Increase In High-density Lipoprotein Cholesterol Research Articles

Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters.

Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m2) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. This study is registered on ClinicalTrials.gov (NCT06661330).

Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program.

Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Our cohort comprised 121 patients (mean age 61.67 ± 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 ± 9.18 vs. 39.8 ± 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11-0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89-0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89-0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07-1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1-1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP.

Metabolic and bariatric surgery in adolescents: a single-center study of efficacy and outcome predictors.

Some adolescents undergoing metabolic and bariatric surgery (MBS) have suboptimal responses to surgery, particularly over the longer term. This study aimed to quantify changes in weight loss over time in adolescents undergoing MBS and identify preoperative predictors of weight loss. This was a prospective, observational cohort study of 73 adolescents (12-19 years) living with obesity undergoing MBS. Absolute and relative changes in anthropometric and biochemical parameters were evaluated up to 30 months. Changes in anthropometric measures were assessed using a mixed residual maximal likelihood model. Univariable and multivariable logistic regression were used to identify predictors of a >35.0% reduction in BMI z-score from baseline to 12 months. Predictive accuracy was assessed by ROC-AUC analysis. Most patients (87.7%) underwent laparoscopic sleeve gastrectomy (12.3% underwent laparoscopic sleeve bypass). Weight, weight z-score, BMI, and BMI z-score significantly decreased over 30 months (p<0.001) up to a -53.8% relative change in BMI z-score at 30 months. There was a significant increase (p=0.02) in HDL cholesterol and a significant decrease in triglycerides (p=0.0001) and ALT (p=0.0004) after surgery. A higher preoperative BMI was associated with a reduced odds (OR 0.89, 95%CI 0.79-0.97, p=0.03) of a >35% reduction in BMI z-score at 12 months. A baseline BMI >52.6 kg/m2 had a sensitivity of 100% and specificity of 40.6% for detecting a >35.0% postoperative decrease in BMI z-score. MBS results in sustained weight loss in adolescents. A high preoperative BMI predicts resistance to optimal weight loss after surgery and argues against delaying surgery once eligibility thresholds are met.

The effects of low-carbohydrate diet on glucose and lipid metabolism in overweight or obese patients with T2DM: a meta-analysis of randomized controlled trials.

The dual burden of Type 2 Diabetes Mellitus (T2DM) and obesity is a critical public health issue. Low-carbohydrate diets have emerged as a potential intervention, yet clinical evidence remains inconclusive. This meta-analysis assesses the impact of low-carbohydrate diets on metabolic profiles in overweight or obese T2DM patients, aiming to guide clinical practice. A systematic review identified randomized clinical trials (RCTs) comparing low-carbohydrate diets to control diets in T2DM patients from PubMed, Embase, and the Cochrane Library databases up to April 2023. Seventeen RCTs, encompassing 1,197 participants, demonstrated that low-carbohydrate diets significantly improved HbA1c levels and fasting plasma glucose (mean difference [MD] = -0.36, 95% CI -0.44 to -0.29, p < 0.00001; MD = -10.71, 95% CI -14.39 to -7.03, p < 0.00001). They also reduced triglycerides and increased HDL cholesterol (MD = -19.91, 95% CI -28.83 to -10.99, p < 0.00001; MD = 2.49, 95% CI 1.07-3.91, p = 0.0006), without affecting LDL and total cholesterol. Weight loss, reduced BMI, lower diastolic blood pressure, and decreased waist circumference were additional benefits. Low-carbohydrate diets may enhance glycemic control and lipid profiles in overweight or obese T2DM patients, warranting consideration in T2DM management. However, the variability in diet definitions and methodologies underscores the necessity for further research to standardize dietary guidelines and evaluate long-term effects.

