Significant Decrease In Total Cholesterol Research Articles

The Effect of Conjugated Linoleic Acid Supplementation on Lipid-Related Cardiovascular Biomarkers in Obese Adults

Background: Studies have shown incompatible findings regarding the effects of conjugated linoleic acid (CLA) supplementation on cardiovascular diseases (CVDs) risk factors. The aim of this study was to evaluate the effect of daily CLA supplementation on serum insulin and lipid- related CV biomarkers in obese adults. Methods: This randomized double-blind clinical trial was conducted on 54 adults categorized as class I obesity. The participants were randomly assigned into two groups (n=27) receiving a total of 3,000 mg/d of a 50:50 mixture of CLA isomers for three months in intervention group (IG) and 500 mg/d paraffin in placebo group (PG). Moreover, fasting serum levels of insulin, lipid profile, non-HDL-Cholesterol (non-HDL-C), atherogenic index of plasma (AIP), total triglyceride (TG)/HDL-C, and cholesterol/HDL-C ratio were measured. The main statistical analysis method was independent t-test for changes. Results: Changes between the groups showed a significant decrease in total cholesterol (P=0.03), LDL-C (P=0.04), and non-HDL-C (P=0.03), and also a significant increase in AIP (P=0.04) in IG compared to the PG. A remarkable decrease was found in HDL-C and cholesterol/HDL-C ratio. In addition, a remarkable increase was observed in TG in this context. Serum insulin, VLDL-C, and LDL-C/HDL-C ratio showed no significant changes during the intervention period. The use of CLA supplementation could help reduce some adverse fractions of serum lipid profile, particularly TC, non-HDL-C and LDL-C. Conclusions: Regarding the augmenting effects of CLA intake on AIP as a strong predictive marker for CVDs, it is difficult to confirm the beneficial effects of CLA supplementation in preventing CVDs.

Eicosapentaenoic acid supplementation alleviates pruritus, enhances skin moisture, and mitigates depression in maintenance hemodialysis patients

BackgroundThe objective of this study is to investigate the effects of oral supplementation with eicosapentaenoic acid (EPA) on circulating inflammatory factors, cardiometabolic parameters, skin moisturization, and the consequent symptoms of pruritus and depression in maintenance hemodialysis patients.Materials and methodsA total of 60 maintenance hemodialysis patients with severe pruritus symptoms completed this randomized, placebo-controlled study. Subjects of treatment group (n = 30) were instructed to consume 1000 mg fish oil (>900 mg EPA) and subjects of placebo group (n = 30) were instructed to consume 1000 mg soybean oil twice daily for 3 months. 5-D pruritus scoring, the Beck Depression Inventory (BDI) scale, skin moisture, serum creatinine, inflammatory factors, and cardiometabolic parameters were examined at baseline, and at the first, second, and third month post-supplementation.ResultsA significantly decreased pruritus level was observed in the treatment group, whereas an opposite result was observed in the placebo group. Increased skin moisture levels on both the face and arms were observed in the treatment group, but not in the placebo group. Supplementation of EPA significantly decreased serum CRP and IL-6 levels. Significant decreases in total cholesterol (CHO), and triglycerides (TG) levels were observed; however, a decrease in high-density lipoprotein (HDL) level was observed in the treatment group. There was no change in plasma creatinine (CR) observed in both groups. A significantly decreased BDI score was observed, whereas the opposite result was observed in the placebo group. A correlational study showed that the severity of pruritus was significantly associated with skin moisture and serum CRP. The severity of pruritus was also positively correlated with the BDI score.ConclusionSupplementation of EPA may provide multiple benefits including alleviating pruritus symptoms, addressing skin dryness, and mitigating depression in maintenance hemodialysis patients.

Investigation of setmelanotide, an MC4R agonist, for obesity in individuals with Smith-Magenis syndrome

