Parameters Of Lipid Metabolism Research Articles

Potential role of skeletal muscle glycerophosphocholine in response to altered fluid balance in humans: an in vivo nuclear magnetic resonance study.

Many cells adapt to hyperosmolal conditions by upregulation of organic osmolytes to maintain cell function and integrity. Glycerophosphocholine (GPC), a recognized osmolyte in renal medullary cells, is the major phosphodiester (PDE) in human skeletal muscle, wherefore we hypothesized muscular GPC to be associated with surrogate parameters of fluid status and osmolality in healthy humans. The objective of this study was to investigate the relationship of muscular GPC with surrogate parameters of body fluid status and osmolality. We analyzed data of 30 healthy volunteers who underwent noninvasive 31P-magnetic resonance spectroscopy of either calf (n = 17) or thigh (n = 13) muscle. Therefore, we conducted correlation analyses between phosphor metabolites, and blood values depicting body fluid status and osmolality. Relevant parameters were further implemented in a multivariable regression model to evaluate if GPC concentrations can depict variations in fluid and electrolyte balance. Uric acid (0.437, P = 0.018) and urea (0.387, P = 0.035) were significantly correlated with GPC, which in case of uric acid was independent of sex. Considering sex, following multivariable regression reported GPC as suitable parameter to predict uric acid (R2 = 0.462, adjusted R2 = 0.421; P < 0.001). Our data indicate a connection between muscular GPC concentrations and uric acid, which is a marker of body fluid status, in healthy human subjects, suggesting that skeletal muscle might regulate GPC content in adaptation to changes in fluid status.NEW & NOTEWORTHY Using in vivo magnetic resonance spectroscopy, our study is the first one indicating fluid balance-dependent properties of glycerophosphocholine concentrations in human skeletal muscle. In vivo examination of GPC as organic osmolyte in human skeletal muscle marks a novel approach, which might give further insight on how water and electrolyte balance affect muscle tissue. Beside this main finding, glycerophosphocholine of both calf and thigh muscle correlated remarkably with blood laboratory parameters of lipid metabolism in our study population.

Chromium Nanoparticles Together with a Switch Away from High-Fat/Low-Fiber Dietary Habits Enhances the Pro-Healthy Regulation of Liver Lipid Metabolism and Inflammation in Obese Rats.

The study on Wistar rats was conducted to investigate the effects of a pharmacologically relevant dose 0.3 mg/kg body weight of chromium supplementation (commonly used picolinate or novel form as nanoparticles) and switching away from obesogenic dietary habits on the parameters of lipid metabolism, inflammation, and oxidative stress in liver and plasma. Favorable effects related to dietary changes from the obesogenic diet were considerably enhanced when the diet was supplemented with chromium nanoparticles. This combination exerted the strongest fat content and cholesterol reduction in the liver. Moreover, in this group, a favorable antioxidative effect was observed through GSH/GSSG elevation in the liver as well as ALT activity reduction in the plasma and IL-6 levels in the liver. The molecular mechanisms associated with regulating lipid metabolism, oxidative stress and inflammation might be related to lower expression of HIF-1α, COX-2, and LOX-1 and upregulation of PPARα in the liver. Supplementation with chromium nanoparticles without changes in the obesogenic diet also favorably affected lipid metabolism and oxidative stress in the liver; however, the examined effects were moderate. In conclusion, the favorable effects of switching from an obesogenic to a balanced diet on hepatic lipid metabolism, oxidative stress, and inflammation induced by an obesogenic diet might be enhanced by supplementation with chromium nanoparticles.

Interdependence of glycemic and lipid modulation in cured chronic hepatitis C patients by direct-acting antiviral agents.

Chronic hepatitis C virus (HCV) infection causes various liver diseases and metabolic disorders. With direct-acting antiviral agents (DAAs), which effectively eradicate pan-genotypic HCV, hepatic and concomitant metabolic restorations are achieved. The study aims to evaluate the posttherapeutic benefits of lipid and glycemic homeostasis. Nighty-five chronic hepatitis C patients who achieved sustained virological response (SVR) by using DAAs were enrolled to collect plasma samples and fractionated lipoproteins at baseline, SVR, and during the post-SVR follow-ups for 6 months (pS6m) and 1 year (pS1yr). The lipid and glycemic parameters were analyzed to establish muturally modulatory relationships. Plasma cholesterol (Chol) and glucose were elevated at SVR from baseline, whereas plasma Chol remained increased until pS1yr; however, glucose returned to the basal level. The post-SVR responses included a peak elevation of glycated hemoglobin at pS6m, a sustained elevation of triglyceride (Tg), and sustained declines in insulin, homeostasis model assessment (HOMA)-insulin resistance, and HOMA-beta levels until pS1yr. The changes in plasma Chol and high-density-lipoprotein Chol showed positive correlations, as did the plasma Tg with low-density-lipoprotein Tg and very-low-density-lipoprotein Tg per particle load. Very-low-density-lipoprotein was found to be loaded with increased Tg and Chol and underwent efficient Tg catabolism in the form of conversion into low-density-lipoprotein. Additionally, the posttherapeutic dynamics exhibited correlations of high-density-lipoprotein Chol with plasma glucose and HOMA-beta. Irrespective of the baseline metabolic status, the posttherapeutic interdependent modulation of blood glycemic and lipid metabolic parameters were revealed in chronic hepatitis C patients following clearance of HCV viremia by DAA treatment.

