body fat, fat mass, fat-free mass, and systolic blood pressure with greater improvement at 6 months in body mass, BMI metrics, body fat, fat mass, fat-free mass, and systolic blood pressure. Parents/guardians of the participants had similar statistically significant body composition and blood pressure improvements (p < 0.05). In addition, children had significant improvements in high-density lipoprotein (HDL) cholesterol and aspartate aminotransferase (AST) liver enzymes at 6 months. Conclusions: Overall, this study demonstrated that an evidence-based FHWP can result in statistically meaningful declines in BMI z-score and accompanied clinically meaningful changes in health risk. Participants lost ∼4% of their body mass in 12 weeks, while their parents/guardians lost closer to 7% of their body mass, which supports previous literature suggesting body mass changes influence health.

Comparison of the effectiveness of lifestyle interventions and multi-interventional therapy on biochemical parameters of metabolic syndrome among women.

Metabolic syndrome is one of the emerging health issues in developing countries. It includes diabetes, high blood pressure, obesity, and elevated blood cholesterol. This study aimed to compare the effects of two different types of interventions: multi-interventional therapy (MIT) and lifestyle interventions (LIs) on high-density lipoprotein (HDL), triglycerides, and fasting blood sugar (FBS) among women with metabolic syndrome. The study used a quasi-experimental nonequivalent control group design with two experimental groups and one control group. This study was conducted among self-help group women from nine area development societies (ADS) in a selected area in South India from March 1, 2019, to February 28, 2020. Women (aged between 35 and 55 years) with metabolic syndrome were recruited by multistage sampling (N = 220) and randomly assigned into three groups: (a) control, (b) MIT (intervention 1), and (c) LIs (intervention 2). Reflexology foot massage, dietary modification, moderate-intensity exercise, and structured education were given to the MIT group and dietary modification, moderate-intensity exercise, and structured education were given to the LI group for 12 weeks. The control group received routine care. A demographic and clinical data sheet is used to collect the basic information. Biochemical variables (HDL, triglycerides, and FBS) were assessed before and after the intervention. The data obtained from the study were computed using a frequency distribution to describe the demographic characteristics, and a Chi-square (x2) test was conducted to find the homogeneity. Both parametric and nonparametric tests were conducted for the comparison of the effectiveness of different methods of interventions on biochemical parameters of metabolic syndrome. Women who received MIT and LI had significantly lower values of HDL, triglycerides, and FBS after the treatment from baseline and compared with the control group. The study found a significant improvement in the biochemical parameters in the MIT group as compared to the control group and the LI group (<0.001). Paired t-test shows significant improvement in HDL, triglycerides, and FBS (P < 0.001) in both the LI and MIT groups. In case of triglycerides, MIT was found to be more effective (P < 0.001). Both MIT and LIs can be considered interventions for reducing triglycerides and FBS and increasing HDL.

Does intermittent hypoxic exposure enhance the cardioprotective effect of exercise in an inactive population?

The aim of this study was to determine whether exercise supplemented with passive intermittent hypoxic exposure (IHE) improved overall cardiovascular disease risk and individual risk factors. Participants were randomized to exercise-only (Ex, n = 18, 5 males, 13 females; age: 56.4 ± 6.5years; weight: 81.2 ± 15.9; height: 167.3 ± 8.42) or exercise + IHE (IHE + Ex, n = 16; 6 males, 10 females; age: 56.7 ± 6.4years; weight: 78.6 ± 12.4kg; height: 168.0 ± 8.8cm). Both groups received the same strength and aerobic exercise training (1h, 3days/wk, 10weeks). IHE + Ex also received IHE (5min hypoxia: 5min ambient air ×6) for 2-3days/wk. Measurements were collected before (Baseline), after (Post), and 4- and 8-week following the intervention. There were small, beneficial reductions in overall 5- year cardiovascular risk in both groups. At Post, for IHE + Ex compared to IHE there were unclear to likely improvements in high density lipoprotein (8.0% ± 8.0%), systolic blood pressure (-3.4% ± 3.4%) and VO2peak (3.1% ± 7.7%). These improvements persisted at 8-week. There was an unclear improvement in arterial wave reflection (augmentation index) at Post (-6.1% ± 18.4%, unclear), but became very likely harmful at 8-week (8-week: 24.8% ± 19.7%). The conflicting findings indicate that in inactive adults, the addition of IHE to exercise may be beneficial to systemic markers of cardiovascular health but may also increase myocardial load due to increased arterial wave reflection.

