Increase In High-density Lipoprotein Cholesterol Research Articles

Pleiotropic effects of PPAR-α – from benchside to bedside

Here we review literature data on properties of a member of nuclear hormone receptors - peroxisome proliferator-activated receptor-α. It was shown that PPARα was expressed on different cells including dendritic cells, macrophages, B- and T-cells. We discuss structure of natural and synthetic ligands of PPARa, molecular and cellular mechanisms of PPARa regulation of lipid and carbohydrate cellular metabolism. PPARa activity in hepatocytes results in decrease of intracellular concentrations of lipid acids. This leads to reduction of VLDL cholesterol, increase in HDL-cholesterol and decrease in triglycerides in plasma of patients taking PPARα agonists. Modulation of PPARa activity may change multiple biological effects of glucocorticoids (GCS) and insulin resistance. It is assumed that PPARα agonists reduce side effects of GCS and at the same time enhance their anti-inflammatory activity due to transrepression of NF-kB. We analyzed the results of several randomized studies, meta-analyses devoted to assessment of efficacy and safety of PPARa agonist fenofibrate in patients with type 2 diabetes mellitus with high risk of micro- and macrovascular events. The studies showed good safety profile of monotherapy with fibrates as well as of their combinations with statins, ezetimibe. Fibrates reduced not only cardiovascular events but also overall mortality. We present the data on the role of PPARa in control of glucose and lipid metabolism in subpopulations of innate and adaptive immunity cells. The data show that glucose and lipid metabolism play an important role in the fate of cells of innate and adaptive immunity. The metabolic state of lymphocytes has dynamic nature and depends on their functional activity. Transition from dormant cells with relatively low metabolism rate to activated and proliferating cells is accompanied with increase of metabolic demands. This transition is supported with the switch from oxidative metabolism to anaerobic glycolysis (Warburg effect) after antigen recognition by T-cells and B-cells. It was shown that granulocytes, dendritic cells and M1 macrophages were dependent on glucose metabolism during their activation while M2 macrophages were dependent on fatty acids oxidation. In contrast with lymphocytes, activated myeloid cells do not proliferate well but still have increased glycolysis which is necessary for their effector function. It is stressed that modulation of immune cells metabolism via PPARα gives new opportunities to modulate intensity and duration of immune responses in chronic diseases. We analyze studies performed on animal models of some chronic diseases, human patients with rheumatoid arthritis and different phenotypes of osteoarthritis. Most of the studies showed clinical efficacy and pleiotropic effects of PPARα agonists: antiinflammatory, immunomodulating and lipid modulating, primarily reduction of triglycerides and increase in HDL-C. The presented literature data suggest efficacy of PPARα agonists against individual components of polypathies. This could reduce risk of polypharmacy and reduce direct treatment costs. It is not unlikely that the use of PPARα agonists in a patient with multimorbidity could prevent acquiring a new disease. These are merely suggestions and much effort and time is required to perform large-scale randomized controlled studies evaluating new indications for the use of PPARa agonists.

Growth pattern, lipid composition, oxidation status, and serum biochemical profile of broiler chicken fed flaxseed meal for different durations

This research studied the effects of flaxseed meal (FSM) feeding for different durations on growth performance, fatty acid profile, oxidative stability of meat, and serum biochemical profile of broiler chicken. In basal diet 100 g FSM replaced soybean meal. The FSM based diet was fed for different durations resulting in six dietary treatments viz. T1 (0-5 weeks), T2 (1-5 weeks), T3 (2-5 weeks), T4 (3-5 weeks), T5 (4-5 weeks), and T6 (without FSM). The results revealed significant negative effects of FSM feeding beyond 3 weeks duration (2-5 weeks) on the weight gain, feed efficiency, production efficiency factor, protein efficiency ratio, and energy efficiency ratio of broiler chicken. Significant improvement of fatty acid profile of chicken meat was observed by FSM feeding up to 3 weeks only. Increasing the FSM feeding beyond 1 week in case of thigh meat and 2 weeks in case of breast meat significantly decreased the antioxidant capacity of broiler chicken meat. The lipid oxidation of broiler chicken meat increased significantly by feeding FSM beyond 2 weeks. Increase in the duration of FSM feeding has significantly decreased the serum triglyceride, cholesterol, cardiac risk ratio, atherogenic coefficient, and atherogenic index of plasma, though, the decline was not significant beyond the 2 weeks (3-5 weeks) feeding duration. The progressive increase in serum HDL cholesterol, serum antioxidant enzyme activities, and MDA concentration was observed with increase of FSM feeding duration. Thus, the 100 g FSM feeding for 2 weeks duration (3-5 weeks) has no negative effect on the growth performance with better health indices and serum biochemical profile of broiler chicken. However, increasing the duration of feeding beyond 1 week (4-5 week) exerts negative effects on the oxidative stability of meat and serum antioxidant enzyme profile.