HDL-C is inversely associated with the incidence of osteoarthritis among the USA: evidence from the NHANES program of 1999–2020

Osteoarthritis (OA) has been the most common arthritis affecting public health all over the world. Previous experimental research reported that increased low-density lipoprotein cholesterol, along with decreased high-density lipoprotein cholesterol may be associated with increased ectopic bone formation and possible knee OA, while clinical evidence is absent. This study aimed to investigate the association between blood high-density lipoprotein cholesterol (HDL-C) and OA. In this cross-sectional study, all the data were acquired from the National Health and Nutrition Examination Survey (NHANES) program from 1999 to 2020. The blood lipid metabolites of each participant were acquired from the laboratory data, using the standard approach. The diagnosis of OA was established through a questionnaire interview. The multivariate logistic regression analysis, subgroup analysis, and smooth curve fitting analysis were applied to investigate the association between the blood lipid metabolites and OA after adjusting with covariates including gender, age, race, BMI, marital status, physical activity, smoking, hypertension, and diabetes. The interaction analysis and Subgroup analysis were also performed. A total of 28,933 participants, including 3710 people with self-reported OA and 25,223 people without arthritis, were finally eligible for inclusion in this study. The multiple logistic regression indicated that in the 3rd and 4th quartiles, the HDL-C level showed a positive association with the risk of OA (Q3: OR = 1.1342, 95% CI 1.0071, 1.2773, p < 0.05; Q4: OR = 1.2354, 95% CI 1.0937, 1.3956, p < 0.001). The smooth curve fitting showed a trend that the OA odds ratio increased with the increase of HDL-C. Subgroup analysis continued to show that increased HDL led to increased OA risk at certain quartiles in different subgroups. This study shows a positive correlation between blood HDL-C levels and osteoarthritis (OA) risk, suggesting HDL-C may be a risk factor. Further research is needed, especially on lipid-lowering drugs like statins, which can affect HDL-C and influence this association.

In silico investigation and in vivo effect of Berastagi orange (Citrus sinensis) peel extract on male obese rats

Our previous studies show that Berastagi orange peel extract (BOPE) has anti-obesity properties, indicated by its active compounds and effects on reducing body weight gain and body fat percentage. This present study further analysed the effects of BOPE by evaluating docking analysis of BOPE’s phytochemicals and measuring lipid profiles, atherogenic indexes, triglyceride metabolism-related proteins (CD36, DGAT1, and DGAT2) levels, and dipeptidyl peptidase-4 (DPP4) activity in high-fat high-fructose (HFHFr)-induced obese rats. Docking analysis shows that BOPE’s phytochemicals, i.e., naringenin and hesperidin, potentially inhibit CD36 and DGAT1. BOPE significantly reduced LDL cholesterol, triglyceride levels, and DPP4 activity while increasing HDL cholesterol levels. BOPE also improved atherogenic indexes, indicating that BOPE has anti-atherosclerotic and cardioprotective effects. However, no significant effect was observed in the levels of triglyceride metabolism-related proteins, thus warranting further research towards the development of BOPE as a nutraceutical product for obesity prevention and treatment.

Association between high-density lipoprotein cholesterol and risk of abdominal aortic aneurysm among males and females aged 60years and over.

Whether high-density lipoprotein cholesterol (HDL-C) has a protective role against abdominal aortic aneurysm (AAA) development in both older males and females remains uncertain. This study aims to assess the sex-specific association between HDL-C and incident AAA in older adults from the UK Biobank. This cohort study included 86,184 males and 95,682 females aged ≥60years from the UK biobank. Baseline HDL-C was modelled either as a continuous or categorical variable. The primary outcome was incident AAA. Cox proportional hazard models were used for sex-stratified analysis, adjusting for baseline confounders. Restricted cubic splines were plotted to visualize any nonlinear relationship. Harrell's C-index was calculated to assess the added value of HDL-C to the discrimination of model including age and smoking. Over a mean follow-up of 14.4years, 1549 and 328 incident AAA were observed in males and females, respectively. Adjusted hazard ratios for AAA with a 1-mmol/L HDL-C increase was 0.26 (95% confidence interval, 0.21- 0.32) and 0.31 (95% confidence interval, 0.21-0.46) in males and females, respectively (both P< .001). Consistent with the results from Cox model modelling HDL-C as a categorical variable showing an inverse and dose-dependent relationship between HDL-C and incident AAA in both sexes, restricted cubic splines confirmed the monotonic, inverse associations. Adding HDL-C to a model including age and smoking significantly improve the model discrimination for AAA in both sexes (C-index+2.1% in males and+1.5% in females; both P< .05). This study revealed a significant association between low HDL-C levels and a high risk of incident AAA in both older males and females, suggesting the potential clinical usefulness of HDL-C for AAA risk stratification. Our study was limited by its observational design and the presence of possible residual confounding. Studies using real-world data are warranted to evaluate the practical implications of incorporating HDL-C into AAA screening guidelines and its impact on patient outcomes.