Biochemical evaluation of DPP4 inhibitors on lipid profile in type 2 diabetes mellitus patients: A hospital-based prospective study

Background: Lipid lowering action of oral hypoglycemic drugs is still unclear. Hence, this study was conducted to address the same using monotherapy and with combination of oral hypoglycemic in patients suffering with type 2 diabetes. Aims and Objectives: The main aim and objective of the study was to evaluate the DPP4 inhibitors inducted changes in low-density lipoprotein (LDL), VLSL, high-density lipoprotein (HDL), and total cholesterol (TC) in patients suffering with type 2 diabetes. Materials and Methods: This randomized control study was done in the Department of General Medicine, Chennai Medical College Hospital and Research Center, Irungalur, Tiruchirappalli, between June 2014 and July 2015. Cases with type 2 diabetes mellitus (T2DM) aged 30–70 years who had been on glibenclamide or metformin for the past 3 months and had uncontrolled blood glucose levels were selected for the study. Total 180 patients are fulfilling the inclusion and exclusion criteria were divided into six groups (Each with 30 patients.) At the 0th and 12th weeks, fasting lipid profile was assessed. The data were expressed in number, percentage, mean, and standard deviation. Results: Oral hypoglycemic drug either as monotherapy or in combination has significant effect on lipid profile among the cases with T2DM. Furthermore, the significant decrease in TC and maximum improvement in HDL was noted with the use of glibenclamide in combination with Sitagliptin and maximum reduction in triglycerides and LDL was noted with the use of Metformin in combination with Sitagliptin. Conclusion: Oral hypoglycemic agents have an additional favorable effect on lipid profile among the cases with T2DM.

Efficacy of oral rosuvastatin intervention on HDL and its associated proteins in men with type 2 diabetes mellitus.

High-density lipoprotein (HDL) undergoes structural and functional modification in patients with type 2 diabetes mellitus (T2DM). There are limited data on effect of rosuvastatin on HDL-associated proteins and the antiatherogenic effects of rosuvastatin. The present study intended to study the efficacy of rosuvastatin intervention on HDL-associated proteins and its other antiatherogenic effects in men with T2DM. Men with T2DM on oral antidiabetic treatment, with LDL-C levels > 75 mg/dL and willing for rosuvastatin intervention (20 mg/day orally for a period of 12 weeks), were included. Fasting glucose, lipid profile were measured using standard methods. Oxidized low-density lipoprotein (oxLDL), oxidized HDL (oxHDL), paraoxonase-1 (PON-1), tumour necrosis factor-α (TNF-α) and lecithin:cholesterol acyltransferase (LCAT) in serum were measured by ELISA; serum myeloperoxidase (MPO) by spectrophotometric method and cholesterol efflux by fluorometric assay. Carotid intima-media thickness (cIMT) measurement to assess vascular health status was done using doppler. Rosuvastatin produced a significant decrease (p < 0.05) in lipids (total cholesterol, triglycerides, LDL-C); oxidative stress (oxLDL, oxHDL, MPO); inflammation (TNF-α); LCAT concentration; cIMT; significant increase in antiatherogenic HDL and cholesterol efflux (p < 0.05) and no change in apoA-I levels from baseline to 12 weeks of follow-up. A decrease in MPO activity was found to be independently associated with an increase in cholesterol efflux. Post intervention there is a quantitative and qualitative improvement in HDL, which helps in its reverse cholesterol transport (RCT) and antioxidant functions. Improvement in HDL functions and suppression of inflammation by rosuvastatin lead to regression in cIMT, which is beneficial in decreasing the progression of cardiovascular disease (CVD) in men with diabetes.

