Significant Decrease In Total Cholesterol Research Articles

Efficacy, Safety and Protective Effects of Lipid Lowering Drugs in Patients with Diabetes

Aim: The aim of the study was to assess the effects of statins and fibrates on the lipid profile of patients with diabetes and to determine their side effects. Methods: It was a transversal study. We included patients with type 1 or 2 diabetes that are followed in an outpatient department, treated for at least 3 months by statins or fibrates.We performed an interrogatory, a medical examination, dietary survey and biological tests for all patients. Results:The mean age was 59.5 ± 9.2 years. Women were 65% of patients. The mean duration of treatment with statins and fibrates was 2.2 ± 2.6 years and 4.9 ± 4.2 years, respectively.Under statin therapy, total cholesterol and LDL cholesterol decreased significantly by 1.02±1.25 mmol/l and 0.32±0.47 mmol/l, respectively, triglycerides and HDL cholesterol decreased insignificantly.Fibrates caused a significant decrease in total cholesterol and triglycerides by 1.15± 2.24 mmol/l and 1.73 ±2.96 mmol/l, respectively and a non-significant decrease in LDL cholesterol and a non-significant increase in HDL cholesterol. No case of significant hepatic cytolysis was noted. Muscle pain was reported by 10.4% and 11.6% of patients on statins and fibrate, respectively.Under statins, the incidence of gastrointestinal symptoms increased significantly. Conclusion: The efficacy of lipid lowering drugs is widely proven. Although side effects are possible, the prescription of lipid lowering drugs should be largely encouraged for better health care of patients with diabetes.

Efficacy and safety of tenofovir alafenamide versus tenofovir disoproxil fumarate in treatment‐naïve chronic hepatitis B

We used real-world data to evaluate the efficacy and safety of tenofovir alafenamide (TAF) compared with tenofovir disoproxil fumarate (TDF) in treatment-naïve patients with CHB. We analysed 2747 patients with CHB under TAF (n=502) or TDF (n=2245) treatments. Virological responses (VR: HBV DNA <15 IU/ml), on-treatment ALT normalization, the incidence of HCC, renal function and lipid profiles were compared between these groups. Propensity score matching of 495 pairs was conducted for these comparisons. The mean age of the total cohort was 48.6 years and 58.2% of the subjects were male. Cirrhosis had a 33.3% prevalence in the population. VRs at 12, 24 and 36months were achieved in 70.3%, 81.2% and 83.3% of the TAF and 67.9%, 84.3% and 86.1% in the TDF cases respectively (p > 0.05 for all). Normalized ALT, as determined by local laboratory criteria (<40 U/L), occurred in 79.7%, 90.6% and 86.2% of TAF the group and 78.2%, 85.8% and 85.7% of the TDF group at 12, 24 and 36months respectively (p > 0.05 for all). The HCC risk did not statistically differ across the entire cohort or in the PS-matched cohort. The TAF group showed a lower median increase in serum creatinine from baseline during the early study period. Compared with the TAF, the TDF group showed significant decreases in total cholesterol, triglyceride and HDL, but not in LDL. Real-word data indicate that TAF has comparable efficacies to TDF in terms of VR and ALT normalization, with no higher risk of HCC.

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

An integrated approach for very high cardiovascular risk patients. Intermediate results