Effect of Pomegranate Peel Consumption on Liver Enzymes, Lipid Profile, Liver Steatosis, and Hs-CRP in Patients With Non-alcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

The most prevalent chronic liver disease for which there is currently no proven treatment is non-alcoholic fatty liver disease (NAFLD). An incomplete understanding of the underlying mechanisms of NAFLD may be the cause. The onset and development of this illness appear to be influenced by problems with lipid metabolism, insulin resistance, oxidative stress, and inflammation. Considering the antioxidant properties of pomegranate peel extract, this study was conducted to determine the effects of pomegranate peel consumption on some metabolic features in patients with NAFLD. Our hypothesis is that pomegranate peel can improve the grade of fatty liver, liver enzymes, lipid profile, serum high-sensitivity C-reactive protein (hs-CRP), and anthropometric indices. The aim of this study was to investigate the efficacy of pomegranate peel extract in NAFLD patients. This double-blind randomized clinical trial was conducted on 46 patients with NAFLD. Patients were randomly assigned to intervention group (n = 23) and placebo group (n = 23). Patients in the pomegranate peel group consumed two capsules, each containing 500 mg pomegranate peel extract daily as a part of low-calorie diet (i.e., 500-deficit calorie diet) for 10 weeks. While patients in the control group followed the low calorie diet and two capsules containing 500 mg maltodextrin. At the beginning and end of the study, demographic information, anthropometric indices, food intake, physical activity level, grade of fatty liver, liver enzymes, lipid profile, and serum high-sensitivity C-reactive protein (hs-CRP) were measured. Food intake was measured by 24-h food recall questionnaires and physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Analysis of food recall questionnaire was done using Nutritionist IV program. Statistical analysis was performed using SPSS software (version 22), and a p value < 0.05 was defined as statistically significant. Of 46 patients, 42 of them completed the trial. At the end of the trial, pomegranate peel group had significantly higher reduction in TG (triglycerides), ALT(alanine aminotransferase), AST(aspartate transferase), hs-CRP and also had higher significant increase in HDL-C(high-density lipoprotein cholesterol) compared to the control group (p = 0/02, p = 0/02, p = 0/01, p = 0/01, and p = 0/04, respectively). However, changes in LDL-C, TC, ALP, GGT, and fatty liver grade were not significantly different between the two groups at the end of the study. The current study indicates that pomegranate peel extract has a favorable effect on liver enzymes, lipid profile, and serum high-sensitivity C-reactive protein (hs-CRP) in patients with NAFLD. To support these results, trials examining various dosages over longer time periods are necessary.

The Association between Serum Lipid Profile Levels and Hypertension Grades: A Cross-Sectional Study at a Health Examination Center.

Hypertension and dyslipidemia are major cardiovascular risk factors that often coexist. Hyperlipidemia is a crucial modifiable risk factor in preventing cardiovascular disease. We aimed to explore the relationship between lipid levels and the grading of hypertension in a community-based adult population. A total of 63,091 non-employed individuals were included in this study. Measurements included systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting plasma glucose (FPG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (STB), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Chi-square and t-tests were used to obtain basic population characteristics. Multivariate logistic regression was used to evaluate the association between the prevalence of hypertension and lipid profiles, as well as to identify influencing factors. A P-value < 0.05 was considered statistically significant. Statistical charts were utilized to analyze the relationship between lipid parameters and hypertension grades. A total of 30,588 men and 32,503 women with an average age of 64.57 ± 12.5 years participated in this study. After adjusting STB and TC, every 1 mmol/L increase in TG and LDL-c was associated with a 6.0% and 6.5% increase in the prevalence of hypertension, respectively. Conversely, for every 1 mmol/L increase in HDL-c, the prevalence of hypertension decreased by 4.1%. Increases in TG and LDL-c levels were observed across all grades of hypertension, while very high HDL-c was significantly associated in grade III hypertension (1.54→1.66 mmol/L). Additionally, age, BMI, FPG, ALT, AST, SCr, and BUN significantly influenced the association between hypertension and lipid levels. Hyperlipidemia and hypertension often coexist in health examination populations. Elevated levels of TG and LDL-C are associated with all grades of hypertension, while extremely high HDL-C level is linked to more severe hypertension.