Efficacy of extended, comprehensive outpatient cardiac rehabilitation on cardiovascular risk factors: A nationwide registry

Cardiac rehabilitation (CR) is a key component of the treatment of cardiac diseases. The Austrian outpatient CR model is unique, as it provides patients with an extended professionally supervised, multidisciplinary program of 4-6 weeks of phase II (OUT-II) and 6-12 months of phase III (OUT-III) CR. The aim of this analysis was to assess the efficacy of the Austrian outpatient CR model using a nationwide registry. Data of all consecutive patients (N = 7560) who completed OUT-II and/or OUT-III between 1 January 2005 and 31 December 2015 were entered prospectively into a registry. OUT-III patients were analyzed separately according to whether the preceding phase II was performed as outpatient (OUT-II/OUT-III, N = 2403) or in-patient (IN-II/OUT-III, N = 2789). All patients underwent assessment of anthropometry, resting blood pressure, lipid profile, fasting blood glucose, exercise capacity, quality of life, anxiety and depression. During OUT-II, patients significantly improved their metabolic risk factor profile and increased exercise capacity by 14.3%. OUT-II/OUT-III patients achieved an additional increase in exercise capacity by 10%, further improvement in high-density lipoprotein (HDL) and stabilization of the remaining risk factors. IN-II/OUT-III patients increased their maximal exercise capacity by 18.4% and there was improvement in blood pressure, HDL, low-density lipoprotein and glucose levels. Extended, professionally supervised, multidisciplinary outpatient CR in a large nationwide registry of consecutive patients consistently improved maximal exercise capacity and relevant modifiable cardiovascular risk factors beyond effects seen after IN- or OUT-II alone.

The Effects of DPP4 Inhibitors on Lipid Status and Blood Pressure in Rats with Diabetes Mellitus Type 2

Abstract The aim of the present study was to examine, evaluate and compare the effects of administered dipeptidyl peptidase-4 (DPP4) inhibitors saxagliptin and sitagliptin on lipid status parameters and blood pressure in rats with streptozotocine induced diabetes mellitus type 2. Forty-eight Wistar albino rats were divided randomly into 4 groups: 1. group I: control healthy group; 2. group II: rats with diabetes mellitus type 2; 3. group III: rats with diabetes mellitus type 2+ treated with 0.6 mg/kg of sitagliptin; 4. group IV: rats with diabetes mellitus type 2 treated with 0.45 mg/kg of saxagliptin. The rats from experimental groups were fed with a high-fat diet for 4 weeks and after 6–8 h of starvation received one dose of streptozotocin (STZ) intraperitoneally (25 mg/kg body weight) to induce type 2 diabetes mellitus (T2DM). Animals with fasting glucose above 7 mmol/L and insulin over 6 mmol/L were included in the study as rats with T2DM. Upon completion of the experiments, the blood was collected from the anesthetized animals and serum triglyceride (TG), total cholesterol (TCH), high density lipoprotein (HDL), and low density lipoprotein (LDL) were measured using spectrophotometry and commercial kits. At the beginning of the study and the day before sacrificing animals, the blood pressure and heart rate were measured by a tail-cuff noninvasive method. DPP4 inhibitors, as glucagon-like peptide-1 (GLP-1) agonists, were associated with modest reductions in DBP, LDL-C, TCH, and TGL and significant improvement in HDL, SBP and HR.

Does chronic high-intensity endurance training have an effect on cardiovascular markers of active populations and athletes? Systematic review and meta-analysis

ObjectiveThe objective of this study was to ascertain the effects of high-intensity chronic endurance training on cardiovascular markers of active populations and athletes.MethodsThis review was conducted in accordance with the...

Clinical investigation to modulate the effect of fenugreek polysaccharides on type-2 diabetes

Fenugreek is used extensively as spice, herb, food and medicine. Its active ingredient includes galactomannan, saponins, trigonelle, diosgenin and 4-hydroxyisoleucine has pronounced effect in controlling diabetes. The effect of galactomannan derived from fenugreek on fasting blood glucose, HbA1c and lipid profile was observed in newly diagnosed type-2 diabetics. The study was conducted as a 12-week interventional randomized, single blind control study with 4-week washout period on newly diagnosed type-2 diabetics (n = 64). After systematic randomization study, the group (n = 32) received 1 gm/day galactomannan and a control group (n = 32) received placebo. Fasting blood glucose, HbA1c and lipid profile were measured thrice i.e. at baseline, 12-weeks and finally after washout period of 4-weeks. Mean and SD were calculated for each variable. The study group showed significant decrease in fasting blood glucose, HbA1c, total cholesterol, triglyceride and low-density lipoprotein. Although, there was improvement in high density lipoprotein but was not significantly raised. The results suggest that galactomannan in low dose can be used as alternative therapy for management of hyperglycemia and dyslipidemia in newly diagnosed type-2 diabetics.