Meta-Analysis of Experimental Studies of the Effect of Melatonin Monotherapy on the Level of Circulation Triglycerides, Cholesterol, Glucose and Insulin Depending on the Diet of Rats

It is known that melatonin modulates the daily and seasonal rhythms of metabolism. However, the effect of long-term intake of exogenous melatonin on the parameters of lipid and carbohydrate metabolism in various diets is still unclear. In our work, we conducted the meta-analysis of 53 publications investigating the effect of melatonin monotherapy on lipid and carbohydrate metabolism in rats kept on a standard diet (44 publications), as well as diets with a high content of fructose (7 publications), fats (11 publications) and cholesterol (5 publications). According to the literature, high fructose diet caused a significant increase in the levels of triglycerides, glucose and insulin in rats. In rats fed high fat diet, an increase in triglycerides, total cholesterol (TC), insulin, and a decrease in high-density lipoprotein (HDL) was observed. In rats kept on high cholesterol diet an increase in the level of TC and a decrease in the concentration of HDL was observed. Melatonin therapy reduced triglyceride, TC, and insulin levels but did not alter glucose levels in rats fed diets rich in fructose and fats. On a cholesterol-rich diet, melatonin decreased TC levels and increased HDL and glucose levels, but did not change triglyceride concentrations. Our meta-analysis found no beneficial effect of increasing the dose of melatonin with fortified diets. With a standard diet, long-term melatonin therapy also reduced insulin levels, but had no effect on TC and increased glucose levels. The deterioration in carbohydrate metabolism was associated with higher doses of melatonin at the beginning of therapy, with intraperitoneal administration or with administration through a gastric tube, with administration in the light phase. In addition, high doses of melatonin have been associated with poor lipid metabolism in the standard diet. The effect of melatonin was directed towards minimizing changes in the lipid profile caused by diet, which confirms the homeostatic role of melatonin in lipid metabolism.

Hypolipidemic Effects of Beetroot Juice in SHR-CRP and HHTg Rat Models of Metabolic Syndrome: Analysis of Hepatic Proteome

Recently, red beetroot has attracted attention as a health-promoting functional food. Studies have shown that beetroot administration can reduce blood pressure and ameliorate parameters of glucose and lipid metabolism; however, mechanisms underlying these beneficial effects of beetroot are not yet fully understood. In the current study, we analysed the effects of beetroot on parameters of glucose and lipid metabolism in two models of metabolic syndrome: (i) transgenic spontaneously hypertensive rats expressing human C-reactive protein (SHR-CRP rats), and (ii) hereditary hypertriglyceridemic (HHTg) rats. Treatment with beetroot juice for 4 weeks was, in both models, associated with amelioration of oxidative stress, reduced circulating lipids, smaller visceral fat depots, and lower ectopic fat accumulation in the liver compared to the respective untreated controls. On the other hand, beetroot treatment had no significant effects on the sensitivity of the muscle and adipose tissue to insulin action in either model. Analyses of hepatic proteome revealed significantly deregulated proteins involved in glycerophospholipid metabolism, mTOR signalling, inflammation, and cytoskeleton rearrangement.

Association between Intrapancreatic Fat Deposition and Lower High-Density Lipoprotein Cholesterol in Individuals with Newly Diagnosed T2DM.

Intrapancreatic fat deposition (IPFD) usually occurs in individuals with type 2 diabetes mellitus (T2DM), but its physiopathological influence remains controversial. The present study aimed to investigate IPFD and its associations with various aspects of glucose and lipid metabolism in individuals with newly diagnosed T2DM. A total of 100 individuals were included, consisting of 80 patients with newly diagnosed T2DM and 20 age- and sex-matched healthy controls. Then, we assessed IPFD using magnetic resonance imaging (MRI) and various parameters of glucose and lipid metabolism. Individuals with newly diagnosed T2DM had a significantly higher IPFD (median: 12.34%; IQR, 9.19-16.60%) compared with healthy controls (median: 6.35%; IQR, 5.12-8.96%) (p < 0.001). In individuals with newly diagnosed T2DM, IPFD was significantly associated with FINS and HOMA-IR in unadjusted model (β = 0.239, p=0.022; β = 0.578, p=0.007, respectively) and adjusted model for age and sex (β = 0.241, p=0.022; β = 0.535, p=0.014, respectively), but these associations vanished after adjustment for age, sex, and BMI. The OR of lower HDL-C for the prevalence of high IPFD was 4.22 (95% CI, 1.41 to 12.69; p=0.010) after adjustment for age, sex, BMI, and HbA1c. Lower HDL-C was an independent predictor for a high degree of IPFD.