Intake of pitaya (Hylocereus polyrhizus (F.A.C. Weber) Britton & Rose) beneficially affects the cholesterolemic profile of dyslipidemic C57BL/6 mice

Dyslipidemias are disorders in the serum lipid profile whose numbers of cases have been increasing annually, however, pharmacological therapy is expensive and may cause side effects, such as myalgia and liver disease. In this sense, the natural products, which are rich in antioxidant and therapeutic components, have been proposed as an alternative therapy. An example of this is pitaya (Hylocereus polyrhizus), that is a cactaceous fruit rich in phytochemicals, and could be exhibit beneficial effects on lipid metabolism. Thus, this study aimed to investigate the activity of the edible portion of pitaya (pulp and seed) on dyslipidemic mice's metabolism. Firstly, the composition of pitaya was assessed by UPLC-QTOF-MSE and oligosaccharides, quercetin, and betanine, among other phytochemicals, were putatively identified. In the in vivo assays, the mice were divided into 6 groups (n = 8) which were called according to treatment received: Standard Diet (SD), Hypercholesterolemic Diet (HD), Simvastatin (SIMV), Pitaya 100 mg/kg (P100), Pitaya 200 mg/kg (P200) and Pitaya 400 mg/kg (P400). For dyslipidemia induction, the daily administration of pitaya in C57BL/6 mice with dyslipidemia (HD, SIMV, P100, P200 and P400). The pitaya treatment resulted in an increase HDL-cholesterol, and a decrease in total and LDL-cholesterol, triacylglycerols, glycemia, alanine aminotransferase and aspartate aminotransferase. The red pitaya showed therapeutic potential in dyslipidemia disorders and had a hypoglycemic effect, contributing to reducing the risk of cardiovascular diseases.

PROPHYLACTIC LIPID LOWERING EFFECTS OF AQUEOUS EXTRACT OF EMILIA PREATEMISSA ON CARBON TETRACHLORIDE (CCL4)-INDUCED HYPERLIPIDEMIC ALBINO RATS

Objective: Hyperlipidemia has been described as one of the greatest risk factors contributing to the prevalence and severity of cardiovascular diseases which has been identified as a primary cause of death. This study evaluates the lipid-lowering effects of aqueous extract of Emilia praetermissa (EP) leaves.
 Methods: The investigation was carried out on rats induced with Carbon tetrachloride (CCl4 1 ml/kg body weight), pretreated with the aqueous extracts of Emilia praetermissa and then compared with a standard hypolipidemic drug, Simvastatin. The effects of Emilia praetermissa on the lipid profile were assessed by measuring the levels of total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol. The effect on HMGCoA Reductase and Lecithine Cholesterol Acyltransferase (LCAT), which are important enzymes in lipid metabolism were also evaluated in the plasma, liver and heart of albino rats.
 Results: Administration of 50, 100 and 200 mg/kg doses of aqueous extract of Emilia praetermissa leaves led to a significant reduction (P<0.05) in total cholesterol, LDL cholesterol, triglyceride levels and a significant increase (P<0.05) in HDL cholesterol in the tissues in a manner close to that of Normal and Standard control group. Emilia praetermissa aqueous extract led to a significant increase (P<0.05) in the activity of LCAT and inhibition of HMGCoA reductase.
 Conclusion: These results suggest that Emilia praetermissa leaves could play a cardioprotective role and probably serve as a new potential natural product for the management of hyperlipidema. Further investigations are warranted to elucidate the mechanism of its lipid-lowering action.

