Significant Increase In High-density Lipoprotein Cholesterol Research Articles

Effects of levonorgestrel and desogestrel in low-dose oral contraceptive combinations on serum lipids, apolipoproteins A-I and B and glycosylated proteins

Fasting serum lipids, apolipoproteins and glycosylated serum proteins were studied in 20 women before, after three months of treatment and two months after termination of treatment with oral contraceptives containing 30 μg ethinyloestradiol (EE) plus 150 μg levonorgestrel or desogestrel. Levonorgestrel + EE induced significant increases in total triglycerides (48%), apoB (19%) and the ratio apoB/apoA-I (18%) and no significant changes in HDL-cholesterol (8% decrease), apoA-I, % HDL-cholesterol, total cholesterol and serum glycosylated proteins. Desogestrel + EE induced significant increases in HDL-cholesterol (12%), % HDL-cholesterol (15%), triglycerides (35%) and apoA-I (20%), no changes in total cholesterol, apoB and glycosylated serum proteins and a significant decrease in the ratio apoB/apoA-I (17%). Two months after termination of treatment the values for all parameters for both preparations were similar to those observed before treatment. The differences between the effects of the two preparations on the parameters HDL-cholesterol, % HDL-cholesterol, apoA-I, apoB and the ratio apoB/apoA-I were statistically significant and can be explained by a difference in the intrinsic androgenicity of the two progestagens.

Treatment of type III hyperlipoproteinemia with four different treatment regimens

The efficacy of clofibrate (CPIB) and nicotinic acid (NA) in the treatment of type III hyperlipoproteinemia was evaluated in 5 male subjects in a randomized cross-over study with clofibrate 1 g b.i.d. and NA 3 g/day (given either b.i.d. or t.i.d.). Following a baseline period of 6 weeks, each drug was given for 12 weeks with samples for lipid and lipoprotein determinations obtained at 6, 9, and 12 weeks. Both clofibrate and NA resulted in a significant reduction from baseline of total cholesterol (23% and 28%), VLDL cholesterol (49% and 56%), total triglycerides (40% and 43%), and VLDL triglycerides (46% and 48%), as well as a significant increase in HDL cholesterol (22% and 28%) and HDL/LDL ratio (31% and 62%). The HDL/LDL ratio was higher on NA than clofibrate (0.47 ± 0.19 vs. 0.38 ± 0.09, P < 0.05). Four subjects were continued in the study and treated sequentially with NA 3.0 g/day (alternate to the previous schedule) and gemfibrozil 1.2 g/d in divided doses. Each of the 4 regimens resulted in a significant change from baseline of each of the measured lipid and lipoprotein determinations except LDL cholesterol. Comparison among the treatment regimens revealed no differences except for significantly higher HDL cholesterol and HDI./LDL ratio with NA given t.i.d.

Effect of weight loss in moderate obesity on plasma lipoprotein and apolipoprotein levels and on high density lipoprotein composition.

Plasma lipids, lipoprotein and apolipoprotein levels were determined in seven women and seven men with moderate obesity before, during 7 weeks of continuous weight loss (10.4% to 9.6% of body weight, 1000 kCal/day diet), and after 3 months at a stable, reduced weight. Plasma triglyceride levels decreased by 30.4% in men and by 39.4% in women (p less than 0.0001) after 1 week of caloric restriction and remained at this level throughout the study period. The plasma cholesterol decreased by 19.0% in men (p less than 0.001) and by 10.9% in women (p less than 0.01) in the period of active weight loss, but returned to prediet values after stabilization at a leaner body mass. Similar changes were observed in LDL cholesterol levels. No change in high density lipoprotein (HDL) cholesterol levels occurred during active weight reduction, but after 3 months at a reduced weight, a significant increase in HDL cholesterol was evident, and the ratio of HDL cholesterol to plasma cholesterol increased over prediet values (p less than 0.001), women). Separation of HDL subpopulations by zonal ultracentrifugation before and after weight reduction revealed that HDL2 increased slightly in men and decreased slightly in women. In both genders, HDL3 tended to decrease after weight reduction. Plasma levels of apolipoprotein A-I decreased during active weight loss, but this was significant only in women (p less than 0.05). After 3 months of reduced weight, plasma apo A-I increased to prediet levels. No significant changes in plasma apo A-II or apo E were noted.(ABSTRACT TRUNCATED AT 250 WORDS)

冠動脈疾患患者の運動療法: 血清リポ蛋白の変動

Serum lipids and apolipoproteins were studied in 7 male patients with coronary artery disease (5 old myocardial infarction, 2 stable angina pectoris) and 4 control men undergoing a mild training program using aerobic threshold as a exercise intensity for 10 weeks. The training caused a significant increase in HDL-cholesterol (HDL-C) apo A-I and LCAT activity in control men. On the contrary, no significant changes in serum lipids, HDL-C and apolipoproteins were observed in patients with coronary artery disease. In one patient significant increase in HDL2-C level was observed by long term training (60 weeks), whereas no changes in total HDL-C level. There was a significant correlation between HDL-C level before training and increase in HDL-C level after training.The present suggest that mild exercise program in patients with coronary artery disease require more prolonged training period to obtain beneficial effects on lipoprotein and apolipoprotein levels.