Soluble endoglin as a perspective marker of endothelial dysfunction in patients with primary hyperparathyroidism: a pilot study

BACKGROUND: Primary hyperparathyroidism (PHPT), one of the most common endocrine pathologies, is associated with a higher incidence of cardiovascular diseases, in particular, those caused by endothelial dysfunction. Evaluation of endothelial dysfunction in patients with PHPT will predict the development of cardiovascular pathology and determine the optimal tactics for PHPT management.AIM: To evaluate the concentration of soluble endoglin and photoplethysmographic parameters as potential markers of endothelial dysfunction in patients with PHPT.MATERIALS AND METHODS: A single-center interventional single-stage study was carried out. 2 groups were formed. The first group included 50 patients with verified PHPT who did not have cardiovascular or other concomitant somatic pathologies in anamnesis. The comparison group included 21 healthy volunteers comparable in sex and age. All participants underwent a biochemical blood test (total calcium, ionized, albumin, lipidogram, urea, uricacid, glucose, creatinine, alkaline phosphatase), parathyroid hormone, 25 (OH) D and endoglin concentrations were evaluated. In addition, echocardiography, ultrasound of the brachiocephalic arteries and arteries of the lower extremities, as well as photoplethysmography were performed.RESULTS: The groups differed in mineral parameters associated with PHPT; no differences were found in parameters of lipid, uric acid and carbohydrate metabolism. Serum levels of endoglin were lower in PHPT patients (p=0.002). We found a negative correlation between the concentration of albumin-corrected calcium and PTH with endoglin (r1=-0.370, p1=0.003 and r2=-0.475, p2&lt;0.001, respectively) and a positive correlation between the concentration of endoglin and phosphorus (r=0.363, p=0.003). These associations s were accompanied by changes in photoplethysmographic parameters that indicate an increase in the vascular wall stiffness.CONCLUSION: The serum level of soluble endoglin is lower in patients with PHPT than in healthy volunteers, negatively correlates with calcium and PTH concentrations and positively with serum phosphorus concentrations. Further studies will make it possible to establish the pathogenetic mechanism of the identified relationships and evaluate the role of endoglin as a potential predictor of cardiovascular pathology in PHPT population.

A low chromium diet increases body fat, energy intake and circulating triglycerides and insulin in male and female rats fed a moderately high-fat, high-sucrose diet from peripuberty to young adult age.

Trivalent chromium (Cr) may function to potentiate the action of insulin, but the effects of chromium intakes on metabolic parameters are unclear. Cr is listed as a potentially beneficial element for rodents based on studies that show feeding low quantities affect glucose metabolism. Cr is recommended at 1 mg per kg in rodent diets. This study examined the effects of different levels of dietary Cr on body weight, body composition, energy intake, food efficiency and metabolic parameters of lipid and glucose metabolism in male and female rats when fed from peripuberty to young adult age in the background of a moderately high-fat, high-sucrose diet. Sprague-Dawley CD rats (n = 10 males and 10 females/group) at 35 days of age were assigned by weight to the low (LCr, 0.33 ± 0.06 mg/kg), normal (NCr, 1.20 ± 0.11 mg/kg) or high (HCr, 9.15 ± 0.65 mg/kg) Cr diets. Diets were fed ad libitum for 12 weeks (83 days). At baseline, body weights and composition were similar (p≥0.05) among diet groups. Compared to the NCr group, the LCr group weighed more (p<0.01) and consumed more energy (food) from Day 56 onwards, but food efficiency was unaffected. Following an oral glucose challenge (Day 77), dietary chromium levels did not affect plasma glucose, but fasting plasma insulin and insulin at 30 and 60 min after dosing were higher in the LCr group compared to the NCr group. At the end of the study, whole-body fat, accrued body fat from baseline and fasting serum triglycerides were higher in the LCr group compared to the NCr group. Effects were similar in both sexes and not observed in the HCr group. These data show that low dietary Cr affects metabolic parameters common in chronic diseases underscoring the need for clinical trials to define the nutritional and/or pharmacological effects of Cr.