Anti-Obesity Effects of Sulphated Polysaccharides Derived from Marine Macro Algae or Seaweeds: A Systematic Review and Meta-Analysis.

Sulphated polysaccharides (SPs) are negatively charged compounds found in the cell wall of seaweeds or marine macro algae. These compounds exhibit a range of pharmacological activities, including anti-obesity effects. The aim of this systematic review as well as meta-analysis was to assess the potentials of seaweed-derived SPs to mitigate obesity through a systematic review and meta-analysis of animal model-based studies. A comprehensive summary of the included articles was conducted, focusing on the following obesity-related parameters: food intake, body weight gain, epididymal fat size, adipocyte size, liver weight, serum alanine transaminase (ALT) and aspartate transaminase (AST), insulin and tumour necrosis factor-α (TNF-α), and the lipid profile (total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c)). The systematic review demonstrated that seaweed-derived SPs exhibit ameliorative effects against obesity, as evidenced by reductions in food intake, body weight gain, epididymal fat and adipocyte size, liver weight, ALT and AST levels, serum insulin and TNF-α, LDL-c, total cholesterol, and triglycerides and an increase in HDL-c in obese rats administered with seaweed-derived SPs. However, the meta-analysis revealed statistically significant anti-obesity effects of seaweed-derived SPs for most, but not all the parameters tested. Further research in human subjects is necessary not only to ascertain the results of preclinical studies but also to provide conclusive evidence of the anti-obesity potential of SPs in humans.

The Effectiveness and Safety of a Nutraceutical Combination in Overweight Patients with Metabolic Syndrome.

The aim of the present study was to evaluate the effectiveness and safety of a nutraceutical combination given to insulin-resistant overweight patients with altered lipid profiles. To this end, an observational study was designed in which 74 individuals (50 females and 24 males) underwent an observational period of 3 months. During this time, a specific nutraceutical combination containing myo-inositol, glycine, Coprinus comatus, α-lipoic acid, phlorizin, zinc, vitamin B6, and chromium picolinate was administered. Patients were asked not to modify their lifestyles so that no variable that might interfere with results was introduced. After the 3-month period, the obtained data revealed that insulin levels significantly decreased with respect to the baseline, while glucose levels exhibited a trend towards lower concentrations, which was not significant. In addition, HOMA-IR index, body weight, BMI, and abdominal circumference values all decreased significantly. Regarding lipid profiles, the data obtained before and after the 3-month period showed statistically significant decreases in concentrations of total cholesterol, LDL cholesterol, and triglyceride, as well as a small but statistically significant concomitant increase in HDL cholesterol. Thus, on the basis of these data, it may be stated that the specific nutraceutical combination used in the present study significantly ameliorated a number of metabolic parameters without measurable side effects. The efficacy and safety of the product were, therefore, confirmed in our group of patients.

Assessing alcohol consumption across phosphatidylethanol levels using HDL-cholesterol as a predictor.