Early-life associations between per- and polyfluoroalkyl substances and serum lipids in a longitudinal birth cohort

BackgroundExposures to per- and polyfluoroalkyl substances (PFASs) may affect metabolic outcomes, including lipid concentrations in the blood. However, few studies have evaluated potential associations between PFASs and lipids longitudinally. ObjectivesWe estimated associations between PFAS and lipid concentrations at birth and at several points in childhood. MethodsWe measured concentrations of five major PFASs in cord serum and in serum collected at 18 months, five years and nine years in 490 children from a prospective cohort in the Faroe Islands. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations were measured at birth, 18 months and nine years. We estimated associations between PFAS and lipid concentrations and evaluated possible effect modification by sex. We also tested whether PFAS associations with age-nine lipids varied by exposure period. ResultsSerum PFAS concentrations at ages five and nine were positively associated with lipid concentrations at age nine. Cross-sectional associations between PFASs and lipids at age nine were the strongest, with increases in serum concentrations of perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA) and perfluorooctanesulfonic acid (PFOS) associated with increases in TC, HDL-C and LDL-C. We found statistically significant differences in estimated PFAS effects by sex, where girls had stronger positive associations between PFASs and TC and LDL-C and boys had stronger positive associations with HDL-C. In repeated measure models, exposure period was a significant modifier of PFAS effects. ConclusionsOur findings suggest that childhood PFAS exposures may be associated with elevated serum lipid concentrations. This is a public health concern, as a detrimental lipid profile in childhood is a risk factor for later development of hyperlipidemia and cardiovascular disease.

Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting.

Background: The prevention and treatment of obesity and its cardio-metabolic complications are relevant issues worldwide. Among lifestyle approaches, very low-calorie ketogenic diets (VLCKD) have been shown to lead to rapid initial weight loss, resulting in better long-term weight loss maintenance. As no information on VLCKD studies carried on in a real-world setting are available, we conducted this multi-centre study in a real-world setting, aiming at assessing the efficacy and the safety of a specific multiphasic VLCKD program in women with overweight or obesity. Methods: A multi-center, prospective, uncontrolled trial was conducted in 33 outpatient women (age range 27–60 y) with overweight or obesity (BMI: 30.9 ± 2.7 kg/m2; waist circumference: 96.0 ± 9.4 cm) who started a VLCKD dietary program (duration: 24 weeks), divided into four phases. The efficacy of VLCKD was assessed by evaluating anthropometric measures and cardiometabolic markers; liver and kidney function biomarkers were assessed as safety parameters. Results: The VLCKD program resulted in a significant decrease of body weight and BMI (−14.6%) and waist circumference (−12.4%). At the end of the protocol, 33.3% of the participants reached a normal weight and the subjects in the obesity range were reduced from 70% to 16.7%. HOMA-IR was markedly reduced from 3.17 ± 2.67 to 1.73 ± 1.23 already after phase 2 and was unchanged thereafter. Systolic blood pressure decreased after phase 1 (−3.5 mmHg) and remained unchanged until the end of the program. Total and LDL cholesterol and triglycerides were significantly reduced by VLCKD along with a significant HDL cholesterol increase. Liver, kidney and thyroid function markers did not change and remained within the reference range. Conclusions: The findings of a multi-center VLCKD program conducted in a real-world setting in a cohort of overweight/obese women indicate that it is safe and effective, as it results in a major improvement of cardiometabolic parameters, thus leading to benefits that span well beyond the mere body weight/adiposity reduction.

Is Trikatu an ayurvedic formulation effective for the management of flu-like illness? A narrative review.

The aim of this review is to summarise and appraise the findings of various studies on Trikatu. COVID-19 or SARS-CoV-2 disease a pandemic principally contaminating the respiratory tract and bringing about Severe Acute Respiratory Syndrome is liable for significant mortality around the world. Far-fetched, there is no exact treatment accessible till today. Consequently, it is critical to discover the alternative methodology which can decrease the weight of illness. Trikatu powder recommended by authorities for the management of mild cases of COVID-19 is a conventionalayurvedicformulation containing three spices;Zingiber officinale, Piper nigrum, and Piper longum. A comprehensive search of the articles published since inception to 01/08/2020 on Trikatu was carried out. Major electronic medical databases such as Pub Med/MEDLINE and Cochrane Database of Systematic Reviews were used for the literature search. A total of 21 records were identified by electronic searches between since inception to 01/08/2020 of which 13 records were included for review. The reviewed articles highlight Trikatu as a safe, anti-inflammatory, and immune-modulatory property by suppression of the production of pro-inflammatory cytokines TNF-a, IL-1b, IL-6, IL-17, alteration in levels of circulating immune complexes, anti-dyslipidaemia agent by reduced triglycerides and LDL cholesterol and increased HDL cholesterol, enhancing bio-availability of co-drug by reducing the elimination half-life (t1/2β) and zero time intercept of the elimination phase. The findings of this review seem to show Trikatu as a potential anti-inflammatory, anti-dyslipidaemia, and immune-modulatory ayurvedic formulation can be used for combating flu like illnesses and also in the management of COVID-19 as an adjuvant. However, rigorous double blind randomized controlled trials with larger sample size are warranted for better validation in such clinical conditions.