BackgroundSmith Magenis Syndrome (SMS) is a rare genetic disorder caused by RAI1 haploinsufficiency. Obesity in people with SMS is believed partially due to dysfunction of the proximal melanocortin 4 receptor (MC4R) pathway. We therefore studied effects of treatment with the MC4R agonist setmelanotide on obesity and hunger, as well as metabolic, cardiac and safety, in individuals with SMS. MethodsPeople with SMS received once-daily setmelanotide injections, with the dose titrated bi-weekly to a maximum of 3 mg over ∼1 month; and a full-dose treatment duration of 3mo. The primary outcome was percent change in body weight. Secondary outcomes included hunger, waist circumference, body composition, and safety. Results12 individuals, ages 11–39 y, enrolled and 10 completed the full-dose treatment phase. Mean percent change in body weight at end-treatment was − 0.28 % [(95 % CI, −2.1 % to 1.5 %; n = 12; P = 0.66]. Participants experienced a significant decrease in total cholesterol associated with a significant decrease in HDL-cholesterol and a trend for lower LDL-cholesterol. Self-reported hunger was reduced at end-treatment (p = 0.011). All participants reported adverse events (AEs), most commonly injection-site reactions and skin hyperpigmentation. No AEs led to withdrawal or death. ConclusionsIn this trial, setmelanotide did not significantly reduce body weight in participants with SMS. Participants reported significant differences in hunger, but such self-reports are difficult to interpret without a placebo-treated group. The changes in lipid profiles require further investigation. Results of this study do not suggest that dysfunction of the proximal MC4R pathway is the main etiology for obesity in people with SMS.

Investigation of acute, sub-chronic toxicity, effects of mangiferin and mangiferin solid dispersion (HPTR) on Triton WR1339-induced hyperlipidemia on Swiss albino mice

Mangiferin is a xanthonoid found in Mango leaves in abundance with many effects as a hypoglycemic, antioxidant, and anti-inflammatory agent, plant metabolite, and so on. However, nowadays, mango leaves are merely a waste product in Vietnam. To take advantage of this valuable medicinal resource, extraction conditions of mangiferin using classical and ultrasound methods were researched, and mangiferin was purified from Cat Chu mango leaves (Mangifera indica L., Anacardiaceae) collected in Dong Thap. Ultrasound-assisted extraction method was conducted with the following conditions and mangiferin was extracted at a percentage of 6.728% with a purity of 91.11%. Purified mangiferin was evaluated using molecular absorption spectroscopy UV-Vis, scanning electron microscopy (SEM), X-ray diffraction (XRD) spectroscopy, simultaneous thermal analysis (STA: TGA/DSC), and dissolution measurement method. To optimize the solubility and permeability of mangiferin, the solid dispersion system (HPTR) was made by the combination of HPMC 6M:mangiferin at the ratio of 1:5. To investigate the acute, sub-chronic toxicity and hypolipidemia effect of HPTR as compared to purified mangiferin, we followed guidelines for preclinical and clinical trials of Traditional Medicine and Herbal Medicines by the Vietnam Ministry of Health and OECD, and used tyloxapol (Triton WR1339, 400 mg/kg, i.p.) to induce hyperlipidemia. Our results indicated that purified mangiferin and HPTR extract showed no acute toxicity and sub-chronic toxicity and has potential as an antihyperlipidemic agent. The HPTR brought about a significant decrease in total cholesterol, triglycerides and LDL-c when compared to mangiferin, however there was no significance between them.

Лазеротерапия и разгрузочная лечебная гимнастика в лечении нарушений липидного обмена

Based on clinical practice, some patients with lipid metabolism disorders (LMD) are resistant to lipid-lowering therapy (LLT) — in such patients, taking optimal doses of LLT drugs does not reduce levels of cholesterol and its fractions to target levels and using LLT at higher doses is associated with increased odds of adverse events. To optimize the treatment, 58 patients with ischemic heart disease with LMD resistant to LLT were examined. The patients were divided into two groups: in the main group, 29 patients received laser therapy and unloading therapeutic gymnastics; in the control group, 29 patients continued to take their usual medications. The obtained results showed a significant lipid-lowering effect of the treatment in the main group: we observed a significant decrease in total cholesterol (by 27.7%, p < 0.01) as well as low-density lipoprotein cholesterol (by 34.7%, p < 0.01), a significant increase in high-density lipoprotein cholesterol (28.1%, p < 0.01), a significant decrease of atherogenic coefficient (by 50.2%, p < 0.01) and in the levels of triglycerides (by 49.6%, p < 0.01). At the same time, no significant positive changes in lipid profile were observed in the control group. In patients of the main group, tolerance to physical activity increased significantly, with statistically insignificant changes in the control group accordingly.