Effect of vitamin E supplementation on serum and high-density lipoprotein-cholesterol in renal patients on maintenance hemodialysis

A significant increase in high-density lipoprotein-cholesterol after the ingestion of short-term megadoses of vitamin E has been documented in the recent literature. No attempt has been made to examine the effect of vitamin E supplementation on the serum lipids in chronic renal patients undergoing maintenance hemodialysis. This patient group typically exhibits subnormal high-density lipoprotein-cholesterol levels which may be a factor responsible for their increased mortality rate from atherosclerosis. In the present study, seven male renal patients on dialysis were given 600 IU of vitamin E daily for 4 wk. The level of total, free, and esterified cholesterol and triglyceride in whole serum and high-density lipoprotein were measured pre- and postregimen. No significant change was noted in any of the parameters examined for the group as a whole. Our results suggest that short-term high-dose vitamin E ingestion is unlikely to benefit the majority of renal patients on maintenance hemodialysis in regards to their circulating levels of high-density lipoprotein-cholesterol.

Effects of two low-dose oral contraceptives on serum lipids and lipoproteins: Differential changes in high-density lipoprotein subclasses

Oral contraceptives containing dl-norgestrel or norethindrone with ethinyl estradiol were administered by random assignment to 21 menstruating women, matched for anthropometric measurements, age, diet, alcohol consumption, smoking, and exercise habits. Pretreatment and 7-week treatment blood samples were obtained and assayed for serum cholesterol, triglyceride high-density lipoprotein cholesterol (HDL-C), and total high-density lipoprotein (HDL), HDL2a, HDL2b, and HDL3 subclasses by analytic ultracentrifugation. Subjects using the norethindrone oral contraceptive had a significant increase in HDL-C: baseline, 46 mg/dl; 7 weeks, 51 mg/dl. Values for the subjects using the norgestrel oral contraceptive were not significantly changed; 46 and 44 mg/dl, respectively. Users of the norethindrone oral contraceptive had significant elevations of total HDL and HDL3, while norgestrel oral contraceptive users demonstrated no significant changes. HDL2b increased with the norethindrone oral contraceptive and declined with the norgestrel oral contraceptive. The changes in HDL2b from baseline to treatment were not significant (p > 0.05), but the change with the norethindrone oral contraceptive did differ significantly from that with the norgestrel oral contraceptive (p < 0.02). These changes may indicate oral contraceptive-induced alterations in HDL structure and metabolism that could be related to the risk of development of atherosclerosis.

The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with Type 2 (non-insulin-dependent) diabetes mellitus: a prospective study.

Intensive dietary therapy in 57 newly diagnosed Type 2 (non-insulin-dependent) diabetic patients led to an increase, compared with pre-treatment levels, in serum high density lipoprotein (HDL) cholesterol and the HDL/total cholesterol ratio after 3 and 6 months (0.05 less than p less than 0.1). The increase in HDL cholesterol was related to the degree of weight loss achieved. In 28 patients whose weight decreased by greater than or equal to 10% average body weight during the 6 months, HDL cholesterol rose from 1.22 +/- 0.06 to 1.36 +/- 0.06 mmol/l (p less than 0.001), whereas patients who lost less weight showed no significant increase in HDL cholesterol. The increase in mean serum HDL-cholesterol levels in female patients was associated with a mean weight reduction of 12.1% average body weight. Patients who were obese at diagnosis lost more weight during the study than non-obese patients (mean 13.2 versus 5.6% average body weight), and showed a significant increase in serum HDL-cholesterol levels. We conclude that intensive dietary therapy may lead to a less atherogenic lipid profile in Type 2 diabetes, particularly in patients who achieve a major weight reduction.