The main objective of secondary prevention measures is to modify key risk factors such as hypertension (HTN) and dyslipidemia in patients with established cardiovascular diseases. Its proper implementation improves both short- and long-term outcomes. Telehealth technologies contributes to faster achievement of target levels and better control of key risk factors.Aim. To establish a comprehensive personalized follow-up framework for patients recovered from an acute coronary syndrome (ACS) that integrates telehealth software and to test its clinical and patient-centered efficacy.Material and methods. The three-month follow-up data of 50 patients (50% of planned enrollees; median age, 57 years [53; 61]; males, 84%) who suffered ACS with myocardial revascularization and low-density lipoprotein cholesterol (LDL-C) at least 2,5 mmol/L at admission. We introduced the simple and save telehealth software for home BP monitoring and lipid profiling. The basic demographic, clinical and laboratory characteristics of patients were described, as well as the changes lipid profile, office and home BP over this period was analyzed. The primary endpoint was a change in LDL-C after 3 months. In addition, we also focused on pharmacological therapy and its dynamics, as well as on remote counseling and patient’ experience with the mobile application.Results. Three months after inclusion, we have noted significant decrease of total cholesterol (-1,67 mmol/L, p&lt;0,0001) and triglycerides (-0,48 mmol/L, p&lt;0,0001). LDL-C changes were also significant (-1,49 mmol/L, adjusted for age, sex and lipid-lowering therapy; p&lt;0,0001) and was associated only with the baseline LDL-C levels (R2=-0,521, p&lt;0,0001). Thirty-nine (78%) patients achieved at least 1 mmol/L drop of LDL-C. Nine of them reached target LDL-C &lt;1,4 mmol/L (and/or a decrease of 50% from baseline). Both high-density lipoprotein cholesterol (-0,48 mmol/l, p=0,348), office and home BP remained mostly unchanged. The proportion of patients with target office BP levels was almost the same (χ2=3,06, p=0,08). Patients who were recommended combined lipid-lowering therapy with cholesterol absorption inhibitor (ezetimibe) were more likely to achieve target LDL-C (χ2=10,95; p=0,003) than those with single agent (67% versus 17%, p=0,003). No differences were found in subgroups of patients in LDL-C reduction. In each patient an average of 15 remote consultations have been performed (from 1 to 54 per patient per 3 moths). Investigators have had to send reminders to 22 patients regarding the need for regular home BP monitoring. The majority of patients treated telehealth software as easy-to-use and user-friendly.Conclusion. According to the 3-month follow-up of patients after ACS who used the framework integrated with telemonitoring and remote counseling, a positive trend in reducing atherogenic lipid levels was demonstrated, but not in office BP. Only a fifth of patients reached the target LDL-C, but the vast majority had target BP. Despite the fact that the program is convenient to use, almost half of participants require additional reminders from physician on self-monitoring.

Effect of Continuous Positive Airway Pressure on Lipid Profiles in Obstructive Sleep Apnea: A Meta-Analysis.

Background: Obstructive sleep apnea (OSA) is associated with dyslipidemia. However, the effects of continuous positive airway pressure (CPAP) treatment on lipid profiles are unclear. Methods: PubMed/Medline, Embase and Cochrane were searched up to July 2021. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment and reported pre- and post-intervention lipid profiles were included. Weighted mean difference (WMD) was used to assess the effect size. Meta-regression was used to explore the potential moderators of post-CPAP treatment changes in lipid profiles. Results: A total of 14 RCTs with 1792 subjects were included. CPAP treatment was associated with a significant decrease in total cholesterol compared to controls (WMD = −0.098 mmol/L, 95% CI = −0.169 to −0.027, p = 0.007, I2 = 0.0%). No significant changes in triglyceride, high-density lipoprotein nor low-density lipoprotein were observed after CPAP treatment (all p > 0.2). Furthermore, meta-regression models showed that age, gender, body mass index, daytime sleepiness, OSA severity, follow-up study duration, CPAP compliance nor patients with cardiometabolic disease did not moderate the effects of CPAP treatment on lipid profiles (all p > 0.05). Conclusions: CPAP treatment decreases total cholesterol at a small magnitude but has no effect on other markers of dyslipidemia in OSA patients. Future studies of CPAP therapy should target combined treatment strategies with lifestyle modifications and/or anti-hyperlipidemic medications in the primary as well as secondary cardiovascular prevention models.

Comparison of adverse drug reactions between tamoxifen and toremifene in breast cancer patients with different CYP2D6 genotypes: A propensity-score matched cohort study.