Investigation of acute and sub-chronic oral toxicity and effects of Allium ascalonicum L. extract on Triton WR1339-induced hyperlipidemia on Swiss albino mice

IntroductionMetabolic disorders are increasingly rapidly becoming a burden on global healthcare systems. Among these, hyperlipidemia frequently leads to cardiovascular diseases such as myocardial infarction and cerebral stroke, posing significant life-threatening risks. The pharmacological drugs, which are often costly and may cause a range of adverse side effects detrimental to health. Allium ascalonicum L., a member of the Alliaceae family, a widely used species of the Allium genus, is commonly employed as a spice and food ingredient in Asia. Allium ascalonicum (AS) is rich in triterpenoids, phenolic acids, flavonoids, thiosulfates, and anthocyanins, whose therapeutic effects have been documented. In Chinese, Allium ascalonicum L. is known as 葱 (Cōng), which is used for various types of onions and similar plants in Chinese, including shallots. Ancient Chinese medicine documented that AS has a sweet and mildly spicy taste with a slight astringency and is warm in nature. In traditional Chinese medicine, AS is prepared as infusions, juices, and poultices to harness their health benefits, and commonly used in cooking for their nutritional and medicinal purposes. Modern medicine has discovered that this type of bulb possesses antibacterial and anti-inflammatory properties, acts as a diuretic, treats diarrhea, reduces blood sugar levels, lowers blood pressure, reduces cholesterol, and among its other roles. Currently, there is a lack of in vivo study on the cholesterol-regulating potential of AS. MethodsFor our experiments, 24 and 32 Swiss albino mice were employed to investigate the acute and sub-chronic oral toxicity according to the Guidelines for preclinical and clinical trials of Traditional Medicine and Herbal Medicines by the Vietnam Ministry of Health and OECD. To investigate the effects on hyperlipidemia, 40 mice of both sexes were divided into five groups (n = 6–8 each). Tyloxapol (Triton WR1339, 400 mg/kg, i.p.) was used to induce hyperlipidemia. Atorvastatin (60 mg/kg, p.o.) was used as the standard, and AS extract was conducted at the doses of 500 mg/kg and 1000 mg/kg. Hyperlipidemic activity was assessed using a variety of parameters. ResultsAllium ascalonicum (AS) extract showed no acute toxicity and sub-chronic toxicity. The AS showed a significant decrease in total cholesterol, triglycerides and LDL-c but showed no changes in HDL-c. ConclusionOur results indicated that AS is safe to use for a longtime and has a potential as an antihyperlipidemic agent, possibly due to its ability to inhibit the elevation of total cholesterol, triglycerides and LDL-c. The AS is rich in phytochemicals like triterpenoids, flavonoids and saponins, which may contribute to its hypolipidemic effect.

A46 METABOLIC OUTCOMES 12-MONTHS POST-BARIATRIC SURGERY: SLEEVE VERSUS ROUX-EN-Y GASTRIC BYPASS

Abstract Background Obesity and its related comorbidities, such as type 2 diabetes (T2D), hyperlipidemia, cardiovascular disease (CVD), and non-alcoholic fatty liver disease (NAFLD) are on the rise. When lifestyle modifications, such as diet and exercise, are ineffective at producing sustained weight loss and improvements in obesity-related comorbidities, other interventions may be recommended. Bariatric surgery is considered in those who have a body mass index (BMI) over 40 kg/m2 or with comorbid conditions and a BMI between 35-40 kg/m2. Two commonly used procedures within this category of surgery are Roux-en-Y gastric bypass (RYGB), the gold standard for weight loss; and laparoscopic sleeve gastrectomy (LSG). Though both surgeries are effective at inducing weight loss, more information is needed on their comparative effectiveness in improving clinical and biochemical outcomes in patients with T2D, hyperlipidemia, and NAFLD in real-world practice. Aims Therefore, our objective was to determine the overall effectiveness of RYGB versus LSG at 12-months post-surgery and specifically assess their responses in those with hyperlipidemia, T2D and NAFLD. We chose to analyze both glucose and lipid parameters along with anthropometric measures as they not only provide insight into improvements in comorbid outcomes of obesity but also little-to-no prospective studies compare all of these outcomes in one study using the same cohort. Methods This is a prospective cross-sectional and cohort study of 142 patients who underwent bariatric surgery. Clinical and biochemical data were collected at baseline, prior to surgery and 12-months post-bariatric surgery. A liver biopsy was collected during surgery to diagnose NAFLD. The main outcome was 12-month changes in lipid parameters, mainly total cholesterol, between types of surgery. Results 107 individuals underwent RYGB (75.4%) and 35 underwent LSG (24.6%). Both groups were similar at baseline except for the higher waist circumference and proportion of males undergoing LSG. At 12-months post-surgery, RYGB versus LSG resulted in a significantly lower BMI (pampersand:003C0.0001), triglycerides (pampersand:003C0.05), total and LDL cholesterol (pampersand:003C0.005). Interestingly, ALT was significantly lower in those who underwent LSG (pampersand:003C0.005). In subgroup analysis for determining the effect of the type of surgery in those with comorbidities of obesity, RYGB was superior at improving lipid-related parameters in those with hyperlipidemia with a significant decrease in total cholesterol -0.48 (-0.84, 0.34) (pampersand:003C0.05) whereas LSG was superior at reducing ALT in those with NAFLD with significant decreases in total cholesterol and LDL. Conclusions RYGB leads to greater reductions in BMI and lipid parameters, especially in those with hyperlipidemia, whereas LSG showed greater improvements in liver enzymes in those with NAFLD. Funding Agencies CIHR