Effects of sleeve gastrectomy on liver enzymes, non-alcoholic fatty liver disease-related fibrosis and steatosis scores in morbidly obese patients: first year follow-up

Abstract Background Non-alcoholic fatty liver disease (NAFLD) has a high prevalence among patients undergoing laparoscopic sleeve gastrectomy (LSG). Although liver biopsy is the gold standard for assessing histopathologic changes in the liver, it is an invasive procedure. The objective of this study was to evaluate the effect of sleeve gastrectomy on liver enzymes, fibrosis and steatosis scores; ultrasonographic findings; biochemical parameters; and anthropometric measurements in morbidly obese patients with NAFLD. Methods Ninety-seven obese patients who underwent LSG were included in this study. Sex, age, body mass index (BMI), comorbidities, liver enzymes, ultrasonographic findings and laboratory parameters to calculate fibrosis and steatosis scores were collected before surgery and after 1 year of follow-up. Results A total of 88.7% of patients had liver steatosis at the pre-surgical ultrasonographic evaluation and this ratio decreased to 46.4% 1 year after surgery. Alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance index (HOMA-IR), aspartate aminotransferase-to-platelet ratio index (APRI) and liver fat score (LFS) were significantly higher in patients with steatosis grade III vs. others. There were improvements in high-density lipoprotein (HDL), triglycerides (TG), glycated hemoglobin (HbA1c), glucose, insulin, BMI, liver enzymes and all NAFLD-related fibrosis and steatosis scores. Conclusions HOMA-IR, ALT, LFS and APRI scores can be used for follow-up procedures in morbidly obese patients with NAFLD who underwent LSG.

Increased Consumption of Virgin Olive Oil, Nuts, Legumes, Whole Grains, and Fish Promotes HDL Functions in Humans.

To evaluate whether increases in the consumption of cardioprotective food groups (virgin olive oil, nuts, fruits/vegetables, legumes, whole grains, fish, and wine) are associated with improvements in high-density lipoprotein (HDL) functions in high cardiovascular risk subjects. The association between 1-year changes in food group consumption and HDL functionality traits in 296 high cardiovascular risk subjects is assessed. Increases in virgin olive oil (10 gd-1 ) and whole grain consumption (25 gd-1 ) are associated with increments in cholesterol efflux capacity (+0.7%, P = 0.026, and +0.6%, P = 0.017, respectively). Increases in nut (30 gd-1 ) and legume intake (25 gd-1 ) are linked to increments in paraoxonase-1 activity (+12.2%, P = 0.049, and +11.7%, P = 0.043, respectively). Legume intake increases are also related to decreases in cholesteryl ester transfer protein activity (-4.8%, P = 0.028). Fish consumption increments (25 gd-1 ) are associated with increases in paraoxonase-1 activity (+3.9%, P = 0.030) and declines in cholesteryl ester transfer protein activity (-1.6%, P = 0.021), HDL cholesterol concentrations (-1.1%, P = 0.039), and functions related to HDL levels (cholesterol efflux capacity, -1.1%, P = 0.010). Increases in the consumption of virgin olive oil, nuts, legumes, whole grains, and fish (achievable through a regular diet) were associated with improvements in HDL functions in high cardiovascular risk subjects.

Evaluation of a group-based hypertension self-management education programme among hypertensive community dwellers