CYP2D6 gene polymorphism has a profound impact upon the effect of tamoxifen as adjuvant endocrine therapy in breast cancer. However, it had never been reported whether the adverse drug reactions vary by CYP2D6 metabolic status for patients treated with tamoxifen or toremifene. We conducted a retrospective study in breast cancer patients to investigate the impact of CYP2D6 metabolic status on liver dysfunction events, gynecological events and dyslipidemia events. According to CYP2D6*10 (100C → T) genotype, the enrolled patients were further categorized into four cohorts (extensive metabolizers taking tamoxifen [EM + TAM], extensive metabolizers taking toremifene [EM + TOR], intermediate metabolizers taking tamoxifen [IM + TAM], and intermediate metabolizers taking toremifene [IM + TOR]). A total of 192 patients were included in the study, with a median follow-up time of 26.2months. In EM + TAM cohort, the risks of liver dysfunction events (P=.004) and gynecological events (P=.004) were significantly higher compared to EM + TOR cohort. In IM + TAM cohort, the risks of liver dysfunction events (P=.14) and gynecological events (P=.99) were not significantly different from IM + TOR cohort. A significant decrease of total cholesterol was observed in EM + TAM cohort around 1year after taking tamoxifen (P < .001). Significant interactions between CYP2D6 metabolic status and endocrine agents were observed in terms of liver dysfunction events (P-interaction=.007) and gynecological events (P-interaction=.026). These findings suggested that CYP2D6 gene polymorphism played a significant role in predicting liver dysfunction, gynecological diseases and lipid metabolism changes among patients taking tamoxifen or toremifene.

Promene serumskih lipida i telesne mase nakon primene dijetetskog suplementa sa glukomananom i ekstraktom crvenog pirinča u maloj interventnoj studiji

Glucomannan and red rice extract combined in a dietary supplement could exhibit a synergistic effect in lowering blood lipid levels. We aim to explore the changes in blood lipid levels, and body composition in healthy middle-aged overweight people with mild hypercholesterolemia following the 45-day intake of a dietary supplement containing glucomannan and red rice extract. We present a single-arm non-randomized, non-blind intervention study. In total, 31 participants consumed a dietary supplement containing glucomannan dietary fibers (Konjak glucomannan, E425ii, 4 grams) and red rice extract (Monascus purpureus, 1 gram) for 45 days, without changes in their current diet. Body weight and composition were measured every two weeks. Blood lipids were tested at the beginning and the end of the intervention. After 45 days, there was a significant decrease in total cholesterol (by 16-18%), LDL cholesterol (by 20-24%), and triglyceride levels (by 11-23%) in both genders. In addition, women lost on average about 1 kilogram of body weight, 1.5 kilograms in body fat, and decreased their body mass index by 0.5 kg/m2. In men, body composition did not change. Concurrent use of glucomannan and red yeast rice extract resulted in a significant reduction in blood lipid levels in both genders. It could be a safe and effective treatment option for the population of healthy middle-aged overweight people with mild hypercholesterolemia. Trial registry information. Study protocol was registered under ChiCTR1800016300.

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

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

Switching efavirenz to rilpivirine in virologically suppressed adolescents with HIV: a multi-centre 48-week efficacy and safety study in Thailand.

IntroductionEfavirenz (EFV) is commonly used for first‐line antiretroviral therapy in children and adolescents with HIV, but is associated with neuropsychiatric and metabolic side effects. Rilpivirine (RPV) is better tolerated, and switching from EFV to RPV in virologically suppressed adults has been safe and efficacious, but data in adolescents are limited. Our primary objective was to describe the 48‐week immunologic and virologic outcomes in virologically suppressed adolescents switching from EFV‐ to RPV‐based antiretroviral therapy. Secondary objectives included assessment of neuropsychiatric adverse events, quality of life (QOL) and metabolic profiles while on RPV.MethodsWe conducted an open‐label, single‐arm, multi‐centre study in Thailand in virologically suppressed adolescents aged 12–18 years receiving EFV plus two nucleoside/tide reverse transcriptase inhibitors (NRTIs/NtRTI) for ≥3 months. Participants were switched to an RPV (25 mg) tablet once daily, with the same NRTIs. HIV RNA viral load, CD4 cell count, fasting total cholesterol (TC), triglyceride, glucose, neuropsychiatric adverse events, depression and QOL were assessed over 48 weeks. Data were collected between February 2016 and September 2018.ResultsOne hundred and two (52% male) adolescents were enrolled. Median age at entry was 15.5 years (IQR 14.4–17.0), median CD4 count was 664 cells/mm3 (29.9%); 58% were receiving tenofovir‐DF and emtricitabine. At weeks 24 and 48, 96 (94.1%) and 94 (92.2%) participants were virologically suppressed, respectively, with no significant change in CD4 cell counts from baseline. Six (5.9%) participants experienced virologic failure, two of whom had RPV‐associated mutations (K101E and Y181C) and a lamivudine‐associated mutation (M184V/I). There were significant decreases in TC, triglyceride, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL) at weeks 24 and 48 and a significant increase in LDL/HDL ratio at week 48 compared to baseline. No substantial changes in EFV‐related symptoms, depression score or health‐related QOL were observed over time; however, there was significant improvement in performance‐based assessments of executive function at week 24.ConclusionsA high proportion of adolescents (>92%) remained virologically suppressed up to 48 weeks after switching from EFV to RPV along with no significant change in CD4 cell counts. RPV was well tolerated and associated with improvements in metabolic profiles and executive function.