Effect of combined oral contraceptives with estrogen identical to natural estrogen on the metabolic profile and body composition in females during the menopausal transition

Aim. To study the effect of combined oral contraceptives (COC) with estrogen identical to natural estrogen on the metabolic profile and body composition in females during the menopausal transition.&#x0D; Materials and methods. Females in the menopausal transition who needed contraception were divided into two groups. Group 1 (19 patients) received COCs containing estradiol valerate/dienogest (E2V/DNG) with a dynamic dosing regimen; Group 2 (19 patients) received monophasic COCs containing 17-estradiol/nomegestrol acetate (E2/NOMAC) for 6 months. Blood pressure (BP), parameters of carbohydrate and lipid metabolism, leptin, adiponectin, C-reactive protein, uric acid, and body composition by dual-energy X-ray absorptiometry were assessed initially and after the 6 months of therapy.&#x0D; Results. No significant changes in weight and body composition after 6 months of COC use were found in both groups. COCs with E2V/DNG had no significant effect on BP and all assessed metabolic parameters. Females taking COCs with E2/NOMAC showed increased fasting glucose of 4.85 (0.43) and 5.30 (0.37) mmol/L (p=0.002), insulin of 4.97 (2.35) and 8.82 (4.67) U/mL (p=0.012), NOMA index of 1.06 (0.54) and 1.88 (0.75); p=0.010 compared to baseline. However, the parameters remained within the reference values.&#x0D; Conclusion. COCs containing estrogens identical to natural estrogens do not affect body composition and have no significant adverse effect on BP and metabolic parameters in females during the menopausal transition, indicating that the use of these agents is acceptable from the perspective of their metabolic effects in this group of patients.

The apolipoprotein B and apolipoprotein A-I Ratio serves as a strong prognostic factor for the overall survival of patients with colorectal cancer.

The lipid metabolism status of patients with colorectal cancer (CRC) has not been understood comprehensively. The present study investigated the characteristics of lipid metabolism parameters in CRC patients with or without metastases and identified the independent prognostic factors of long-term prognosis. The clinicopathological data of 231 CRC patients along with 259 formalin-fixed paraffin-embedded samples with or without liver or lung metastasis were retrieved and stained for apolipoprotein B (apoB) via immunohistochemistry (IHC) in our center. The correlation and multivariable analysis between blood circulating apolipoprotein A-I (apoA1), apoB and overall survival (OS) were analyzed. In the multivariable analysis, apoA1, apoB and apolipoprotein B and apolipoprotein A-I (apoB/A) ratio, were identified as independent prognostic factors for OS. Moreover, the apoB/A ratio showed a significantly negative association with OS time (R=-0.187, P=0.004). CRC patients with low apoB/A ratio had better 1-, 3- and 5-year OS rates than those who had high apoB/A ratio (87.1%, 54.3%, and 37.1% vs. 92.5%, 72.0%, and 59.5%, respectively, P=0.001). On histological level, similar expression intensity of apoB between primary CRC and liver metastases indicated better prognostic outcomes than those with different expression levels (100%, 83.3%, and 77.8% vs. 100%, 66.7%, and 33.3%, respectively; P=0.033). Higher level of apoB in the primary CRC interprets into increased incidence of liver metastases. However, the apoB expression levels in the CRC tumor were not parallel to the circulating lipid metabolism parameters. The apoB/A ratio was a reliable independent prognostic factor for predicting the long-term OS of CRC patients. Moreover, the IHC of the primary CRC and metastatic lesions verified the metastatic potential of apoB through a different aspect. Lipid metabolism status for cancer progression reported in the present study possessed potentially prognostic value, but bench-scale studies are needed for their future clinical applications.

Association Between Blood Calcium, Magnesium, and Non-alcoholic Fatty Liver Disease in Adults: a Cohort-Based Case-Control Study.

Previous studies have shown that calcium (Ca), magnesium (Mg), and Ca/Mg ratio are associated with inflammation and metabolic disorders, but their relationship with non-alcoholic fatty liver disease (NAFLD) is unclear. Thus, we aimed to explore the association between Ca, Mg, Ca/Mg ratio, and NAFLD in Chinese adults. We conducted a case-control study based on the Kailuan Cohort in China, including 1816 cases and 1111 gender- and age-matched controls. Dose-response relationships between blood Ca, Mg, Ca/Mg ratio, and NAFLD were evaluated using restricted cubic splines. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. A negative association between blood Ca (overall association P < 0.001 and linear association P < 0.001) and NAFLD as well as Ca/Mg ratio (overall association P = 0.002 and linear association P = 0.024) and NAFLD was observed. Compared with the highest quartile, the adjusted OR (95% CI) for the lowest quartile of Ca and Ca/Mg ratio was 2.116 (1.679-2.667) and 1.358 (1.076-1.713), respectively. A U-shaped relationship was found for blood Mg and NAFLD, with the highest OR of 1.685 in the lowest quartile group when using the second quartile as a reference. Additionally, we observed the interaction between alanine aminotransferase and blood Ca (P = 0.024), total cholesterol (P = 0.017), low-density lipoprotein-cholesterol (P = 0.013), and blood Mg, as well as total cholesterol and Ca/Mg ratio (P = 0.014). Lower blood Ca and Ca/Mg ratio were significantly associated with the risk of NAFLD. Liver function or lipid metabolism parameters may modify their association, suggesting an individualized prevention strategy for NAFLD.