Dietary amino acid patterns and cardiometabolic risk factors among subjects with obesity; a cross-sectional study

BackgroundThe prevalence of obesity is a growing global public health concern. Certain dietary amino acids have been shown to have a potential therapeutic role in improving metabolic syndrome parameters and body composition in individuals with obesity. However, some amino acids have been linked to an increased risk of cardiometabolic disorders. This cross-sectional study aims to investigate the association between dietary amino acid patterns and cardiometabolic risk factors in individuals with obesity.MethodsThis cross-sectional study included 335 participants with obesity (57.9% males and 41.5% females) from Tabriz and Tehran, Iran. The participants were between the ages of 20–50, with a body mass index (BMI) of 30 kg/m2 or higher, and free from certain medical conditions. The study examined participants’ general characteristics, conducted anthropometric assessments, dietary assessments, and biochemical assessments. The study also used principal component analysis to identify amino acid intake patterns and determined the association between these patterns and cardiometabolic risk factors in individuals with obesity.ResultsUpon adjusting for potential confounders, the study found that individuals in the third tertiles of pattern 1 and 2 were more likely to have lower LDL levels (OR = 0.99 and 95% CI (0.98–0.99)) for both. Additionally, a significant decrease in total cholesterol was observed in the third tertiles of pattern 2 in model II (OR = 0.99, 95% CI (0.98–0.99)). These findings suggest a potential cardioprotective effect of these amino acid patterns in managing cardiometabolic risk factors in individuals with obesity.ConclusionsThis study found that two identified amino acid patterns were associated with lower serum LDL and total cholesterol levels, while a third pattern was associated with higher serum triglycerides. The specific amino acids contributing to these patterns highlight the importance of targeted dietary interventions in managing cardiometabolic risk factors in individuals with obesity.

Effect of Lactuca sativa supplemented diet on Poloxamer 407 induced hyperlipidemic albino rats (Rattus norvegicus)

Abstract. Ayo VI, Adondua MA, Morayo AE, Ekele JU, Amilo D, Ochuele DA, Ayantse LM, Barrah C, Abdulsalam IO, Eya SB, Iheanacho CC, Tibile ST, Mohammed RI, Barde CE. 2023. Effect of Lactuca sativa supplemented diet on Poloxamer 407 induced hyperlipidemic albino rats (Rattus norvegicus). Asian J Nat Prod Biochem 21: 67-78. Cardiovascular diseases (CVDs) have primarily contributed to the global disease burden. They represent the leading cause of mortality and healthcare expenditures in developed and third-world nations, responsible for approximately 30 percent of global deaths and 10 percent of global diseases annually. This study investigated the effects of a Lactuca sativa L. (lettuce) supplemented diet on Poloxamer 407-induced hyperlipidemic albino rats. Twenty-four (24) rats were grouped into six groups of treatments, i.e., four rats in each treatment. Treatments applied in this study were: control treatment (feed and water only), a P-407 induced without Atorvastatin, a P-407 induced treated with Atorvastatin, and P-407 induced with 10%, 30%, and 50% L. sativa supplemented diet. P407 was administered intraperitoneally at 1000 mg/kg body weight. Body weight was measured every three days for 14 days. Blood sample collection was carried out for the analysis of lipid profiles (High-Density Lipoprotein Cholesterol (HDL-C), Low-Density Lipoprotein Cholesterol (LDL-C), Very Low-Density Lipoprotein (VLDL), Triacylglycerides (TAG), and Total Cholesterol (TC)) and liver function parameters (ALP, ALT, AST, GGT, TP, ALB and GLB). The liver and brain tissues were analyzed for lipid peroxidation levels. Results showed that induction of P407 resulted in a higher body weight gain (p<0.05) compared to other treatments. The treatment groups other than the P-407 treatment showed a significant decrease in Total Cholesterol (TC), triacylglycerides (TAG), and LDL cholesterol levels and a significant increase in HDL cholesterol. The TC, TAG, LDL-C, and HDL-C levels in treating P-407 with a 50% L. sativa-supplemented diet did not differ (P>0.05) compared to the control treatment. The atherogenic risk prediction indices indicated a decreased risk in the treated groups with Atorvastatin or L. sativa-supplemented diet. Furthermore, liver function parameters were better in the treatment groups with Atorvastatin or L. sativa-supplemented diet, including decreased liver function parameters and increased total protein, albumin, and globulin levels. The L. sativa-supplemented diet also exhibited anti-lipid peroxidation activity, as indicated by reduced malondialdehyde (MDA) levels. In conclusion, the L. sativa-supplemented diet had hypolipidemic effects, anti-lipid peroxidation activity, and hepatoprotective effects, suggesting its potential as an antihyperlipidemic agent.

Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjects: a randomised controlled intervention study.

Background: Pure bergamot juice exerts lipid lowering effects in dyslipidemic subjects. It is unknown whether bergamot-based beverages exert similar effects in healthy subjects. Aim: To assess the effects, if any, of a bergamot-based beverage (BBB, bergamot juice ≤25%) on lipid, metabolic and inflammatory biomarkers. Methods: Forty-five healthy subjects were randomised 1 : 1 to BBB intake (400 mL day-1) (55.5%) or control (44.5%) for 12 weeks. Anthropometric (waist circumference, body mass index (BMI)) and clinical (blood pressure) parameters, blood samples (glucose, glycated haemoglobin, insulinemia, lipid profile, liver and renal function, inflammatory biomarkers) and 24-h urine for the analysis of (poly)phenol metabolites were collected at the baseline and at 12 weeks. Intakes of energy, nutrients and food groups were assessed by a 7-day dietary record. Results: Both groups exhibited a time-related significant decrease in total cholesterol (p = 0.02), fasting plasma glucose (p = 0.016), insulin (p = 0.034), BMI (p < 0.001) and waist circumference (p = 0.04), but with no significant between-arm difference. The urinary profile of metabolites from the BBB-derived (poly)phenols well discriminated the two study groups, documenting good compliance in the intervention arm. Notably, urinary bergamot 3-hydroxy-3-methylglutaryl (HMG) -containing flavanones or derived HMG-containing metabolites were not detectable. BBB was well tolerated and no adverse events were recorded. Conclusion: This first randomized controlled trial of BBB consumption in healthy subjects showed no effects of BBB on the cardiometabolic risk profile. BBB consumption is a safe nutritional adjunct in the context of a well balanced diet.

Effects of dietary phytosterols or phytosterol esters supplementation on growth performance, biochemical blood indices and intestinal flora of C57BL/6 mice.

This study was conducted to evaluate the effects of phytosterols (PS) and phytosterol esters (PSE) on C57BL/6 mice. Three groups of 34 six-week-old C57BL/6 mice of specific pathogen free (SPF) grade, with an average initial body weight (IBW) of 17.7g, were fed for 24 days either natural-ingredient diets without supplements or diets supplemented with 89 mg/kg PS or diets supplemented with 400 mg/kg PSE. Growth performance, blood biochemistry, liver and colon morphology as well as intestinal flora status were evaluated. Both PS and PSE exhibited growth promotion and feed digestibility in mice. In blood biochemistry, the addition of both PS and PSE to the diet resulted in a significant decrease in Total Cholesterol (TC) and Triglyceride (TG) levels and an increase in Superoxide Dismutase (SOD) activity. No significant changes in liver and intestinal morphology were observed. Both increased the level of Akkermansia in the intestinal tract of mice. There was no significant difference between the effects of PS and PSE. It was concluded that dietary PS and PSE supplementation could improve growth performance, immune performance and gut microbiome structure in mice, providing insights into its application as a potential feed additive in animals production.

Effects of proprotein convertase subtilisin-kexin type 9 inhibitors on inflammatory and hemostatic parameters in post myocardial infarction patients