Effects of a Self-Prepared Carbohydrate-Reduced High-Protein Diet on Cardiovascular Disease Risk Markers in Patients with Type 2 Diabetes.

We previously observed beneficial effects of a carbohydrate-reduced, high-protein (CRHP) diet on cardiovascular risk markers in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, when all food was provided to subjects as ready-to-eat meals. Here, we report the results from a 6-month open label extension: 28 patients with T2DM were instructed to self-prepare the CRHP diet with dietetic guidance. At weeks 0, 6, 12, and 36, fasting and postprandial (4-h meal test) blood samples were collected for measurements of total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triacylglycerol (TG), apolipoproteins A1 and B, non-esterified fatty acids (NEFA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6. Diurnal blood pressure and heart rate were also assessed. At the end of the study (week 36), concentrations of fasting total and LDL-cholesterol, fasting and postprandial NEFA and TG, and fasting apolipoprotein-B, CRP and TNF-α concentrations were significantly lower compared with week 0 (p < 0.05). A significant decrease in diurnal heart rate was also observed. From week 12 to 36, an increase in HDL-cholesterol and apolipoprotein-A1 concentrations and a further reduction in fasting and postprandial NEFA (p < 0.05) were found. These changes were independent of minor fluctuations in body weight. We conclude that the substitution of dietary carbohydrate for protein and fat has beneficial effects on several cardiovascular risk markers in patients with T2DM, which are maintained or augmented over the next 6 months when patients select and prepare the CRHP diet on their own in a dietitian-supported setting.

Twelve weeks’ treatment with a polyphenol-rich seaweed extract increased HDL cholesterol with no change in other biomarkers of chronic disease risk in overweight adults: A placebo-controlled randomized trial

Cardiovascular diseases (CVD) are the leading global cause of death. Strategies to reduce CVD risk are urgently needed. Polyphenols represent a class of bioactive compounds with potential to moderate biochemical risk factors for CVD (cholesterol, triglycerides, glucose, and inflammation). This double-blind, placebo-controlled, randomized parallel-groups trial investigated the effect of a polyphenol-rich seaweed (Fucus vesiculosus) extract on biochemical markers of CVD risk. Thirty-four overweight and obese adults (21 female, 13 male) with elevated low-density lipoprotein cholesterol (>2.0 mmol/L) were randomized to either the seaweed extract (2000 mg/d) or placebo for twelve weeks. Fasting blood samples were collected at baseline, week six and week twelve to assess biochemical markers. Tests of cognitive performance and mood were performed at baseline, week six and week twelve. A 9.5% (-2.3, 12.9) increase in high-density lipoprotein (HDL) cholesterol was identified following the seaweed extract (baseline: mean (SD) 1.28 (0.23) mmol/L, week 12: 1.35 (0.24) mmol/L) which was different to placebo (baseline: 1.38 (0.54) mmol/L, week 12: 1.35 (0.59) mmol/L) (P=.045). No changes were identified in low-density lipoprotein cholesterol, total cholesterol, triglycerides, glucose, insulin, interleukin (IL)-2, IL-6, IL-8, IL-10, or tumour necrosis factor-alpha levels in the blood, or in cognitive performance or mood between the treatment and placebo groups. Despite the small increase observed in HDL cholesterol, the polyphenol-rich seaweed extract did not change CVD risk factors in adults with high fasting lipids. A larger sample size would be required to confirm the clinical relevance of the changes in HDL cholesterol.

Nanochitosan Effect on Biomolecular, Hypolipidemic in Rats and Incorporation in Functional Yogurt.