Prior research has established a correlation between increases of High-Density Lipoprotein Cholesterol (HDL-C) levels and alcohol consumption. This study aimed to explore the association between phosphatidylethanol (PEth) levels and the amount of consumed ethanol, utilizing HDL-C as a surrogate marker on a population level. This endeavor offers an adjunct to other studies. PEth and HDL-C levels in 50 751 samples from 29 899 patients in Norway were measured simultaneously in whole blood and serum, respectively. Linear mixed model analyses were employed to assess HDL-C levels within different PEth intervals. Drawing on previous research indicating an increase of .0035mmol/L in HDL-C per gram of pure ethanol consumed per day, and assuming no alcohol intake in the zero PEth group, we estimated mean daily ethanol intake at the group level for males in each PEth interval. Results revealed a significant correlation between PEth and HDL-C levels (Spearman's rho = .385 for women, .420 for men, P <.001). Estimated mean HDL-C levels indicated higher alcohol consumption with increasing PEth. Specifically, men with PEth values in the .031-0.100μmol/L (22-70ng/ml) interval were estimated to consume approximately mean 20 grams of ethanol daily, while those in the .301-0.500μmol/L (212-351ng/ml) PEth interval had an estimated mean daily ethanol intake of 51 grams. The results from this study suggest an approximate estimation of mean daily amounts of consumed ethanol at group levels in different PEth intervals, based on previously shown correlation of ethanol consumption and HDL-C increase.

Characterizing Lipid Changes and Use of Lipid-Lowering Medications in Patients With Alopecia Areata Treated With Baricitinib: Integrated Results From the BRAVE-AA1 and -AA2 Clinical Trials

Introduction. Elevations in total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) can occur with baricitinib treatment, consistent with a class effect of JAK inhibitors. In this analysis, we characterized changes in lipid levels and use of lipid-lowering medication among patients with severe alopecia areata (AA) treated with baricitinib through 152-weeks of treatment. Methods. Two integrated datasets from the BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) trials were analyzed: 1. Extended BARI AA includes patients treated with continuous baricitinib 2 mg (N=383) and 4 mg (N=565) from baseline and censored at dose change: 2. ALL BARI AA (N=1303) includes data for patients who received ≥1 dose of baricitinib at any time. Outcomes included abnormal changes in lipid parameters, mean change from baseline in lipids, and concomitant use of lipid-lowering medications. Results. At time of enrollment, 43% of patients had hypercholesterolemia. Incidence rates for categorical increases in total cholesterol (TC; ≥240mg/dL), LDL-C (≥130 mg/dL), and HDL-C (&gt;60 mg/dL) were 11.8, 13.3, and 12.9 per 100 patients-years of exposure, respectively in the ALL BARI AA dataset. In the Extended BARI AA the mean maximal increase in lipids (mg/dL) for baricitinib 4 mg was 20.9 for TC, 12.4 for LDL-C, and 8.5 for HDL-C. Changes occurred early and stabilized by one year for TC and LDL-C and by 12 weeks for HDL-C. 6.1% (n=79) of patients in the ALL BARI AA dataset used lipid-lowering medication at baseline; post-baseline, 3.9% (n=51) discontinued this medication and 4.7% (n=61) initiated lipid lowering medication. No patients discontinued baricitinib treatment due to treatment-emergent adverse events related to hyperlipidemia. Conclusions. Elevations in TC, LDL-C, and HDL-C, but not triglycerides were associated with baricitinib treatment in patients with AA, consistent with a class effect of JAK inhibitors. The relatively low use of lipid-lowering medications at baseline despite the prevalence of hypercholesterolemia may reflect undermanagement of this condition in the population. Notably, the mean maximal magnitude of increase in lipid levels on baricitinib was modest. Initiation of lipid-lowering medication was infrequent, and no patients discontinued due to lipid abnormalities.

Abstract 4134873: Olezarsen for Hypertriglyceridemia in Patients at High Cardiovascular Risk - A Systematic Review and Meta Analysis