Lipid metabolism and renal function markers in obese adolescents.

To investigate the relationship of renal function markers and lipid metabolism parameters in obese adolescents. The study comprised 76 children aged 11-17 years, hospitalised due to: obesity (group I - 19 children) or obesity accompanied by obesity-induced hypertension (group II - 30 children) or normosthenic children with a diagnosed tension headaches (control group - 27 children). A subgroup with metabolic syndrome (MS - 16 children) was also separated. Renal function was assessed on the basis of: serum creatinine concentration, glomerular filtration rate estimated using Schwartz eqation (eGFR), determination of plasma and urinary neutrophil gelatinase-associated lipocalin and cystatin C. On the basis of statistical analysis, it was checked whether renal function markers depend on lipid metabolism parameters. In the study groups mean creatinine concentrations were significantly higher and eGFR values significantly lower than in the control group, but they remained within norm. Differences in plasma and urinary neutrophil gelatinase-associated lipocalin concentrations were not significant. Mean cystatin C concentrations were significantly higher in the group of obese children. Multiple linear regression analysis showed that the most important predictor was: LDL-C for urinary neutrophil gelatinase-associated lipocalin (R2 = 0.42) and TG for eGFR (R2 = 0.44) concentrations in group I; cholesterol for creatinine concentrations in MS group (R2 = 0.44). Renal function of the obese adolescents included in the study was normal and the associations with lipid metabolism were poorly expressed.

Study on the effect of licochalcone A on intestinal flora in type 2 diabetes mellitus mice based on 16S rRNA technology.

Licorice, has a long history in China where it has various uses, including as a medicine, and is often widely consumed as a food ingredient. Licorice is rich in various active components, including polysaccharides, triterpenoids, alkaloids, and nucleosides, among which licochalcone A (LicA) is an active component with multiple physiological effects. Previous studies from our research group have shown that LicA can significantly improve glucose and lipid metabolism and related complications in Type 2 diabetes mellitus (T2DM) mice. However, research on the mechanism of LicA in T2DM mice based on intestinal flora has not been carried out in depth. Therefore, in this study, LicA was taken as the research object and the effects of LicA on glucose and lipid metabolism and intestinal flora in T2DM mice induced by streptozotocin (STZ)/high-fat feed (HFD) were explored. The results indicated that LicA could reduce serum TC, TG, and LDL-C levels, increase HDL-C levels, reduce blood glucose, and improve insulin resistance and glucose tolerance. LicA also alleviated pathological damage to the liver. The results also showed that LicA significantly affected the intestinal microbiota composition and increased the α diversity index. β Diversity analysis showed that after the intervention of LicA, the composition of intestinal flora was significantly different from that in the T2DM model group. Correlation analysis showed that the changes in glucose and lipid metabolism parameters in mice were significantly correlated with the relative abundance of Firmicutes, Bacteroidetes, Helicobacter, and Lachnospiraceae (p < 0.01). Analysis of key bacteria showed that LicA could significantly promote the growth of beneficial bacteria, such as Bifidobacterium, Turicibacter, Blautia, and Faecococcus, and inhibit the growth of harmful bacteria, such as Enterococcus, Dorea, and Arachnococcus. In conclusion, it was confirmed that LicA reversed the imbalanced intestinal flora, and increased the richness and diversity of the species in T2DM mice.