&lt;b&gt;Background and Objective:&lt;/b&gt; Chitosan has many functional properties and biological activities. This work aimed to prepare and characterize Chitosan Nanoparticles (CN). Then, evaluate the hypolipidemic and antioxidant effect of CN in rats. Incorporate CN in camel yogurt and evaluation of yogurt properties. &lt;b&gt;Materials and Methods:&lt;/b&gt; Chitosan Nanoparticles (CN) were prepared and analyzed for the size, zeta potential and poly Polydispersity Index (PDI). Total 24 rats were divided into 4 groups, the negative control group was fed on the basal diet and the positive control group was fed on a High-Fat Diet (HFD), the group I and II were fed on the HFD+(CC) or (CN). The feeding period was 6 weeks. Prepared and Characterization stirred camel yogurt fortified by CN. &lt;b&gt;Results:&lt;/b&gt; CN the size was 27.20 nm, ζ-potential+38.78. After the feeding period for CN and CC groups were a decrease in body weight, serum lipid profile and liver function in both tested groups and an increase in HDL-cholesterol and an increase in antioxidants in the CN group more than that in the CC group was observed. mRNA expression with qPCR for hepatic PPARγ, HL, GSS and CYP2E1 genes was performed to investigate the alterations in their levels after CN treatment on the liver of rats fed with HFD. &lt;b&gt;Conclusion:&lt;/b&gt; CN possesses the ability to improve the impairment of lipid metabolism as strongly associated with gene expressions related to lipogenesis and oxidative stress. Also, the addition of 2% CN to camel yogurt gave sensory acceptable and microbiological quality.

Plasma high-density lipoprotein cholesterol and risk of dementia: observational and genetic studies.

The association of plasma high-density lipoprotein (HDL) cholesterol with risk of dementia is unclear. We, therefore, tested the hypothesis that high levels of plasma HDL cholesterol are associated with increased risk of dementia and whether a potential association is of a causal nature. In two prospective population-based studies, the Copenhagen General Population Study and the Copenhagen City Heart Study (N = 111 984 individuals), we first tested whether high plasma HDL cholesterol is associated with increased risk of any dementia and its subtypes. These analyses in men and women separately were adjusted multifactorially for other risk factors including apolipoprotein E (APOE) genotype. Second, taking advantage of two-sample Mendelian randomization, we tested whether genetically elevated HDL cholesterol was causally associated with Alzheimer's disease using publicly available consortia data on 643 836 individuals. Observationally, multifactorially adjusted Cox regression restricted cubic spline models showed that both men and women with extreme high HDL cholesterol concentrations had increased risk of any dementia and of Alzheimer's disease. Men in the 96th-99th and 100th vs. the 41st-60th percentiles of HDL cholesterol had multifactorially including APOE genotype adjusted hazard ratios of 1.66 (95% confidence interval 1.30-2.11) and 2.00 (1.35-2.98) for any dementia and 1.59 (1.16-2.20) and 1.87 (1.11-3.16) for Alzheimer's disease. Corresponding estimates for women were 0.94 (0.74-1.18) and 1.45 (1.03-2.05) for any dementia and 0.94 (0.70-1.26) and 1.69 (1.13-2.53) for Alzheimer's disease. Genetically, the two-sample Mendelian randomization odds ratio for Alzheimer's disease per 1 SD increase in HDL cholesterol was 0.92 (0.74-1.10) in the IGAP2019 consortium and 0.98 (0.95-1.00) in the ADSP/IGAP/PGC-ALZ/UKB consortium. Similar estimates were observed in sex stratified analyses. High plasma HDL cholesterol was observationally associated with increased risk of any dementia and Alzheimer's disease, suggesting that HDL cholesterol can be used as an easily accessible plasma biomarker for individual risk assessment.

Serum lipid and adiponectin/leptin ratio changes after a Mediterranean dietary pattern in non-g-allele carriers of the genetic variant of adiponectin gene rs822393.

One common genetic variant rs822393 (-4522C/T) is located in the proximal promoter region of the ADIPOQ gene. The SNP rs822393 regulates adiponectin promoter activity and is associated with hypoadiponectinemia. The aim of our study was to analyze the effects after a hypocaloric diet with Mediterranean diet pattern on serum lipid and adipokine levels taking to account rs822393 of ADIPOQ. A population of 270 obese patients was enrolled. Anthropometric parameter and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, adiponectin, resistin and leptin levels) were measured, at basal time and after 3 months. All patients were genotyped in the rs822393 polymorphism. The genotype distribution was: 160 patients (59.3%) CC, 96 patients CT (35.6%) and 14 patients CT (5.1%). After dietary intervention, BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin levels, HOMA-IR, total cholesterol and LDL- cholesterol improved significantly in both genotypes. After dietary intervention (CC vs. CT+TT), HDL-cholesterol (delta: 5.4±1.4 mg/dl vs. -1.8±0.7 mg/dl; p=0.03), serum adiponectin (delta: 21.2±4.1 ng/dl vs. 3.8±3.3 ng/dl; p=0.02) and adiponectin/leptin ratio (delta: 0.53±0.1 vs. 0.16±0.3 ng/dl; p=0.02) improved only in non-T allele carriers. Basal and post-intervention HDL cholesterol, adiponectin levels and adiponectin/leptin ratio were lower in T-allele carriers than non-T Allele carriers. T allele carriers show lower levels of HDL-cholesterol, adiponectin and adiponectin/leptin ratio than non-T allele carriers. During a hypocaloric diet with Mediterranean partner increases HDL Cholesterol, adiponectin levels and ratio adiponectin/leptin in non-T allele carriers.