Despite progress in treatment, elevated levels of low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a) (Lp(a)), represent a significant part of the residual risk. Both are associated with inflammation and the coagulation fibrinolytic system. The purpose of our research was to evaluate the effect of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) on lipid parameters and indicators of inflammation, coagulation and fibrinolysis. We included 100 post myocardial infarction (MI) patients with insufficiently controlled LDL-C values despite the maximum dose of statin, and highly elevated Lp(a). Patients received alirocumab or evolocumab (150 mg sc or 140 mg sc every two weeks, respectively), or placebo for 6 months.In patients receiving PCSK9i, a significant decrease in total cholesterol (TC), LDL-C, triglycerides (TG) and Lp(a), and an increase in high density lipoprotein cholesterol (p < 0.001 for all) was found. Before treatment, the concentrations of TC, LDL-C and TG correlated with the concentrations of thrombin activatable fibrinolysis inhibitor (r = 0.41, p < 0.001; r = 0.353, p < 0.001; r = 0.311, p = 0.003, respectively), and plasminogen activator inhibitor-1 (r = 0.302, p = 0.007; r = 0.218, p = 0.049; r = 0.278; p = 0.013, respectively). The concentrations of TC and LDL-C correlated with overall fibrinolytic potential (r = −0.220, p = 0.034; r = −0.207, p = 0.047, respectively). The concentration of TG was related to the concentration of interleukin 6 (r = 0.290, p = 0.004) and interleukin 8 (r = 0.332, p = 0.001). No correlations between Lp(a) and inflammatory or hemostatic variables were found. No associations were found after treatment. Our results show that inflammatory cytokines and fibrinolytic parameters are related to LDL-C and not Lp(a) in post-MI patients before and with neither of them following PCSK9i treatment.The trial registration number: NCT04613167, Date of registration: November 3, 2020.

Effect of camel milk on lipid profile among patients with diabetes: a systematic review, meta-analysis, and meta-regression of randomized controlled trials

The effects of camel milk (CM) intake on lipid profile among patients with diabetes remain controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to calculate the effect size of CM intake on blood lipids among patients with type 1 (T1D) and type 2 (T2D) diabetes. We searched nine databases from inception until December 31, 2022, to identify relevant RCTs. Effect sizes for total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) were calculated and expressed using mean differences (MD) and confidence intervals (CI). Of 4,054 retrieved articles, 10 RCTs (a total of 347 participants aged 8–70 years, 60.5% male) were eligible for inclusion. The pooled results from a random-effects model showed statistically significant decreases in TC (MD − 21.69, 95% CI: 41.05, − 2.33; p = 0.03; I2=99%), TG (MD − 19.79, 95% CI: −36.16, − 3.42; p=0.02, I2=99%), and LDL (MD −11.92, CI: −20.57, −3.26; p = 0.007, I2=88%), and a significant increase in HDL (MD 10.37, 95% CI, 1.90, 18.84; p=0.02, I2=95%) in patients with diabetes supplemented with CM compared with usual care alone. Subgroup analysis revealed that only long-term interventions (> 6 months) elicited a significant reduction in TC levels and TG levels. Consumption of fresh CM by patients with diabetes resulted in significant reductions in TC, TG, and LDL levels, while showing a significant increase in HDL levels. Patients with T1D elicited a more beneficial effect in lowering TC, LDL, and TG levels and in increasing HDL levels than their corresponding partners with T2D. In conclusion, long-term consumption of CM for patients with diabetes, especially those with T1D, could be a useful adjuvant therapy to improve lipid profile alongside prescribed medications. However, the high heterogeneity in the included studies suggests that more RCTs with larger sample sizes and longer intervention durations are required to improve the robustness of the available evidence.

Comparison of virtual vs face-to-face medical nutrition therapy in patients with hyperlipidemia

Since the COVID-19 pandemic, utilization of telemedicine visits has increased. The outcomes of virtual compared to face-to-face (F2F) visits for treating hyperlipidemia are uncharacterized. This observational study compared pre- to post-visit change in lipid markers between 41 virtual and 151 F2F visits with a registered dietitian nutritionist at the University of Michigan Preventive Cardiology program from 3/31/2019–9/31/2022. Total cholesterol (TC), high-density lipoprotein (HDL), and triglycerides (TG) were collected pre- and post-visit with a median 33 days between collections. Low-density lipoprotein (LDL-C) was calculated using the Sampson equation. We used paired T-tests to evaluate mean change in lipid markers for each visit type between pre and post timepoints, and linear regression to compare virtual to F2F visits. There was a significant decrease in TC, LDL-C, and non-HDL-C for both visit types. There was no significant difference in mean change in lipid markers between virtual and F2F visits. Telehealth is a promising strategy for increasing access to medical nutrition therapy.