Background: Hypertriglyceridemia, a common lipid disorder linked to increased risks of cardiovascular diseases and metabolic syndrome, remains a global health challenge. Traditional treatments, though widely used, often have limited efficacy and adverse effects. Olezarsen, a novel antisense oligonucleotide, targets apolipoprotein C-III and shows promise in significantly reducing triglyceride levels. Aim: To conduct a meta-analysis comparing Olezarsen with placebo in patients with hypertriglyceridemia. Methods: We performed an extensive literature search of PubMed, EMBASE, and Cochrane Library databases up to May 2024 to identify studies comparing Olezarsen and placebo in patients with hypertriglyceridemia, irrespective of comorbid cardiovascular disease. Effect estimates were pooled using a random-effects model and reported as risk ratios (RR) for dichotomous outcomes and standard mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CIs) for each. Results: Three randomized controlled trials (RCTs) with a total of 334 participants were included. Olezarsen significantly reduced triglyceride levels at 6 months (SMD: -1.69; 95% CI -2.22 to -1.17; P &lt; 0.00001; Figure ) and 12 months (SMD: -1.64; 95% CI -2.22 to -1.07; P &lt; 0.00001; Figure ). VLDL levels also decreased at 6 months (SMD: -1.95; 95% CI -2.38 to -1.51; P &lt; 0.00001) and 12 months (SMD: -0.83; 95% CI -1.13 to -0.53; P &lt; 0.00001). Lipid profile improvements included reductions in total cholesterol, non-HDL cholesterol, and apoB levels, with increases in HDL cholesterol and apoA-1. Adverse events were comparable between Olezarsen and placebo, although serious adverse events were significantly higher in the Olezarsen group (RR: 2.55; 95% CI 1.17 to 5.58; p = 0.02). Conclusion: Olezarsen demonstrates significant efficacy in reducing triglyceride and VLDL levels while improving overall lipid profiles in hypertriglyceridemia patients. Despite higher rates of serious adverse events, its overall safety profile remains acceptable.

Efectividad de un programa en la reducción de los factores de riesgo cardiovascular.

Introduction: The prevalence of cardiovascular risk factors such as overweight, dyslipidemia, hypertension (HTN) and diabetes mellitus (DM2) has increased in recent decades, so there are multiple programs to reduce this prevalence. Objective: To evaluate the early effect of a program aimed at reducing cardiovascular risk factors in secondary education teachers. Methods: An intervention study was carried out based on the application of physical exercises and nutritional education workshops once a week for three consecutive months. General data were recorded and the lipid profile, glucose, blood pressure and body composition were quantified by using the bioimpedance balance, at the beginning of the intervention and 3 months later in the intervention group and the control group. To evaluate the effect of the program, the averages were compared and the level of significance was defined at 0.05. Results: Of a total of 556 people who completed the study, the average age was 44 years; overweight and obesity was at 65.5%. In the intervention group, an increase in HDL cholesterol was evident (OR 1.409; 95% CI 1.213-2.089; p=0.037); decrease in total weight (OR 1.135; CI5% 1.081-1.424; p=0.041) and decrease in visceral fat (OR 2.651; CI5% 1.781-3.271; p=0.024). Conclusion: The intervention program based on weekly exercise and nutritional educational workshop is effective in the short term in reducing some cardiovascular risk factors.

The Effects of Bitter Melon ( Mormordica charantia ) on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Research indicates that bitter melon could be useful in the management of dyslipidemia. Still, there is disagreement concerning the findings. This systematic study was undertaken to clarify the impact of consuming bitter melon on lipid profile. The databases Web of Science, Cochrane Library, PubMed, and Scopus were queried from inception until February 9, 2023. The study assessed triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. The effect sizes were calculated using weighted mean differences (WMDs) and 95% confidence intervals (CIs). Eight randomized controlled trials (RCTs) with a total of 423 participants were included. Bitter melon consumption resulted in a significant decrease in plasma concentrations of TC (WMD; -9.71 mg/dL; CI: -17.69 to -1.74, p = 0.01) and TG (WMD; -10.24 mg/dL; CI: -19.92 to -0.56, p = 0.03), while bitter melon did not significantly lower blood LDL-C (WMD; -8.66 mg/dL; CI: -19.83 to 2.50, p = 0.12) and HDL-C concentrations (WMD; 0.54 mg/dL; CI: -2.38 to 3.45, p = 0.71). Subgroup analysis showed a significant decrease in TC and LDL-C and an increase in HDL-C at a dose of ≤ 2000 mg/day and an intervention period of ≤ 8 weeks. Also, the greatest impact of LDL-C and HDL-C was seen in diabetic and prediabetic people. Bitter melon supplementation positively impacts TC and TG levels. The limitations of this study were short-term trials (less than 3 months).