Effect of high-intensity interval training and pre-meal water consumption on lipid profile in overweight and obese students

Introduction: Obesity and overweight in adolescents and adults are associated with chronic diseases. The objective of this study was to determine the effect of high-intensity interval training and pre-meal water intake on the lipid profile of overweight and obese students. Methods: This was a pre-post experimental study. Twenty-seven overweight and obese students (mean BMI 26.0±3.1 kg/m2 and mean age 19.7±0.7 years) were divided randomly into three groups. The first group (n=9; BMI=26.6±3.6 kg/m2) received Plain Water Intake (PWI) intervention, whereby students received three bottles of plain water (600 mL) per mealtime (total 1.8 L/ day) and consumed ad libitum 30 to 45 minutes before mealtime (breakfast, lunch, and dinner). The second group (n=9; BMI=25.9±2.4 kg/m2) received High-Intensity Interval Training (HIIT) intervention and underwent three exercise sessions per week (18 minutes/day; 70–85% of HRmax) that was introduced through a video recording. The last group (n=9; BMI= 25.7±3.4 kg/m2) received a combination of PWI+HIIT intervention. Nutritional status, nutrient intake, and lipid profile [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] were assessed before and after the interventions. Data were analysed using paired sample t-test and Analysis of Variance (ANOVA). Results: The PWI group showed a significant increase in HDL-C, while the HIIT group showed a significant reduction in TC (p&lt;0.05). On the other hand, the PWI+HIIT group showed significant improvements in lipid profile (TC, TG and HDL-C) (p&lt;0.05). Conclusion: A combination of PWI+HIIT intervention may be effective in improving lipid profile.

HDL Cholesterol and Non-Cardiovascular Disease: A Narrative Review.

High density lipoprotein (HDL) cholesterol has traditionally been considered the “good cholesterol”, and most of the research regarding HDL cholesterol has for decades revolved around the possible role of HDL in atherosclerosis and its therapeutic potential within atherosclerotic cardiovascular disease. Randomized trials aiming at increasing HDL cholesterol have, however, failed and left questions to what role HDL cholesterol plays in human health and disease. Recent observational studies involving non-cardiovascular diseases have shown that high levels of HDL cholesterol are not necessarily associated with beneficial outcomes as observed for age-related macular degeneration, type II diabetes, dementia, infection, and mortality. In this narrative review, we discuss these interesting associations between HDL cholesterol and non-cardiovascular diseases, covering observational studies, human genetics, and plausible mechanisms.

Alirokumab in the practice of a multidisciplinary outpatient hospital: results of an open, noncomparative prospective study

Aim. Evaluation of efficacy and safety of alirocumab in patients with atherogenic dyslipidemia in real clinical practice. Materials and methods. Patients with atherogenic dyslipidemia and failure to achieve target lipid levels were included in a prospective, non-comparative study. For the final analysis, the data of 92 patients were studied: 61 men and 31 women; average age 59.8 ± 9.6 years. Alirokumab (Praluent, Sanofi) was administered at a dose of 150 mg subcutaneously once every 2 weeks for 3 months. The primary endpoint was the achievement of the target level of low-density lipoprotein cholesterol (LDL-C). Additionally, the level of lipoprotein(a) (LP(a)) and high-density lipoprotein cholesterol (HDL-C) was assessed. To assess safety, liver tests, creatinine levels and glycemia were examined; side effects have been studied. To test statistical hypotheses, a paired t-test and Wilcoxon’s test were used. Results. After 3 months therapy, there was a statistically significant decrease in LDL-C: 1.45 [0.99; 2.14] vs 3.00 mmol / l [2.17; 3.81] initially ( p &lt; 0.0001); the median of the decline was –47% [–25; –65]; the target level of LDL-C was achieved in 40 (43%) patients. An increase in HDL-C was noted after 3 months treatment, their level was 1.36 ± 0.41 mmol / L vs 1.31 ± 0.38 mmol / L at baseline ( p &lt; 0.01). The concentration of LP(a) was re-measured in 21 patients with a baseline level &gt; 30 mg / dL : a statistically significant decrease was achieved after 3 months: 67 mg / dL [46; 155] vs 85 mg / dL [58; 187] initially ( p &lt; 0.001). Indicators of liver function tests, creatinine and fasting glycemia did not change significantly. Side effects and undesirable effects were not recorded. Conclusion. In real clinical practice, after 3 months treatment with alirokumab there was a significant decrease in the level of LDL-C, target levels were achieved in 43% of patients, there was a significant decrease in the level of LP(a) and an increase in HDL-C.