Diabetic Cardiovascular Autonomic Neuropathy: Effects of Simvastatin and Omega-3 Polyunsaturated Fatty Acids on Insulin Resistance and Lipid Profile Parameters

Introduction. Currently, there is no unified treatment algorithm of cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to investigate the effects of simvastatin (SIM) and -3 polyunsaturated fatty acids (-3 PUFAs) on blood lipid profile and insulin resistance (IR) in patients with type 2 diabetes mellitus and definite cardiac autonomic neuropathy. Materials and methods. The study involved 72 patients with T2DM and definite CAN. Patients were divided into four groups: 1st - received standard hypoglycemic therapy - control (n = 15); 2nd (n = 22) – in addition simvastatin (SIM) 20.0 mg/q.d.; 3rd (n = 18) - in addition 1 capsule/q.d. of the ω-3 PUFAs; 4th (n = 17) - in addition SIM 10.0 mg/q.d and 1 capsule/q.d of the ω-3 PUFAs for three months. The concentration of glucose, glycated hemoglobin A1c, immunoreactive insulin (IRI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) in the blood were determined. Homeostasis model assessment IR (HOMA-IR), atherogenic coefficient (AC), TG/LDL-C, TG/TC, TG/LDL-C and TG and glucose index (TyG) were calculated. Results. Prescription of SIM was accompanied by a statistically significant decrease in TC, LDL-C, TG concentrations. In parallel, SIM induced a decrease of AC, TG/HDL-C, increase in HDL-C, and does not affect the IRI, HOMA-IR, TG/LDL-C, TG/TC, TC/LDL-C/HDL-C, TyG. The use of ω-3 PUFAs has contributed to a significant reduction in TG, AC, TG/LDL-C, TG/TC, TG/HDL-C, TyG index, increase in HDL-C, and was not accompanied by changes in IRI content, HOMA-IR, TC, LDL-C, and TC/LDL-C/HDL-C. The combined prescription of SIM and -3 PUFAs was accompanied by more pronounced, statistically significant changes in the blood lipid spectrum, as well as a decrease in the IRI and HOMA-IR. Conclusions. Obtained results justify the appropriateness of combined simvastatin and -3 polyunsaturated fatty acids prescription to patients with type 2 diabetes mellitus and definite cardiac autonomic neuropathy. Keywords: diabetes mellitus, cardiac autonomic neuropathy, treatment.

Hypocholesterolemic effect of designer yogurts fortified with omega fatty acids and dietary fibers in hypercholesterolemic subjects

A cohort study of 90 days was designed to explore the hypercholesterolemic associated blood pressure with intake of extruded flaxseed powder (EFSP) fortified yogurts. The hypercholesterolemic subjects were distributed into two groups (1 and 2), then blood samples and blood pressure were taken. Descriptive statistics were used for comparison between groups. A significant increase in serum total cholesterol (TC) (6.330.48 to 6.510.04 mmol/dL) and low-density lipids-cholesterol (LDL-C) (5.170.28 to 5.370.47 mmol/dL) was observed in participants consuming plain milk yogurts for 30 days. A significant decrease in TC (6.470.95 to 6.28 ± 0.84) and LDL-C (5.350.29 to 5.130.44 mmol/dL) was observed in the group consuming EFSP fortified sheep milk yogurt. Similarly, a significant decrease in serum TC (6.381.01 to 6.200.98 mmol/dL), and LDL-C (5.301.16 to 4.980.99 mmol/dL) was noticed in the group consuming EFSP fortified cow milk yogurt. The intake of fortified yogurts reduced significantly serum cholesterol associated with blood pressure in both groups.