PS-BPC02-2: CLINICAL IMPACTS OF ENDOTHELIUM-DEPENDENT FLOW-MEDIATED VASODILATION ASSESSMENT ON PRIMARY ALDOSTERONISM

Objective: Primary aldosteronism (PA) is defined as autonomous aldosterone production from the adrenal glands and represents the most common and treatable cause of hypertension. Also, it is well known that the incidence of cardiovascular morbidity is higher among patients with PA than among those with essential hypertension (EH). Histologically, PA is divided into two major subtypes, aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA). However, the nature of vascular function in PA patients remains to be determined. The aim of this study was to determine the vascular function and investigate the implications of vascular function assessments in the patients with PA. Design and Method: All patients were diagnosed with PA according to the guidelines of the Japan Endocrine Society. Flow-mediated dilation (FMD), as an index of endothelial function, and cardio-ankle vascular index (CAVI), as an index of arterial stiffness, were retrospectively compared between 42 patients with APA, 37 patients with IHA, and 42 patients with EH. These values were also compared with background factors, KCNJ5 mutation and clinical outcome in terms of blood pressure reduction after adrenalectomy in the APA group. Results: No differences were found among the three groups (APA, IHA and EH) with regard to age, sex, duration of hypertension, body mass index, blood pressure, renal function and hemoglobin A1c. FMD was significantly lower in the APA group (4.8 ± 2.1%) and IHA group (4.1 ± 1.9%) than in the EH group (5.7 ± 2.1%). CAVI did not differ significantly among APA, IHA and EH groups (7.9 ± 1.3, 7.8 ± 1.0, 7.8 ± 1.1, respectively). Although no significant correlations were seen between FMD and background factors (i.e. age, body mass index, renal function, glucose and lipid metabolic parameters, and hormonal data) in the IHA group, FMD correlated negatively with BMI and plasma aldosterone concentration in the APA group (rs = -0.313, rs = -0.342, respectively). No significant difference in FMD (4.8 ± 1.4%, 4.5 ± 2.1%, respectively) or CAVI (8.1 ± 1.8, 8.0 ± 1.1, respectively) was seen between the KCNJ5-mutant group and the wild-type group. A cut-off FMD of 4.3% was selected for complete clinical success after adrenalectomy, offering 78% sensitivity and 80% specificity. Conclusions: Patients with PA displayed impaired endothelial function. Complete clinical success after adrenalectomy was associated with preserved endothelial function. This study provides a better understanding of FMD assessment in patients with PA.

Сравнительная оценка комбинированной гиполипидемической терапии у пациентов с очень высоким сердечно-сосудистым риском

Aim: to assess the efficacy and safety of combined lipid-lowering therapy including statin and ezetimibe in patients with acute coronary syndrome (ACS) who are followed up in a short-term study. Patients and Methods: a prospective cohort study involved 50 patients who were divided into 2 groups (25 patients in each group) by sequential inclusion. In group 1, atorvastatin (80 mg) plus ezetimibe (10 mg) were prescribed. In group 2, pitavastatin (4 mg) plus ezetimibe (10 mg) were prescribed. Over a 6-month follow-up period, changes in the clinical signs and parameters of carbohydrate and lipid metabolism were evaluated. Results: at baseline, total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and glucose levels were similar in the groups. After 1 month, LDL-C &lt;1.4 mmol/L were reported in less than 50%. Meanwhile, a decrease in LDL-C &lt;1.4 mmol/L or a decrease in LDL-C by ≥50% occurred in 17 (68%) patients in each group. After 6 months, glucose levels in group 1 were significantly higher than those in group 2 (p=0.034). Intragroup analysis of blood glucose changes over time revealed a significant increase after 6 months in group 1 (p=0.005) but no significant changes in group 2. Over a 6-month follow-up period, diabetes was newly diagnosed in four patients, with no significant differences between the groups. Conclusion: a comparable clinical lipid-lowering efficacy of both treatment regimens was demonstrated. Significantly higher blood glucose levels were reported in the atorvastatin group than in the pitavastatin group, with no significant differences between the groups in newly diagnosed carbohydrate metabolism disorders. The most significant limitation of this study was the small sample size and relatively short follow-up period. KEYWORDS: diabetes, acute coronary syndrome, atorvastatin, pitavastatin, ezetimibe, lipid metabolism, carbohydrate metabolism. FOR CITATION: Druk I.V., Korennova O.Yu., Yukhina Yu.E., Savchenko M.V., Podol'naya S.P., Shukil L.V. Comparative assessment of combined lipid-lowering therapy in patients with very high cardiovascular risk. Russian Medical Inquiry. 2023;7(9):572–579 (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-3.

ПАРАМЕТРИ ЛІПІДНОГО ПРОФІЛЮ У ДОНОРІВ, ЯКІ ПЕРЕХВОРІЛИ НА COVID-19 ТА МАЮТЬ РІЗНІ ТИТРИ АНТИ-SARS-CoV-2 IgG У ПЛАЗМІ КРОВІ