THERAPEUTIC ASPECTS OF ONION IN TREATMENT OF CANCER AND RELATED ISSUES: A REVIEW

Human has always found nature as its good mate. Human beings have always used herbal/ayurvedic remedies in the treatment of their several diseases with very less side effect. Allium species are one of the herbs whose parts like roots, leaves, stems and also juices is very useful for curing cancer, cardiovascular diseases, inflammation, reducing blood sugar, baldness, gastric ulcer, colic diseases, oxidative study (Khan, May 2017). Consumption of Allium vegetables indicated decreased cancer risk, particularly gastrointestinal tract cancers as reported by epidemiological studies; though of limited asses. Mechanistic studies give the major supporting evidence of cancer preventive effect of Allium vegetables. The studies highlight mechanism of compounds having sulfur, extracts of onion, various preparations and their lower activation of carcinogens, antioxidant, antimicrobial, antibacterial and oxidoreduction modification. Onion is also seen as reducing obesity and thus reducing the risk of cancer associated with potential obesity. Onion can be used as an obesity reducing agent by acting on the low-density cholesterol and increase high density lipoprotein cholesterol.

Lipid effects of sodium-glucose cotransporter 2 inhibitors.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are widely used antihyperglycemic drugs that show remarkable cardiorenal protective effects in patients with or without type 2 diabetes. Furthermore, they are effective among patients across a wide range of baseline renal and cardiac function. Numerous mechanisms have been evaluated to understand these remarkable clinical benefits. From an early stage, these agents were noted to affect the plasma lipid profile. Here we review lipid profile alterations attributable to SGLT2 inhibitors and also some mechanisms explored in model systems and human studies. SGLT2 inhibitors given to patients with diabetes as monotherapy shift substrate utilization from carbohydrates to lipids, and have mild effects on the lipid profile. Increased LDL cholesterol appears to be associated with increased hepatic production and decreased catabolism. Increased HDL cholesterol and decreased triglycerides appear to be associated with improved insulin sensitivity and increased lipolysis. Lipid effects of SGLT2 inhibitors are further modulated by background therapy with other diabetes medications and statins. The minor lipid profile alterations observed in patients treated with SGLT2 inhibitors are offset by the staggering range of beneficial pleiotropic mechanisms that likely explain the marked cardiorenal benefits of these agents.

Differences in Immune Response and Biochemical Parameters of Mice Fed by Kefir Milk and Lacticaseibacillus paracasei Isolated from the Kefir Grains.

The health benefits of kefir consumption have been well-known for hundreds of years. The objective of this study was to investigate the effect of kefir milk and the probiotic strain Lacticaseibacillus paracasei Ž2 isolated from kefir grains on the immune response and selected parameters of the lipid and liver enzymatic profiles of mice. Mice fed with kefir milk showed significantly increased phagocytic activity and percentages of B cells in the blood and increased gene expression for mucins and percentages of CD8+ lymphocytes in the gut. By applying kefir, we achieved a significant reduction in serum LDL cholesterol and an LDL/HDL ratio that favored an increase in HDL cholesterol. Regarding the hepatic enzymes, in particular a significant reduction in ALT activity was observed. L. paracasei Ž2 alone stimulated the immune response more markedly compared with kefir milk. Regarding the systemic level, we observed increases in the proportion of all T cells (CD3+), CD4+ lymphocytes and the ratio of CD4+:CD8+ cells, and regarding the local intestinal level we noted a significant increase in gene expression for mucins (MUC-1 and MUC-2) and IgA. Moreover, we confirmed the formation of a biofilm on the surface of the forestomach only after the application of L. paracasei Ž2 alone, but not after kefir administration. The results confirmed the hypothesis that the final effect of the probiotic does not correspond with the effect of the individual strain but is the result of mutual interactions of the microorganisms presented in a preparation, and therefore in the case of multi-strain probiotics, in vivo testing of the complex preparation is necessary.