Effect of Dorsomorphin Homolog 1 (DMH1) against Diabetic Dyslipidemia in Streptozotocin-induced Diabetic Rats

Dyslipidemia is usually observed in both types of diabetes and, particularly, “atherogenic dyslipidemic triad” is strongly linked to a higher risk of adverse cardiovascular outcome. On the other hand, bone morphogenetic proteins (BMP) are a group of wide variety of proteins which were found overexpressed and implicated in contribution and acceleration of atherosclerotic calcification. So, the present study aimed to assess effect of DMH1, a selective BMP inhibitor, in a rat model of diabetic-induced dyslipidemia.&#x0D; Methods: STZ-induced diabetes in Wistar rats was used as a model to assess the&#x0D; antihyperlipidemic effect of DMH1(5mg/kg) for a period of 8 weeks. Rats were divided intonormal control (C=10), diabetic control (DC=10), diabetic+vehicle (DV=10) and diabetic DMH1-treated rats (DT=10). Fasting blood glucose (FBG) level was measured on weekly bases. Then, at the end of the experiment, rats were anesthetized and blood samples were collected for the determination of total cholesterol (TC), triglyceride (TG), LDL and HDL levels using the appropriate ELISA assay.&#x0D; Results: FBG levels for all diabetic groups were significantly high, during the experiment period, compared to the control (P&lt; 0.001). While dyslipidemia was remarkable in the diabetic non-treated groups, DMH1 treatment showed a significant decrease in TC (P&lt; 0.001), TG (P&lt; 0.05) and LDL levels (P&lt; 0.001) compared to the non-treated groups (DC &amp; DV). Concurrently, HDL levels for DT group were significantly increased compared to DC or DV groups (P&lt; 0.01).&#x0D; Conclusion: The present experiment showed that DMH1 possessed encouraging activityagainst dyslipidemia in STZ-induced diabetic rats. Our results are promoting for more interest and investigation regarding antihyperlipidemic effect of DMH1 and BMP/Smad pathway in further experimental studies.

The effects of high fructose fruits and honey on the serum level of metabolic factors and nonalcoholic fatty liver disease.

The effect of the natural sources of fructose such as high fructose fruits and honey on the risk of fatty liver is still challenging. This study aimed to compare the effect of fructose, high fructose fruits, and honey on the metabolic factors and non-alcoholic fatty liver disease (NAFLD). Forty-four rats were divided into four groups including normal diet group, high fructose group (HF), high fructose fruits group (HFF), and honey group (HO). After 120days of intervention, the levels of insulin resistance, hepatic enzyme, and lipid profile were measured. Also, the expression levels of the acetyl-coA carboxylase (ACC), sterol regulatory element-binding protein 1c (SREBP-1c), Interleukin 6 (IL-6), and transforming growth factor-beta (TGF-β) genes were assessed. In addition, a histopathologic assessment was performed on liver tissues. Insulin resistance (IR) increased significantly in the HF, HFF, and HO groups (All P < 0.05). The levels of liver enzymes was significantly increased only in the group receiving the HF regimen (P < 0.01). A significant decrease in total cholesterol and HDL-C (high density lipoprotein cholesterol) levels was found in HO group compared to the control group (P < 0.05). The expression levels of ACC and SREBP-1c genes in HF, HFF, and HO groups were significantly higher than the control group (All P < 0.05). The HF group had a greater increase in the level of gene expression of IL-6 and TGF-β (All P < 0.05). Histopathological assessment did not find any changes in fatty liver formation and inflammatory damage. Consumption of fructose-rich honey and fruits improved the status of inflammatory markers and liver enzymes compared with the industrial fructose-rich products.

Remodelin, a N-acetyltransferase 10 (NAT10) inhibitor, alters mitochondrial lipid metabolism in cancer cells.