Efficacy of Food Industry By-Product β-Glucan/Chitin–Chitosan on Lipid Profile of Overweight and Obese Individuals: Sustainability and Nutraceuticals

Fat-binding nutraceutical supplements have gained considerable attention as potential cholesterol-lowering strategies to address dyslipidemia in overweight and obese individuals. This study aimed to evaluate the effects of a polysaccharide-rich compound containing β-glucan/chitin–chitosan (βGluCnCs) on lipid profiles and lipoprotein function. In a prospective, two-arm clinical trial, 58 overweight and obese individuals were randomized to receive either 3 g/day of βGluCnCs or a placebo (microcrystalline cellulose) for 12 weeks. Serum lipids and lipoprotein functions were assessed at baseline and at 4-week intervals throughout the study. The administration of βGluCnCs led to a significant increase in HDL cholesterol (HDLc) levels and improved HDLc/non-HDLc and HDLc/total cholesterol (TC) ratios, while reducing apolipoprotein B (ApoB) levels (p &lt; 0.05). However, the intervention did not affect HDL particle diameter, particle number, or lipoprotein functionality. Women demonstrated greater sensitivity to changes in HDLc during βGluCnCs supplementation, whereas men exhibited a significant reduction in ApoB levels. When stratified by baseline LDL cholesterol (LDLc) levels (cut-off: 130 mg/dL), the increase in HDLc and the ApoA1/ApoB ratio was found in the low-LDL group. In contrast, the high-LDL group experienced a significant reduction in atherogenic non-LDLc and LDLc, along with an improvement in HDL’s antioxidant capacity after βGluCnCs intervention. These changes were not statistically significant in the placebo group. In conclusion, our study demonstrated that daily supplementation with βGluCnCs significantly improved lipid profiles, with effects that varied based on sex and baseline LDLc levels.

7866 Efficacy of Zinc and Myoinositol Supplementation on Metabolic Parameters In A Pediatric Population With Obesity: a Randomized Controlled Trial

Abstract Disclosure: V. Antoniotti: None. V. Mancioppi: None. A. Solito: None. C. Partenope: None. A. Petri: None. I. Rabbone: None. L. Scotti: None. F. Prodam: None. Background: In the last decades, pediatric obesity and cardiovascular-associated risks have been relevant challenges. The first treatment against obesity is a lifestyle change, nevertheless, no intervention seems to be effective in the evolution of the condition, especially in the long term. Thus, the interest in non-pharmaceutical as well as pharmaceutical compounds is growing. Inositol compounds have recently been studied in adults with obesity and insulin resistance but have never been investigated in the pediatric age where insulin resistance is a specific trait of puberty. Furthermore, zinc is critical for insulin secretion and growth. Methods. This is a double-blind, randomized, placebo-controlled study aiming to explore the efficacy of 3 months of combined administration of Zinc (5 mg/die) and Myo-inositol (2000 mg/die) in children and adolescents with obesity. 56 patients aged 10- 17.9 years (starting from Tanner 3) with obesity and insulin resistance have been enrolled. The treatment group received 5 mg of Zinc, 2000 mg of Myo-inositol, and 1000 mg of galactooligosaccharides from Pisum sativum, while the placebo group only received 1000 mg of galactooligosaccharides from Pisum sativum. All patients were subjected to an isocaloric diet following the Mediterranean diet style consisting of 55% carbohydrates, 30-35% fat, and 15% protein. Clinical and biochemical evaluations were carried out for the determination of weight, lipid profile, liver function, and glucose-insulin metabolism. Results. At the end of the study, BMI, fasting insulin, and insulin resistance (HOMA-IR) were significantly improved in both groups, while the treatment group also had an increase in HDL cholesterol (p=0.0426). On the other hand, the placebo group significantly improved its eating habits showing greater adherence to the Mediterranean diet than the treatment group. Moreover, subjects were divided according to the degree of obesity. Fasting insulin (p= 0.0137), HOMA-IR (p= 0.0273), and systolic blood pressure (p= 0.0349) showed a significant improvement in treated patients with severe obesity compared to treated patients with low-grade obesity. Thus, subjects with a higher level of obesity respond better to both treatment and lifestyle change than those with a lower grade of obesity. Also, the improvement of the lifestyle and the presence of fiber allow an increase in the metabolic framework in placebo subjects. Conclusions. Supplementation with Zinc and Myo-inositol could be used as a non-pharmacological compound for the control of complications related to obesity also in the pediatric age. Presentation: 6/1/2024

Optimization of Hypercholesterolemia Treatment after Heart Transplant: The Role of PCSK9 Inhibitors.

