Significant Increase In HDL Levels Research Articles

A Prospective Randomised Comparative Four-arm Intervention Study of Efficacy and Safety of Saroglitazar and Vitamin E in Patients With Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcoholic Steatohepatitis (NASH)-SVIN TRIAL

Background and AimVitamin E is widely prescribed for Non-alcoholic steatohepatitis (NASH).Saroglitazar, a novel dual PPAR ɑ/γ agonist, is approved in India for Non-alcoholic fatty liver disease(NAFLD).No head-to-head comparative study for vitamin E and saroglitazar is available. We studied the efficacy and safety of saroglitazar and vitamin E in NAFLD/NASH. Materials and MethodsWe prospectively randomised 175 NAFLD patients into four arms as; Saroglitazar 4mg daily alone (n=44),vitamin E 800IU daily alone (n=41), vitamin E and saroglitazar combination(n=47) and control arm (n=43). All the baseline variables including Liver stiffness measurement (LSM) and Controlled attenuation parameter (CAP) were recorded.Reassessment was done after 24 weeks of treatment. ResultsThe mean age and BMI was 45±11 years and 26±3.6 kg/m2 respectively. Compared to control, the decrease in ALT levels with saroglitazar, vitamin E and combination therapy was significant (95% CI, 6.27-28.25,p=0.002, 95% CI, -3.39-18.88, p=0.047 and 95% CI 8.10-29.54,p=0.001 respectively).The reduction in CAP was significant with saroglitazar and combination therapy (95% CI, -31.94-11.99,p=0.015 and 95% CI, -10.48-30.51,p=0.026 respectively).Only combination therapy shows significant reduction in LSM (95% CI, 0.41-1.68,p=0.001).Among glycaemic parameters, both saroglitazar alone and combination therapy significantly improved HBA1C levels (P=0.001 and P=0.015) and only combination therapy significantly improved HOMA-IR (P=0.047).Saroglitazar alone showed significant reduction in TG and LDL levels (P=0.038 and P=0.018), and combination therapy showed significant increase in HDL levels (P=0.024). ConclusionsCombination of Saroglitazar and vitamin E showed statistically significant reduction of LSM and CAP along with biochemical, glycaemic and lipid parameters. Clinical Trial Registry India no(CTRI/2022/01/039538).

Evaluation of the Efficacy of Enterococcus faecium L3 as a Feed Probiotic Additive in Chicken.

The study was devoted to the comparison of the probiotic effect of enterococcal Enterococcus faecium L3 to the antibiotic enramycin as a chicken feed additive. Two hundred and sixteen chickens were divided into three groups and tested by different parameters including weight gain, food consumption, blood biochemistry, immunology, and caecal microbiome at two checkpoints, 21 and 39days after birth. By the end of the experiment, a group of chickens getting probiotic demonstrated weight gain of more than 100g at the average relative to the control group with no additive in animal feed (P < 0.05). Blood serum biochemistry showed a significant increase in HDL level (P < 0.05) relative to the control group. The 16S RNA sequencing demonstrated the growth abundance of Lachnospiraceae and the decrease of Proteobacteria in probiotic fed group. On the contrary, the antibiotic fed group showed a noticeable increase in the abundance of Proteobacteria which included the genus Salmonella. Thus, probiotic E. faecium L3 being added to chicken food as a single additive may be considered as a possible replacement of antibiotic enramycin.

Detection of SARS-CoV-2 virus using an alternative molecular method and evaluation of biochemical, hematological, inflammatory, and oxidative stress in healthcare professionals

In early December 2019, an outbreak of coronavirus disease 2019 caused by a new strain of coronavirus (SARS-CoV-2), occurred in the city of Wuhan, Hubei Province, China. On January 30, 2020, the World Health Organization (WHO) declared the outbreak a public health emergency of international concern. Since then, frontline healthcare professionals have been experiencing extremely stressful situations and damage to their physical and mental health. These adverse conditions cause stress and biochemical, hematological, and inflammatory changes, as well as oxidative damage, and could be potentially detrimental to the health of the individual. The study population consisted of frontline health professionals working in BHU in a city in southern Brazil. Among the 45 participants, two were infected with the SARS-CoV-2 virus and were diagnosed using immunochromatographic tests such as salivary RT-LAMP and qRT-PCR. We also evaluated biochemical, hematological, inflammatory, and oxidative stress markers in the participants. The infected professionals (CoV-2-Prof) showed a significant increase in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol, lactic dehydrogenase, lymphocytes, and monocytes. In this group, the levels of uric acid, triglycerides, leukocytes, neutrophils, hemoglobin, hematocrit, and platelets decreased. In the group of uninfected professionals (NoCoV-2-Prof), significant increase in HDL levels and the percentages of eosinophils and monocytes, was observed. Further, in this group, uric acid, LDH, triglyceride, and cholesterol levels, and the hematocrit count and mean corpuscular volume were significantly reduced. Both groups showed significant inflammatory activity with changes in the levels of C-reactive protein and mucoprotein. The NoCoV-2-Prof group showed significantly elevated plasma cortisol levels. To our kowledge, this study is the first to report the use of the RT-LAMP method with the saliva samples of health professionals, to evalute of SARS-CoV-2.