Remodelin is a small molecule inhibitor of N-acetyltransferase 10 (NAT10), reported to reverse the effect of cancer conditions such as epithelial to mesenchymal transition, hypoxia, and drug resistance. We analysed RNA seq data of siNAT10 and found many metabolic pathways were altered, this made us perform unbiased metabolic analysis. Here we performed untargeted metabolomics in Remodelin treated cancer cells using high-performance liquid chromatography-tandem mass spectrometry. Statistical analysis revealed a total number of 138 of which 52 metabolites were significantly modified in Remodelin treated cells. Among the most significantly altered metabolites, we identified metabolites related with mitochondrial fatty acid elongation (MFAE) and mitochondrial beta-oxidation such as lauroyl-CoA, cholesterol, triglycerides, (S)-3-hydroxyhexadecanoyl-CoA, and NAD+ . Furthermore, assessment showed alteration in expression of Enoyl-CoA hydratase, short chain 1, mitochondrial (ECHS1), and Mitochondrial trans-2-enoyl-CoA reductase (MECR) genes, associated with MFAE pathway. We also found statistically significant decrease in total cholesterol and triglycerides in Remodelin treated cancer cells. Overall, our results showed that Remodelin alters mitochondrial fatty acid metabolism and lipid accumulation in cancer cells. Finally, we validated these results in NAT10 knockdown cancer cells and found that NAT10 reduction results in alteration in gene expression associated with mitochondrial fatty acid metabolism, clearly suggesting the possible role of NAT10 in maintaining mitochondrial fatty acid metabolism.

Features of clinical and anamnestic characteristics and treatment of patients with hypertriglyceridemia (the data from Kuzbass register of dyslipidemias)

Aim. To study the features of clinical and anamnestic characteristics and treatment of patients with hypertriglyceridemia (HTG) using the data of the lipid control center of Kemerovo.Methods. The single-center retrospective study is based on the data of patients dynamic observation (n = 100) in the Dyslipidemia Registry of Kuzbass in 2019. A comparative analysis of clinical and anamnestic characteristics, lipidogram parameters and therapy was performed at the time when the patients were included in the study and after 6–12 months in patients with HTG (the criterion was the level of triglycerides (TG) above 1.69 mmol/L) and in patients without it. Indications for consulting a lipidologist were high cholesterol (levels of total cholesterol (TC) ˃7.5 mmol/L or low-density lipoprotein cholesterol ˃4.9 mmol/L or TG˃5 mmol/L), requirement of the high dose and/or combination therapy of lipid-lowering drugs; medical history of cardiovascular diseases and/or revascularization of vascular bed in patients under 55 years of age; suspected intolerance to lipid-lowering therapy due to the developed side effects; the issue of lipid-lowering therapy in complex clinical situations.Results. Among the patients who visited a lipidologist in 2019, mixed hypertriglyceridemia was noted in 56 (56%) of cases, while 44 (44%) patients had other lipid metabolism disorders without increased levels of TG. A distinctive feature of patients with mixed hypertriglyceridemia is the lower incidence of myocardial infarctions (p = 0.029) and lower number of coronary stents (p = 0.018) in the medical history, despite the initially higher levels of TC (p = 0.005) and TG (p = 0.000). According to the results of 6–12 months observation, a significant decrease in TC (p = 0.001) and TG (p = 0.044) levels during the lipid-lowering therapy was revealed due to the addition of fenofibrate (p = 0.000) to all groups of patients who were monitored by a lipidologist.Conclusion. The patients with dyslipidemia and HTG are a complex category of patients who require combined lipid-lowering therapy, which can only be prescribed by a lipidologist.

Порівняльна характеристика впливу омега-3 поліненасичених жирних кислот, статинів та їх комбінування на показники ліпідного спектра крові, судинно-тромбоцитарного гомеостазу і варіативності ритму серця у хворих на цукровий діабет 2-го типу з кардіоваскуля