Abstract 16617: Effects of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors on Inflammatory and Haemostatic Parameters in Coronary Artery Disease Patients

Background and aims: Despite progress in treatment, elevated levels of low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) represent a significant part of the residual risk. Both are associated with inflammation and the coagulation fibrinolytic system. The purpose of our research was to evaluate the effect of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) on lipid parameters and indicators of inflammation, coagulation and fibrinolysis. Methods: We included 100 patients after a myocardial infarction with insufficiently controlled LDL-C values despite the maximum dose of statin, and highly elevated Lp(a). Patients received alirocumab or evolocumab (150mg sc or 140g sc every two weeks; respectively) or placebo for 6 months. Results: In the group receiving PCSK9i, a significant decrease in total cholesterol (TC), LDL-C, triglycerides (TG) and Lp(a), and an increase in high density lipoprotein cholesterol (p&lt;0.001 for all) was found. Before treatment concentrations of TC, LDL-C and TG correlated with the concentration of thrombin activatable fibrinolysis inhibitor (r=0.41, p&lt;0.001; r=0.353, p&lt;0.001; r=0.311, p=0.003; respectively), and plasminogen activator inhibitor-1 (r=0.302, p=0.007; r=0.218, p=0.049; r=0.278; p=0.013; respectively). The concentration of TC and LDL-C correlated with overall fibrinolytic potential (r=-0.220, p=0.034; r=-0.207, p=0.047; respectively). The concentration of TG was related to the concentration of interleukin 6 (r=0.290, p=0.004) and interleukin 8 (r=0.332, p=0.001). No correlations between Lp(a) and inflammatory or haemostatic variables were found. No associations were found after treatment. Conclusion: Our results show that fibrinolytic parameters and inflammatory cytokines are related to the concentration of LDL-C and not Lp(a) before and with neither of them after treatment with PCSK9i.

Effects of sumac supplementation on lipid profile: A systematic review and meta-analysis of randomized controlled trials.

This systematic review aimed to gather data on the effects of sumac supplementation on lipid profile. A systematic literature search was carried out using electronic databases (PubMed, Scopus, and Web of Science) up to March 2023 to identify eligible randomized controlled trials (RCTs) assessing the effects of sumac intake on lipid profile as an outcome. All participants enrolled in our study were adult individuals who consumed sumac, in various forms, as an intervention. The included articles were assessed using the Cochrane risk of bias assessment tool. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95% confidence interval. In total, seven RCTs with a total sample size of 570 subjects were included. This study found a significant decrease in total cholesterol (TC) (weighted mean difference [WMD]: -10.01 mg/dL; 95% CI: -18.67, -1.34), triglyceride (TG) (WMD: -8.52 mg/dL; 95% CI: -14.79, -2.25), and low-density lipoprotein (LDL)-C levels (WMD: -9.25 mg/dL; 95% CI: -14.56, -3.93); Moreover, a significant increase was observed in high-density lipoprotein (HDL)-C concentration (WMD: 2.97 mg/dL; 95% CI: 0.75, 5.19). The reduction in TG and TC was greater in studies with a duration of ≥12 compared to <12 weeks. The increase in HDL-C was greater in participants with an intervention duration of ≥12 compared to <12 weeks. Moreover, subgroup analysis based on the dose of sumac suggested a significant reduction in TC and LDL, specifically for doses below 3 g. Consumption of sumac significantly decreased serum TC, LDL-C, and TG concentrations. This study suggested significantly positive effects on HDL-C by intake of sumac. Longer interventions (>12 weeks) have a more favorable impact on TC, LDL-C, and HDL-C, while sumac doses below 3 g/day show greater effects on TC and LDL-C. These findings underscore the potential of sumac supplementation as a valuable approach to lipid profile management.

Effects of Indonesian Shortfin Eel (Anguilla bicolor) By-Product Oil Supplementation on HOMA-IR and Lipid Profile in Obese Male Wistar Rats.

The prevalence of people being overweight and obese has increased globally over the past decades. The use of omega-3 fatty acids-a compound usually primarily found in fish oil-has been known to improve the metabolic profile of obese patients. As the demand for eels increases, the number of waste products from the eels increases and creates environmental problems. This study was conducted to investigate the effect of a newly discovered Indonesian Shortfin eel by-product oil supplementation on the Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) and lipid profiles of obese male (Lee index ≥ 0.3) Wistar rats (Rattus norvegicus). The oil was extracted from waste products (heads). Fifteen obese rats were divided into three groups and were administered NaCl (C), commercial fish oil (CO), and Indonesian shortfin eel by-product oil (EO). All groups had statistically significant differences in total cholesterol, LDL, and triglyceride levels (p < 0.05). The CO and EO group showed a significant decrease in total cholesterol, LDL, and triglyceride after treatment. However, no significant difference was found in HDL levels and HOMA-IR. The supplementation of Indonesian shortfin eel by-product oil significantly improved lipid profile while effectively mitigating environmental challenges.