IntroductionLow self-efficacy level among patients with hypertension could be the underlying reason for poor daily disease self-management, leading to suboptimal blood pressure (BP) control. A structured, group-based hypertension self-management education (HSME) programme could be a potential solution to improve BP control; however, impact of HSME programme in the Malaysian setting remain unknown. This study aimed to evaluate the impact of a structured, group-based HSME programme on hypertensive patients’ clinical and psychosocial outcomes. MethodsA pretest-posttest quasi-experimental study design was employed. Participants attended a total of 4-weekly of the HSME programme at a community hall. Participants’ clinical and psychosocial outcomes were assessed at three time-points. Data were analysed using IBM SPSS version 23.0. ResultsForty-five participants consented to join the programme, with 36 (80.0%) attended two or more sessions. At post 1-week of intervention, participants were found to have significant improvement in high-density lipoprotein (HDL) cholesterol (p = 0.001), number of days spent on vigorous physical activity (p = 0.007), motivation (p = 0.005) and self-efficacy (p = 0.005). At 2-month, participants have sustained increased in HDL cholesterol, motivation and self-efficacy, in addition to a significant improvement in self-care behaviour (p = 0.002). ConclusionsThe short-term HSME programme elicited certain positive clinical and psychosocial outcomes, a larger scale randomised controlled trial should be carried out to determine the effective elements of the HSME programme that lead to the self-care behavioural changes and to evaluate the long-term impacts of sustained self-care practices among community dwellers with hypertension.

Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery.

Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals. We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9months, then three monthly until 24months. There were 101 participants included, age 47.4 ± 10.9years with body mass index 42.6 ± 5.9kg/m2. At 24months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5-12.5% TBWL was achieved, with odds ratio (OR) 1.48-2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2-30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL). Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5-12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone. Australian Clinical Trials Registry (ACTRN12610000049077).

Effect of 6 months intense Yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study.

A significant number of women in India are suffering from hypothyroidism. Hypothyroidism is characterized by elevated lipid profiles and thyroid stimulation hormone (TSH). It leads many comorbid conditions such as coronary artery disease, obesity, depression, osteoporosis, sleep apnea, and etc. Yoga is proven to be effective in reducing weight, dyslipidemia, depression and it brings the balance in autonomous nervous system. We aimed to study the effect of 6 months yoga practice on lipid profile, thyroxine requirement and serum TSH in women suffering from hypothyroidism. Twenty-two household women suffering from hypothyroidism between the age range of 30 and 40 (mean±SD; 36.7±3.2) years, with average 4±1.12-year history of hypothyroidism were included in this study. Subjects with known cardiac issues, hypertension, history, recent surgery, slip disc and low back pain were excluded from this study. None of the subjects were on any other medication except thyroxine which was kept during the intervention phage (mean 65.78±22.74 mcg). All the subjects underwent 6 months of yoga practice 1 h daily for 4 days a week. Lipid profile, thyroxine dosage and serum TSH level were assessed before and after intervention. Data was analyzed using paired sample t test & Wilcoxon's signed rank test. The paired sample t-test showed significant reduction in total cholesterol (p=0.006; -8.99 %), low-density lipoprotein (LDL) (p=0.002; -9.81 %) and triglycerides (p=0.013; -7.6 %), and there was a significant improvement in high-density lipoprotein (HDL) (p=0.02; +9.65 %) along with nonsignificant reduction in TSH level (p=0.452; -9.72 %). Wilcoxon signed-rank test showed significant reduction in thyroxine medication score (p=0.029; -15.30 %) from. 6 months practice of yoga may help in improving cholesterol level, serum TSH, may also help in reducing the thyroxine requirement in female patients suffering from hypothyroidism. However, further randomized controlled studies need to be conducted to confirm the present finding.

Simplification to atazanavir/ritonavir monotherapy for HIV-1 treated individuals on virological suppression: 48-week efficacy and safety results.