Effect of bezafibrate on plasma lipids, lipoproteins, apolipoproteins AI, AII and B and LCAT activity in hyperlipidemic, non-insulin-dependent diabetics

The effect of bezafibrate on plasma lipids, lipoproteins, apolipoproteins AI, AII and B, and LCAT activity was investigated in 16 hyperlipidemic, non-insulin-dependent diabetics, who were treated for 8 weeks with either placebo or bezafibrate in a double-blind, cross-over design. Bezafibrate induced a significant decrease in plasma triglycerides ( P < 0.01), cholesterol ( P < 0.05), VLDL triglycerides ( P < 0.05) and VLDL cholesterol ( P < 0.01), and a significant increase in HDL cholesterol ( P < 0.01), whereas LDL cholesterol remained unchanged. The apolipoprotein AI/apolipoprotein B ratio increased significantly ( P < 0.05), although individual changes in these apolipoproteins were not significant. Apolipoprotein AII increased significantly ( P < 0.0001) and the apolipoprotein AI/apolipoprotein AII ratio decreased ( P < 0.0001), indicating an increase in the HDL 3 rather than the HDL 2 fraction. No significant change in LCAT activity was observed.

Relationship of weight loss and cigarette smoking to changes in high-density lipoprotein cholesterol

To determine the effect of weight loss on serum high-density lipoprotein cholesterol (HDL-C), we measured serum HDL-C as well as total cholesterol and triglycerides in 65 subjects 56 women and 9 men, mean age 41.1 +/- 1.5 (+/- SEM yr) before and after a weight reduction program. At entry into the program there was a significant correlation between HDL-C and several indices of overweight--relative weight, body mass index and sum of skinfold thickness. For all subjects, despite a significant weight loss of 4.5 kg or 5.8% of initial body weight and significant decrease in sum of skinfold thickness, there was no significant increase in HDL-C or correlation between changes in HDL-C and change in body weight or skinfold thickness. For women, but not men, a weak negative correlation between change in HDL-C and change in weight or percentage change in weight was observed. However, in the subset of women who were current cigarette smokers a significant (p less than 0.01) correlation was observed between change in HDL-C and change in weight (r = -0.876) and percentage change in weight (r = -0.881). Thus a modest weight loss is not usually associated with a significant increase in serum HDL-C concentration except in cigarette smoking women.

Effects of casein versus soy protein diets on serum cholesterol and lipoproteins in young healthy volunteers

The effects of casein and soy protein on serum cholesterol levels and lipoprotein composition were studied in 69 healthy volunteers (18 to 28 yr of age) under strict dietary control. Subjects were fed for 6 wk on diets containing 13% of energy as protein, 38% as fat (P/S ratio = 0.6) and about 380 mg cholesterol per day. Of the protein in the diets 65% consisted of casein or soy protein or a 2:1 mixture of casein and soy protein. After a control period of 10 days during which all the subjects received the casein-soy diet, 20 subjects continued on this diet for the next 4 wk as a base-line control, 25 subjects switched to the casein diet, and the remaining 24 subjects switched to the soy diet. Both food records and chemical analysis of double portions revealed that the diets were completely identical except for the type of protein. Average serum cholesterol levels at the end of the control period were 152 +/- 27 mg/dl (3.93 +/- 0.69 mmol/l) and 153 +/- 23 mg/dl (3.95 +/- 0.60 mmol/l) (mean +/- SD) for the casein and soy group, respectively. At the end of the test period the levels were 149 +/- 24 and 150 +/- 23 mg/dl, respectively; thus there was no significant change on either diet. On the casein diet there was no change in the low-density lipoprotein cholesterol concentration, and only a slight, nonsignificant increase in the high-density lipoprotein cholesterol concentration. On the soy diet, however, there was a significant decline in low-density lipoprotein-cholesterol (-6.6 mg/dl; -0.17 mmol/l) and a significant increase in high-density lipoprotein-cholesterol (+5.8 mg/dl; +0.15 mmol/l). The decline in low-density lipoprotein cholesterol in the soy group was significantly different from the small change in the casein group, but the difference in increase in high-density lipoprotein cholesterol in the soy and the casein group was only weakly significant. This suggest that soy protein could have a slight beneficial effect on the distribution of cholesterol over the various lipoprotein fractions, even at constant total cholesterol concentration.

Effect of colestipol and clofibrate on plasma lipid and lipoproteins in Type IIa hyperlipoproteinemia

The effects of 2.0 g of clofibrate and 15, 20 and 30 g of colestipol on plasma lipid and lipoprotein levels were evaluated in adult patients with Type IIa hyperlipoproteinemia. Clofibrate treatment was associated with decreases of 11.0% in plasma cholesterol, 15.2% in LDL cholesterol, 26.1% in triglycerides, and an 11.3% increase in HDL cholesterol. The reductions in total cholesterol with the various doses of colestipol ranged from 11.9 to 17.8% and reductions in LDL cholesterol ranged from 16.1 to 27.3%. Colestipol treatment was not associated with any significant change in HDL cholesterol levels and minor increases in triglycerides. The addition of clofibrate to patients receiving colestipol resulted in a significant increase in HDL cholesterol and a decrease in triglycerides, but no additional reduction in total or LDL cholesterol.