Antihyperglycemic and Antihyperlipidemic Effects of HydroalcoholicExtract of Ferulago angulta in Experimental Hyperlipidemic Rats

BACKGROUND: Metabolic disorders, and their consequences, are among the most important hygienic problems of mod-ern life. OBJECTIVES: Due to the increased global interest in natural remedies and their importance in the treatment of diseases, Ferulago angulata, as one of the oldest known medicinal plants of folk medicine, was evaluated its hypolipidemic and hypoglycemic effects. METHODS: A total of 147 adult male rats were randomly divided into seven groups, each with three replicates (n=7): control group, untreated hyperlipidemia group, three treated hyperlipidemia groups, treated with 125, 250, and 500 mg/kg of the F. angulata hydroalcoholic extract (FAHE), two hyperlipidemia groups treated with atorvastatin (10 mg/kg), and metfor-min (500 mg/kg). After 21 days, serum glucose and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), very low-density lipoprotein (VLDL), and the ratios of LDL/HDL and TC/LDL, were measured. RESULTS: In all hyperlipidemia groups treated with different doses of FAHE, glucose, TG, TC, LDL-C, and LDL/HDL ratios were significantly reduced, while significant increases in HDL-C and cholesterol/LDL ratios were observed com-pared to the untreated hyperlipidemia group; however, a significant reduction of VLDL was only observed at the dose of 500 mg/kg FAHE. Hypolipidemic and hypoglycemic effects of FAHE at 250 and 500 mg/kg doses were comparable to atorvastatin and metformin. CONCLUSIONS: These results indicated the hypolipidemic and hypoglycemic effects of FAHE, which may be due to the high phenolic, flavonoids, and trace element contents, providing powerful antioxidant potential and affecting the en-zymatic pathways of lipid and glucose synthesis and metabolism

EFFECTIVENESS AND SAFETY OF NUTRACEUTICAL COMPOUNDS ADDED TO EZETIMIBE TREATMENT IN HYPERTENSIVE AND HYPER–CHOLESTEROLEMIC SUBJECTS WITH STATIN–INTOLERANCE

Objective: The effectiveness of statins in the primary and secondary prevention of cardiovascular (CV) diseases has been widely proven. However, the onset of adverse events associated with their use, prevents to achieve the therapeutic targets recommended by the guidelines (GL) for the management of dyslipidaemia. In the event of statin intolerance, is recommend to use bile acid sequestrants, fibrates and ezetimibe in monotherapy, but their benefits in improving lipid pattern are quite modest. This study aims at evaluating the effectiveness and safety of a nutraceutical compound (NC) associated with ezetimibe (E) on the lipid profile in statin-intolerant patients with moderate-to-high CV risk Design and method: Ninety-six statin-intolerant hypertensive and hyper-cholesterolemic subjects treated with E 10 mg daily, were randomised in open label (n = 48) to take for 3 months a NC containing Monacolin K (MK) 5 mg, Berberine Hydrochloride, t-Resveratrol, Quercetin, and Chromium, in the form of a gastro-resistant tablet that improves enteric bio-accessibility and bio-availability of these substances. The control group (n = 48), took only E in monotherapy at the same dosage; both groups followed a standardised lipid-lowering diet. The total serum cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatinine phosphokinase (CPK) levels were compared at the follow-up in both groups using Student's t-test. Results: TC and LDL levels reduced in both groups, but there lower in the group treated with E+ NC vs E alone (-25.9 vs -15%, p &lt; 0.05 and -38.7 vs. -21.0%, p &lt; 0.05, respectively). No changes were observed in either group regarding to a decrease in TG (-9.4 vs. -11.7%, NS) and an increase in HDLC (+ 4.2 vs. +1.1%, NS). The AST, ALT and CPK levels increased in the E + NC compared to the control group, but were still within the acceptable range. There was no difference for the lipid-lowering treatment between gender, and no patient withdrawn the study. Conclusions: In hypertensive and hyper-cholesterolemic subjects with statin-intolerance, the E + NC combination therapy is well-tolerated and effective in the short term in improving TC and LDLC levels.