The objective of this study was to assess the 48-week virological efficacy of atazanavir/ritonavir (ATV/r) monotherapy vs. ATV/r along with two nucleoside reverse transcriptase (NRTIs) in HIV-1 treated individuals with HIV-RNA less than 50 copies/ml. A multicentre, randomized, open-label, noninferiority trial. HIV-1 treated individuals on ATV/r 300/100 mg along with two NRTIs were randomized to receive ATV/r monotherapy or to maintain their antiretroviral regimen. The primary endpoint was the confirmed viral rebound (CVR: two consecutive HIV-RNA >50 copies/ml) or treatment discontinuation for any reason. Individuals who experienced CVR on ATV/r monotherapy reintroduced NRTIs and discontinued the study if HIV-RNA was more than 50 copies/ml after 12 weeks since reintensification. One hundred and three patients enrolled. By week 48, 11 patients in ATV/r arm and two in ATV/r along with two NRTIs experienced CVR; four (8%) patients in ATV/r and eight (15%) in ATV/r along with two NRTIs discontinued. At the 48-week primary efficacy analysis (re-intensification = failure), treatment success was 73% in ATV/r arm and 85% in ATV/r along with two NRTIs [difference -12.1%, 95% confidence interval (95% CI) -27.8 to 2.1]. According to the analysis considering re-intensification is equal to success, treatment success was 92% in ATV/r arm and 85% in the ATV/r along with two NRTIs arm (difference 7.5%, 95% CI -4.7 to 19.8). At CVR, no mutation was observed in ATV/r arm and reintensification with NRTIs was effective in all individuals. Overall, Grade 3-4 (P = 0.003) and grade 3-4 drug-related (P = 0.027) adverse events were less frequent in ATV/r arm. A significant increase in total and low-density lipoprotein (LDL)-cholesterol was observed as well as a significant improvement in high-density lipoprotein (HDL)-cholesterol, fasting glucose, liver fibrosis and alkaline phosphatase was observed in ATV/r monotherapy in comparison with ATV/r along with two NRTIs. ATV/r monotherapy treatment simplification showed lower virological efficacy in comparison with maintaining triple therapy; NRTIs reintroduction was effective in all the individuals.

Scientific Validation of Antidiabetic Activity of Ethanol Extract of Ficus glomerata Barks and Roots in Streptozotocin-Induced Diabetic Rats

The tribal people of Chhattisgarh state of India use Ficus glomerata for the treatment of diabetes therefore we planned to investigate antidiabetic effect of bark and root extract of bark and root in Streptozotocin (STZ)-induced diabetic rats. Oral administration of ethanol extract of bark and root of Ficus glomerata at the doses of 200 and 400 mg/kg body weight was studied in STZ-induced diabetic rats. After administration of extract the fasting blood glucose levels were significantly decreased. The oral glucose tolerance was also improved. The effect of extracts on serum lipid profile like total cholesterol, triglycerides, low density lipoprotein (LDL) and high density lipoprotein (HDL) were also measured in the diabetic and non diabetic rats. There was significant reduction in total cholesterol, LDL and improvement in HDL in diabetic rats were observed. The activity of the plant extracts was comparable with glibenclamide, a well-known antidiabetic drug. These results indicated that Ficus glomerata possesses significant antidiabetic and antihyperlipidemic effect.

Effect of lifestyle intervention on cardiometabolic risk factors: results of the POWER-UP trial

To investigate the effects of three weight loss interventions on cardiometabolic risk factors, including blood pressure, lipids, glucose and markers of insulin resistance and inflammation. We also examined whether categories of incremental weight change conferred greater improvements on these parameters. This 2-year trial was conducted in a primary care setting and included 390 obese participants who were randomly assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education about weight management); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly behavioral counseling provided by a trained auxiliary health-care provider); or (3) Enhanced Brief Lifestyle Counseling (the same care as described for the previous intervention, plus weight loss medications or meal replacements). The primary outcome was change in cardiometabolic risk factors among groups. At month 24, participants in Enhanced Brief Lifestyle Counseling lost significantly more weight than those in Usual Care (4.6 vs 1.7 kg), with no other significant differences between groups. Enhanced Brief Lifestyle Counseling produced significantly greater improvements in high-density lipoprotein (HDL) cholesterol and triglyceride levels at one or more assessments, compared with the other two interventions. Markers of insulin resistance also improved significantly more in this group throughout the 2 years. Collapsing across the three groups, greater weight loss was associated with greater improvements in triglycerides, HDL cholesterol and markers of insulin resistance and inflammation at month 24, but was not significantly associated with reductions in blood pressure, total cholesterol and low-density lipoprotein cholesterol at any time. Enhanced Brief Lifestyle Counseling, which produced the largest weight loss, was generally associated with the greatest improvements in cardiovascular risk factors. These findings suggest that an intensive weight loss intervention, delivered in a primary care setting, can help obese individuals improve some cardiometabolic risk factors.