The pleiotropic effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension

Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participa­ted in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement thera­py at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р &lt; 0.05), low-density lipoprotein choleste­rol for 24.5 % (3.39 ± 0.17 mmol/L against 4.49 ± 0.27 mmol/L, Р &lt; 0.01), triglycerides for 19.42 % (1.66 ± 0.11 mmol/L against 2.06 ± 0.16 mmol/L, Р &lt; 0.05) compared to those at baseline. At the same time, patients with subclinical hypothyroidism and hypertension showed a reliable decrease in atherogenic dyslipidemias, 64.52 against 74.19 %. We also observed a reliable improvement of the functional state of the endothelium: the mean value of the endothelium-dependent vasodilation of the brachial artery increased for 11 % (6.56 ± 0.10 % against 5.91 ± 0.05 %, Р &lt; 0.001). The results of the neuropsychological testing showed a reliable improvement of the cognitive functions among examined patients: the average score on the Montreal Cognitive Assessment raised from 23.77 ± 0.60 at baseline to 26.65 ± 0.47 after three months of taking levothyro­xine, Р &lt; 0.001. Conclusions. Levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension was followed by a normalization of lipid profile and a decrease in atherogenic dyslipidemias, an improvement of the functional state of the endothelium and state of cognition.

Achievements in Hypothyroidism Treatment with Herbal Medicine: A Systematic Review of Randomized Controlled Trials.

Background Hypothyroidism is a common endocrine disease in the world that causes morbidity and mortality due to its association with metabolic diseases, especially in old age, and long-term treatment with levothyroxine causes many side effects for patients. Treatment with herbal medicine can regulate thyroid hormones and prevent side effects. Objective The purpose of this systematic review is the evaluation of the effect of herbal medicine on the signs and symptoms of primary hypothyroidism. Method PubMed, Embase, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials were searched until 4 May, 2021. We selected randomized clinical trials (RCTs) that have assessed the effect of herbal medicine on hypothyroidism. Result Out of 771 articles, 4 trials with 186 participants were included. In one study, Nigella sativa L. caused a significant decrease in weight (P=0.004) and body mass index (BMI) (P=0.002). TSH levels were reported to be decreased and T3 increased in the treatment group (P =0.03) (P=0.008), respectively. In another study on Nigella sativa L., results did not show a significant difference between the two groups (p=0.02). A significant decrease in total cholesterol (CHL) and fasting blood sugar (FBS) was reported in participants with negative anti-thyroid peroxidase (anti-TPO) antibodies. In patients with positive anti-TPO antibodies, a significant increase in total cholesterol and FBS was observed in the intervention group (p=0.02). In the third RCT, T3 in the ashwagandha group at 4 and 8 weeks significantly increased by 18.6% (p=0.012) and 41.5% (p < 0.001), respectively. A noticeable increase was found in the T4 level from baseline by 9.3% (p= 0.002) and 19.6% (p < 0.001) at 4 and 8 weeks, respectively. TSH levels fell remarkably in the intervention group compared to placebo at 4 weeks (p <0.001) and 8 weeks (p <0.001), respectively. In the last article selected, Mentha x Piperita L. showed no significant difference in fatigue scores between intervention and control groups at the midpoint (day 7), while fatigue scores improved in the intervention group in all subscales compared to the control group on day 14. Conclusion Some herbal remedies, including Nigella sativa L., ashwagandha, and Mentha x Piperita L., can improve the signs and symptoms of primary hypothyroidism, but using a more extensive and advanced methodology will provide us with more complete results.

GLUCOMANNAN AND RED RICE EXTRACT REDUCE BLOOD LIPID LEVELS IN OVERWEIGHT PATIENTS

Objective: This study aims to explore the changes in blood lipid levels, body composition, and blood pressure in healthy middle-aged overweight people with mild hypercholesterolemia following the 45-day intake of a dietary supplement containing both glucomannan and red rice extract. Design and method: The survey was designed as a single-arm non-randomized, non-blind intervention study. 31 study participants consumed a dietary supplement containing dietary fibers (Konjak glucomannan, E425ii) and red rice extract (Monascus purpureus) for 45 days. Participants were asked not to change their current diet. Their body weight, body composition, and blood pressure were measured every two weeks. Blood lipids were tested at the beginning and at the end of the intervention. Results: 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. No changes in body composition were observed among men, but their systolic pressure decreased by six mmHg on average. Conclusions: 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.