Актуальність. Особливу зацікавленість у лікуванні дисліпопротеїнемій (ДЛП) у хворих на цукровий діабет 2-го типу (ЦД-2) з кардіоваскулярною автономною нейропатією (КАН) викликає аналіз ефективності комбінування омега-3 поліненасичених жирних кислот (w-3 ПНЖК) і статинів, однак інформація про особливості їх використання неоднозначна, має фрагментарний характер, є предметом дискусії, а тому потребує подальшого уточнення. Мета. Проведення порівняльної характеристики впливу w-3 ПНЖК, статинів та їх комбінування на показники ліпідного спектра крові, судинно-тромбоцитарного гомеостазу і варіативності ритму серця (ВРС) у хворих на ЦД-2 з КАН. Матеріали та методи. Обстежено 75 хворих на ЦД-2 із функціональною стадією КАН. У крові визначали концентрацію глюкози, глікозильваного гемоглобіну, загального холестерину (ЗХС), тригліцеридів (ТГ), холестерину ліпопротеїнів високої (ХС ЛПВЩ) і низької щільності (ХС ЛПНЩ); вміст ендотеліну-1 (ЕТ-1), тромбоксану B2 (TXB2), 6-кетопростагландину F1a (6-ketoPGF1a), розраховували коефіцієнт атерогенності (КА), співвідношення TXB2/6-ketoPGF1a. З метою оцінки результатів короткотривалої ВРС використовували часові й спектральні параметри. Пацієнти з ЦД-2 та функціональною стадією КАН були стратифіковані на чотири групи і протягом трьох місяців, окрім цукрознижувальної терапії, отримували: 1-ша група (n = 21) — препарат w-3 ПНЖК 1 капс/добу; 2-га група (n = 22) — симвастатин 20 мг/добу; 3-тя група (n = 17) — препарат w-3-ПНЖК 1 г/добу і симвастатин 10 мг/добу; у контрольній (n = 15) — стандартну цукрознижувальну терапію протягом трьох місяців. Результати. Включення в лікувальні заходи препарату w-3 ПНЖК виявляло більш значуще порівняно з симвастатином зниження рівня ТГ, зменшення вмісту КА та збільшення концентрації ХС ЛПВЩ і не впливало на концентрацію ЗХС і ХС ЛПНЩ. Використання симвастатину супроводжувалось більш вірогідним зменшенням рівня ЗХС, ХС ЛПНЩ, КА, ТХВ2, TXB2/6-ketoPGF1a і зростанням вмісту ХС ЛПВЩ, ЕТ-1, 6-ketoPGF1a; часових і спектральних параметрів ВРС. Комбінація w-3 ПНЖК і симвастатину супроводжувалась найбільш вираженими, позитивними, вірогідними змінами ліпідного обміну, ендотеліальної функції, ТХВ2, TXB2/6-ketoPGF1a; часових і спектральних параметрів ВРС. Висновки. Отримані результати дозволяють вважати, що ефективність комбінованої терапії w-3 ПНЖК і симвастатином не пов’язана зі станом компенсації захворювання, а є результатом безпосереднього впливу цих фармакологічних агентів на досліджувані показники, що обґрунтовує доцільність її використання в лікуванні ДЛП у хворих на ЦД-2 і функціональну стадію КАН.

Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: A multicenter, randomized trial.

Red yeast rice contains monacolin K, an inhibitor of cholesterol synthesis, and gamma-aminobutyric acid, a neurotransmitter. The daily dose of red yeast rice and monacolin K in previous studies was relatively high; therefore, there were safety concerns. We aimed to examine the effects of low daily dose red yeast rice on arteriosclerosis in patients with mild dyslipidemia. Eighteen patients without known cardiovascular disease and unsatisfactory low-density lipoprotein cholesterol (3.96±0.19 mmol/L) controlled only by diet therapy were randomly allocated to receive low dose red yeast rice (200 mg/day) containing 2 mg monacolin K or diet therapy alone for 8 weeks. The primary outcome was the absolute change in low-density lipoprotein cholesterol. Secondary outcomes included total cholesterol, apolipoprotein B, and blood pressure. Low-density lipoprotein cholesterol decreased significantly in the red yeast rice group than in the diet therapy group (median [interquartile range]: control -0.20 [-0.62, 1.19] mmol/L vs. red yeast rice -0.96 [-1.05, -0.34] mmol/L, p=0.030). The red yeast rice group also exhibited significant decreases in total cholesterol, apolipoprotein B, and blood pressure. No severe treatment-related adverse effects on muscles, liver, or renal function were observed. We found that patients in the red yeast rice group exhibited significant reductions in lowdensity lipoprotein cholesterol, total cholesterol, apolipoprotein B, and blood pressure without any recognised adverse effect. This suggests that low daily dose red yeast rice could reduce cardiovascular risk in patients with dyslipidemia.