COVID-19, caused by SARS-CoV-2, is a systemic disorder of with possible pathological complications in human organism. One of the critical targets of SARS-CoV-2 is the metabolism of lipids and products, which may influence the changes in patients with illness. Currently, the mechanism of binding between SARS-CoV-2 and lipids, as well as the consequences of these processes, is unknown. In addition, the long post-COVID-19 period has been confirmed in the majority of people who have suffered from COVID-19; therefore, additional attention should be paid to studying the biochemical parameters of lipid metabolism after SARS-CoV-2 infection. Our work is aimed the studying of lipid profile including concentration of total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), very low-density lipoproteins (VLDL) and triglycerides (TG) in donor groups who had suffered from COVID-19 and had different titers of anti-SARS-CoV-2 IgG in blood plasma. We selected donor groups with maximum and minimum changes of parameters among donor groups with titers of anti-SARS-CoV-2 IgG ≥ 10 Index (S/C), than we compared these groups to donor group with titer of anti-SARS-CoV-2 IgG 0 Index (S/C). We established that the donor group with titer of anti-SARS-CoV-2 95 ± 5 Index (S/C) was characterized by the maximum concentration of total cholesterol, LDL, VLDL, TG, while the donor group with titer of anti-SARS-CoV-2 IgG 75 ± 5 Index (S/C) was determined as the minimum concentration of total cholesterol, HDL, LDL. In addition, donor group with titer of anti-SARS-CoV-2 IgG 85 ± 5 Index (S/C) was described a lower concentration of VLDL and TG then in donors – 0 Index (S/C). These changes may be linked to a potential risk of cardiovascular disease (CVD). Our work can be useful for future research targeting the study of the changes in lipid metabolism during SARS-CoV-2 infection and in the development of the treatment of COVID-19 or laboratory diagnostics of physiological processes in the post-COVID-19 period.

Cerebral microangiopathy in men with obstructive sleep apnea syndrome

To determine factors associated with the development of small vessel disease (SVD) in patients with obstructive sleep apnea syndrome (OSA). One hundred and fifty-two patients with risk factors for the development of cerebrovascular diseases were examined. Based on the results of polysomnography, patients were divided into groups with- (n=84) and without (n=68) OSA. The groups were matched by age, prevalence of arterial hypertension and diabetes mellitus. SVD was diagnosed using brain MRI. Laboratory tests included an assessment of parameters of lipid metabolism, glucose metabolism, concentration of C-reactive protein (CRP), levels of homocysteine and creatinine with the calculation of glomerular filtration rate (GFR). Patients with OSA, compared with those without OSA, were characterized by a statistically significant number of gliosis foci, with their large sizes, more frequent changes on the Fazekas scales and the Hassan scale. The most severe degree of damage according to the Hassan scale in patients with OSA was detected more often (55 (66%) and 27 (39%) OR=2.89, 95% CI 1.47-5.67, p=0.002). More pronounced atrophic changes in the brain, an increase in the size of the III ventricle and the index of the anterior horns, significantly lower GFR and higher levels of CRP were noted in the OSA group. Patients with OSA and duration of nocturnal hypoxia for more than 2 minutes were more likely to have hyperintensity of subcortical regions. In patients with OSAS, pronounced manifestations of SMD were associated with a significantly higher level of morning systolic blood pressure (MAP): 140 [120; 150] vs. 127 [120; 130] p=0.029; increased levels of blood homocysteine: 14 [11; 17.8] vs. 13 [9.7; 12.5] p=0.049; a decrease in GFR: 79 [71; 87.3] vs. 89.8 [80.3; 94] p=0.002, respectively. OSA and intermittent nocturnal hypoxia are independent risk factors for SMD. A more severe micro-focal vascular lesion in OSA is associated with a decrease in renal filtration function, an increase in morning blood pressure and an elevation in homocysteine level.

ВЛИЯНИЕ ЦЕЛЕНАПРАВЛЕННО СИНТЕЗИРОВАННОГО АЗОМЕТИНОВОГО ПРОИЗВОДНОГО ТЕТРАГИДРОБЕНЗТИОФЕНА-3-КАРБОКСАМИДА, НА НЕКОТОРЫЕ ПОКАЗАТЕЛИ ЛИПИДНОГО ОБМЕНА У ЗДОРОВЫХ КРЫС И В УСЛОВИЯХ ЭКСПЕРИМЕНТАЛЬНОЙ ГИПЕРЛИПИДЕМИИ