Effect of Pollypill on cardiovascular parameters: Systematic review and meta-analysis

BackgroundWald and law in their landmark paper published in BMJ in 2003 hypothesized that the use of fixed dose combination of statins, beta blockers, angiotensin-converting-enzyme inhibitor (ACE) inhibitor, and aspirin (Pollypill) may decrease cardiovascular disease by >80% if Pollypills are used as primary prevention. Many clinical trials were started to test this hypothesis. The present systematic review and meta-analysis aims to assess the available clinical trials to see the effect of Pollypill on cardiovascular mortality and on other risk factors that linked with increase in cardiovascular events. Materials and methodsAvailable databases were searched with different specific terms and combination of key words. All randomized clinical trials exploring the effect of Pollypill on various cardiovascular parameters were included in the analysis. Primary endpoints as decided were cardiovascular mortality, systolic blood pressure, diastolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Effect of Pollypill on high-density lipoprotein (HDL) cholesterol, total cholesterol, triglycerides, the number of participants who discontinued treatment, and the number of participants who experienced side effects were measured and analyzed as secondary outcomes. Both fixed and random models were used for analysis. Analysis was performed by comprehensive meta-analysis software. ResultsSix trials were included in systematic review. It was observed that Pollypill decreases systolic and diastolic blood pressure (P = 0.000). Pollypill was also found to decrease LDL cholesterol, total cholesterol, and triglyceride as compared to the control (all P = 0.000); however, there was no significant improvement in HDL (P = 0.39). The number of participants in whom side effects were observed were found to be more in the Pollypill group (odds ratio = 1.73, P = 0.000). It was also observed that dropouts were more in the Pollypill group than in the control group (odds ratio = 1.48, P = 0.02). Due to the lack of sufficient data effect of Pollypill, cardiovascular mortality could not be assessed. ConclusionPollypill decreases various surrogate endpoints related to cardiovascular outcome, but with the increased chance of side effects as compared to control.

Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial.

BackgroundDiabetes remains a major health problem worldwide. Low-risk low-cost alternatives to pharmaceutical interventions are needed where lifestyle modifications have failed. We conducted a double-blind randomised placebo controlled trial to investigate the efficacy of a Chinese herbal formula, Jiangtang Xiaozhi, in treating impaired glucose control and insulin resistance in persons with prediabetes and controlled diabetes.MethodsSeventy-one patients with prediabetes or ‘controlled’ diabetes were randomised to receive 3 capsules of Jiangtang Xiaozhi (n = 39) or placebo (n = 32) three times daily for 16 weeks with a follow up eight weeks later (week 24). The primary outcome was change in glycaemic control as evidenced by fasting blood glucose (FBG), post-prandial plasma glucose and glycosylated haemoglobin (HbA1c). Other measures included change in fasting insulin, insulin resistance and sensitivity, lipids, C-reactive protein (CRP), body mass index (BMI), waist girth, blood pressure (BP), health related quality of life (HRQoL) and safety. Analysis of covariance (ANCOVA) was used to model outcomes at 16 weeks, by treatment group corrected for baseline level of the outcome variable.ResultsIn patients receiving Jiangtang Xiaozhi, FBG was not significantly different (p = 0.73) compared to placebo after 16 weeks of treatment (6.3 ± 1.1 mmol/L vs 6.7 ± 1.3 mmol/L). There was a significant difference (p = 0.04) in the mean levels of fasting insulin between the treatment group (11.6 ± 5.5 mmol/L) and the placebo group (22.1 ± 25.9 mmol/L). Insulin resistance slightly decreased in the treatment group (1.58 ± 0.74) compared to that of the placebo group (2.43 ± 1.59) but this change did not reach statistical significance (p = 0.06). Patients taking Jiangtang Xiaozhi had a significant improvement in high-density lipoprotein (HDL) level compared to the placebo group at week 16 (p = 0.03). Mean levels of cholesterol, triglycerides, BMI, waist-girth, HRQoL, BP, CRP and insulin sensitivity were not significantly different between the two groups. The herbal medicine was well tolerated.ConclusionsIn the current study, the 16 week Jiangtang Xiaozhi treatment did not lower fasting blood glucose, but it improved serum insulin and HDL cholesterol in a Western population with prediabetes or controlled diabetes. Our trial may have been underpowered. Dosage needs to be considered before commencing a longer adequately powered trial.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000128897; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362005

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.