Improved performance of naringenin herbosomes over naringenin in streptozotocin-induced diabetic rats

Objective: To prepare naringenin herbosome and evaluate its antidiabetic activity. Methods: Herbosomes were prepared by the solvent evaporation method. In vitro parameters like particle size, polydispersity index, zeta potential, and entrapment efficiency were estimated and in vitro diffusion study was performed. The in vivo studies were also performed in streptozotocin-induced diabetic male Sprague Dawley rats to evaluate blood glucose, total cholesterol, triglyceride, blood urea nitrogen, total protein, albumin level, aspartate aminotransferase, and alanine aminotransferase levels. Results: The optimized herbosome batch showed a particle size of 564.4 nm, a polydispersity index of 0.412, and zeta potential of -39.3 mV. The percentage entrapment of this formulation was 84.04%, with complete drug release within 8 h. Treatment of diabetic rats with naringenin herbosomes for 28 d significantly reduced the elevated level of plasma glucose as compared to plain naringenin. In biochemical parameters, the treatment showed a significant decrease in total cholesterol, triglyceride, and blood urea nitrogen; while elevated levels of aspartate aminotransferase and alanine aminotransferase were returned to normal. Pure naringenin and herbosome formulation at high dose increased the total protein whereas albumin level significantly increased in naringenin herbosomes at the highest dose but not in the pure naringenin treatment group. Conclusions: Naringenin herbosomes could improve the metabolic profile of diabetic rats, indicating enhanced antidiabetic activity of herbosome formulation.

Evaluation of Lipoprotein Profile and Residual Risk Three Years After Bariatric Surgery.

Obesity is a chronic disease associated with other comorbidities, including atherogenic dyslipidemia (AD). Bariatric surgery (BS) has shown to reduce cardiovascular risk (CVR) by achieving a significant weight reduction and improving the lipid profile. Different surgical techniques may have a different effect on the lipoprotein profile. To evaluate the lipid profile at 3 years after BS according to the surgical technique used and to determine which variables predict variation in the lipid profile at 3 years after BS. Retrospective observational study of 206 patients who underwent BS between 2010 and 2019. We analyzed the variation of lipid parameters in the 3 years of follow-up according to the surgical technique, including a group analysis of patients according to whether they had dyslipidemia and whether they were treated or untreated and determined which variables predict variation in the lipid profile at 3 years after BS. There was a significant increase in high-density lipoprotein cholesterol (HDL-c) with sleeve gastrectomy (SG) and a significant decrease in total cholesterol (TC), LDL-cholesterol (LDL-c), non-HDL, and LDL/non-HDL with biliopancreatic diversion (BPD). Variables predicting lipid profile variation were surgical technique and pre-surgery lipoprotein level. Malabsorptive techniques achieve a greater decrease in TC and LDL-c throughout follow-up and could also improve residual cardiovascular risk (non-HDL and LDL/non-HDL). The type of surgical technique and the presurgery lipid profile predict variation after 3 years of BS.

Phytochemical screening and the effect of Trichosanthes dioica in high‐fat diet induced atherosclerosis in Wistar rats

AbstractTrichosanthes dioica fruit pericarp has a powerful hypolipidemic and antioxidant properties. Wistar rats were divided into five groups (n = 30). The normal control group received vehicle and standard diet throughout the experimental period. Groups II, III, IV, and V were given a high‐fat diet and free access of water for 21 days. Experimental groups IV and V were given high‐fat diet along with T. dioica extract 400 and 800 mg/kg, respectively. Blood was collected at 21 days, and lipid profile estimation was performed. The phytochemical screening was performed by different phytochemical screening methods. Lipid peroxidation and catalase activity were done by taking a liver tissue sample. The phytochemical screening of extract showed good results and indicated the presence of phytoconstituents in extract. 2,2‐Diphenyl‐1‐picrylhydrazyl scavenging activity of T. dioica was found to be 65.79% at a concentration of 100 μg/ml extract, whereas that of the control was 94.06%. The Wistar rats fed with a high‐fat diet with T. dioica showed a significant decrease in total cholesterol (TC), triglycerides (TG), very‐low‐density lipoprotein (VLDL), and low‐density lipoprotein (LDL) levels and an increase in high‐density lipoprotein (HDL) level. The lipid peroxidation and catalase activity of methanol extract of T. dioica were significantly reduced with individual comparison with all groups. The methanol extract of T. dioica has the hypolipidemic effect, which showed a decrease in TC, TG, VLDL, and LDL levels and an increase in HDL level in Wistar rats. It also has antioxidant properties. In this study, we have evaluated the antioxidant and the antihyperlipidemic activities of T. dioica in high‐fat diet induced hyperlipidemia in Wistar rats.