According to WHO data, cardiovascular diseases occupy a leading position in terms of the number per share of the population, both in Russia and in other countries. A prerequisite for the development of these pathologies is atherosclerosis. It is now recognized that drug therapy is leading in curbing the development of atherosclerosis and subsequent complications. In this regard, the urgency of the search for new lipid-lowering drugs aimed at the treatment of this disease is increasing. Recent studies have shown the promise of using the benzothiophene backbone for the synthesis of new effective drugs, since this core has various biological and pharmacological activities, which makes it possible to obtain effective antimicrobial, anticancer, anti-inflammatory, antioxidant, anti-tuberculosis, antidiabetic, anticonvulsant and other drugs on its basis.The purpose of this study was to study the lipid-lowering effect of the azomethine derivative 2-amino-4,5,6,7-tetrahydro-1-benzothiophene-3-carboxamide, a substance under the laboratory code BF-10, on some indicators of lipid metabolism in healthy rats and under pathological conditions with experimental hyperlipidemia. Atorvastatin was chosen as the reference drug. Determination of biochemical parameters of lipid metabolism in the blood serum and in the liver homogenate (the content of cholesterol, triglycerides, total lipids, LDL, VLDL and HDL) was determined by unified biochemical methods using standard Olvex Diagnosticum kits on a Dixion Torus 120 analyzer. Based on the analysis of the obtained data on the effect of the BF-10 substance on lipid metabolism, it can be concluded that they are comparable with the action of the highly effective reference drug atorvastatin, which allows us to expand information on the spectrum of biological activity of azomethine derivatives and consider the compound under the laboratory code BF-10 promising for further development.

Current possibilities of influencing the main cardiovascular risk factors in patients with type 2 diabetes mellitus

Background. Cardiovascular morbidity increases notably among patients with diabetes. A correlation between leptin resistance and cardiovascular risk was found in patients with arterial hypertension and metabolic syndrome. However, there are no data about the influence of empagliflozin on leptin level; empagliflozin effectiveness against key cardiovascular risk factors in diabetic patients with normal weight and overweight has not been studied yet. The purpose of this work was to study the impact of comprehensive treatment using metformin and empagliflozin on the main cardiovascular risk factors in patients with type 2 diabetes mellitus with different body weights. Materials and methods. Ninety-seven patients with type 2 diabetes with normal weight, overweight and obesity were examined. Anthropometric indicators were taken. The parameters of carbohydrate and lipid metabolism, the level of leptin in blood serum were determined and the HOMA-IR was calculated. Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r=0.505, p&lt;0.05; r=0.846, p&lt;0.05; r=0.886, p&lt;0.05 in patients of groups I–III). After a 6-month course of treatment with metformin and empagliflozin, body weight and waist circumference significantly decreased in overweight and obese patients, and no significant changes between groups were found in those with a normal body mass index. A reliable positive effect of comprehensive treatment on indicators of carbohydrate metabolism, systolic blood pressure, regardless of the patient’s weight, was noted. Under the influence of comprehensive treatment with the use of empagliflozin, the level of leptin (p&lt;0.05) and HOMA-IR (p&lt;0.05) also decreased significantly in patients of all groups, regardless of body mass index. Conclusions. It was found that the combined use of metformin and empagliflozin for 6 months had a reliable effect on the modified cardiovascular risk factors in patients with type 2 diabetes of different weights.

Serum lipid profile in relation to free thyroxine and the effect of levothyroxine treatment on lipids in patients with isolated hypothyroxinemia during pregnancy: a single-center retrospective study

BackgroundThyroid function is widely considered a lipid metabolism regulator. However, studies on lipid metabolism in pregnant women with low free thyroxine (FT4) levels are limited and inconclusive. Furthermore, the association between maternal FT4 deficiency and adverse lipid metabolic parameters is unknown. Therefore, we aimed to investigate this association and the effects of levothyroxine (L-T4) treatment on these metabolic indicators.MethodsThis retrospective study included 164 patients with isolated hypothyroidism (IH) (FT4 levels below the 5th percentile with normal thyroid stimulating hormone levels according to the gestational-specific reference range) and 407 euthyroidism patients (control group who had regular antenatal examinations at Zhejiang Provincial People's Hospital, Hangzhou, China) between January 1, 2019, and December 31, 2020. Patients with IH were divided into levothyroxine (L-treatment group, n = 77) and dietary iodine supplement treatment groups (dietary treatment group, n=87) according to the hospital’s treatment policy and clinical experience. The intervention lasted for at least 8 weeks. Metabolic indicators, including thyroid function and lipid parameters, were collected at least twice before and after the intervention. Other data collected included maternal age, history of abortion, prepregnancy BMI, and gestational weight gain (Fig. 1).ResultsCompared with the control group, Patients with IH had a higher degree of dyslipidemia, reflected in elevated total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (Apo B) levels. In IH patients, an inverse correlation was found between FT4 and TG levels, which remained after adjusting for prepregnancy BMI. The L-treatment group demonstrated a significantly slower rate of hypercholesterolemia progression during pregnancy than the dietary treatment group. In addition, there was a relationship between the therapeutic effect and the degree of disease, with the main factors being FT4, TSH and TG levels prior to starting treatment.ConclusionsLow FT4 levels were associated with elevated blood lipid levels. Serum FT4 and lipid levels in patients could be improved by medical intervention.