Previous studies have reported the benefit of statins after heart transplant (HT). However, the use of high-dose statins might be limited in some HT patients due to intolerance and interactions with immunosuppression or might not be enough to achieve low-density lipoprotein (LDL) cholesterol goals. Hyperlipidemia has been associated with coronary allograft vasculopathy. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors might be a safe and effective option in HT patients with suboptimal lipid control. In a retrospective study, we identified HT patients in our center with LDL cholesterol >100 mg/dL, after diet modifications and up-titration of statins to maximum tolerated dose, treated with PCSK9i. The primary endpoint was LDL reduction one month after, and secondary endpoints were the development of donorspecific HLA antibodies (DSA) and the presence of coronary allograft vasculopathy or rejection. From January, 2018, to January, 2024, we identified five HT patients treated with PCSK9 inhibitors. In all cases, evolocumab was used. A significant reduction in LDL cholesterol was observed (151.6 ± 13.5 mg/dl to 72.4 ± 14.6 mg/dl; p = 0.04, mean reduction 75.7 ± 14.1 mg/dl), as well as in total cholesterol (231 ± 34.6 mg/dl to 152.2 ± 38.9 mg/dl; p < 0.01, mean reduction 78.8 ± 22.2 mg/dl). A significant increase in HDL cholesterol was not observed (45.4 ± 10.9 mg/dl to 46.2 ± 11.1 mg/dl; p = 0.60). One patient developed DSA five years after treatment onset. Rejection and coronary allograft vasculopathy were not observed. PCSK9 inhibitors are safe and effective in reducing LDL in HT patients. However, larger studies are needed to clarify if they can reduce the development of coronary allograft vasculopathy.

Emerging Lipid-Lowering Therapies: A Comprehensive Review of Novel Agents Targeting Hyperlipidemia

Background: Hyperlipidemia is a major risk factor for cardiovascular diseases, often necessitating long-term pharmacological intervention to manage cholesterol and triglyceride levels. Traditional treatments, such as statins and niacin, have been effective but are often associated with adverse effects and limited efficacy in certain populations. The development of novel lipid-lowering therapies, targeting specific mechanisms of lipid metabolism, offers new potential for personalized treatment approaches. Methods: This review examines a range of emerging pharmacological therapies for hyperlipidemia, including PCSK9 inhibitors, CETP inhibitors, ACL inhibitors, MTP inhibitors, APOC3 inhibitors, ANGPTL inhibitors, and antisense oligonucleotides (ASOs). Each class of drugs was evaluated for its mechanism of action, efficacy in clinical trials, and associated side effects. Relevant clinical studies were analyzed to compare their efficacy in reducing LDL cholesterol, raising HDL cholesterol, and improving overall cardiovascular outcomes. Results and Discussion: PCSK9 inhibitors (Alirocumab and Evolocumab) demonstrated a significant 60% reduction in LDL cholesterol levels and improved cardiovascular outcomes when combined with statins. CETP inhibitors, such as Dalcetrapib, increased HDL cholesterol by 31% without affecting LDL cholesterol levels, while Bempedoic acid, an ACL inhibitor, proved effective in lowering cholesterol and glucose levels, especially in statin-intolerant patients. APOC3 inhibitors (Volanesorsen, Olezarsen) successfully reduced triglyceride levels by inhibiting lipoprotein lipase activity. ASO drugs (Mipomersen, Inclisiran) provided gene-targeted therapy for primary hypercholesterolemia, offering a novel therapeutic avenue. ANGPTL inhibitors impacted triglyceride metabolism, and icosapent ethyl significantly reduced cardiovascular risk in statin-treated individuals. These novel therapies have demonstrated significant reductions in LDL and triglyceride levels while improving HDL cholesterol and reducing cardiovascular risks.