The effect of tempeh flour from tree bean (Parkia timoriana (dc) Merr.) seeds on lipid profile in protein-energy malnutrition rats

Children with protein-energy malnutrition (PEM) need a food product that can be easily absorbed by the body because they have impaired nutrient utilization and lipid profile disorder. The provision of fermented products such as tempeh is an alternative approach. Seeds of tree bean (Parkia timoriana (DC) Merr.) are a good source of various nutrients needed by children with PEM. This study aimed to prove the effectiveness of the administration of tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds on the lipid profile in PEM rats. PEM in rats was induced by a zero-protein diet containing granulated sugar (20 g), vegetable oil (1 g), and cornstarch (24 g). The animals were categorized into a normal control group (K+), a PEM group without treatment (K−); a group fed tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds 1.5 g.kg-1 BW (P1); and a group fed tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds 3 g.kg-1 BW (P2). The intervention was administered for 30 days. There was a significant increase in HDL levels (p = 0.001) and significant decreases in cholesterol (p = 0.001), triglyceride (p = 0.001), LDL levels (p = 0.001), and atherogenic index of plasma (AIP) (p = 0.000) in treatment groups. In conclusion, the administration of tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds increases HDL levels and decreases cholesterol, triglycerides, and LDL level, and atherogenic index of plasma (AIP) in rats with PEM.

Effectiveness of altering hypercholesterolaemia without drugs: Evidence of lifestyle modifications: A narrative review

Background: Dyslipidemia is a situation of abnormal blood lipids. It is considered as a major risk factor for cardiovascular disease (CVD). Healthy diet is found to be effective in reducing serum cholesterol; thus, using foods that are high in components and that help in reducing cholesterol is recommended. These foods include fruits, green vegetables, avocado, almond, nuts, and fish oil. The aim was to provide an overview of existing research studies and their approaches regarding the effect of dietary and lifestyle modifications in reducing hypercholesterolemia. Materials and Methods: A search of periodical literature by the author involving dietary therapy and soybean was carried out. Items were identified initially through health-oriented indexing services such as Medline, Health STAR, and Cinahl, looking up for articles published in the English language, from 2010 to 2020. Keywords included “Cholesterol,” “Lipid,” “Dyslipidemia,” “Diet,” “and Health.”Results: Those consuming a daily average of 78g of almonds showed a reduction of LDL-cholesterol by 9.4% whereas those consuming 37g/day showed a reduction of LDL-cholesterol by 4.4%, with a significant increase in HDL levels and a decrease in lipoprotein A. It appears that the consumption of soluble fibers can promote a moderate effect in lowering cholesterol in patients with hypercholesterolemia. Studies have shown that fibers seem to act synergistically at the recommended intake dose of total fiber 25g, including 6g from soluble fibers intake. Conclusion: Dietary modification is found to be a powerful nonpharmacological approach that helps in improving blood lipids. Lipid profiles can be improved indirectly through changing the unhealth, performing physical activity, and reducing body weight.

The Effect of Synbiotic Shake on Blood Glucose and Lipid Profile in Hyperglycemia Wistar Rats

Several studies found that the probiotic bacterias such as Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 could prevent glycemia and control the blood lipid profiles. Currently, a probiotic product such as yogurt is not preferable by some consumers since the taste is sour. Therefore, this study was conducted to develop milkshakes supplemented by probiotics Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 which are expected to be more acceptable and have a beneficial effect with the addition of prebiotics and soluble fiber glucomannan. This study aims to determine the effect of synbiotic shakes on fasting blood glucose levels and lipid profiles in hyperglycemia Wistar rat models. The study design was a pre-posttest controlled group with 48 male Wistar rats divided into 8 groups, namely the healthy control group (I); hyperglycemia control group (II); group III that received metformin; group IV that received synbiotic shake with La5 + FOS; group V that received synbiotic shake La5 + inulin; group VI that received synbiotic shake Bb12 + FOS; group VII that received synbiotic shake Bb12 + inulin; and group VIII that received synbiotic shake La5 + Bb12 + FOS. The dose of the intervention was 3.6 ml/day with an intervention duration of 28 days. The results showed that the differences in blood glucose levels were not significant (p&gt; 0.05) except for groups IV and VI that experienced a significant increase (p &lt;0.05). The differences in lipid profiles showed insignificant changes in LDL levels except in groups IV and V, a significant increase in HDL levels (p &lt;0.05) in group V and VI, and insignificant change in triglycerides except in group VI. It can be concluded that the administration of synbiotic shakes with a variety of prebiotics Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 for 4 weeks were able to maintain fasting blood glucose levels and lipid profiles in hyperglycemic rats.

Effect of bee venom on some blood and biochemical parameters in formaldehyde induced arthritis male rats in comparison with prednisolone drug

Background Bee venom(BV) has been used to treat and reduce chronic inflammatory diseases such as rheumatoid arthritis(RA), pain, skin diseases and to treat cancerous tumors. The aim of this study was to investigate the effects of bee venom on some blood and biochemical parameters in male albino rats with Arthritis and compare it with prednisolone drug.Materials & methods: (42) mature male albino rats (135-150) gm, divided into (7) groups, (6) male rats for each group. The experiment was continued for (14) days and included: the first group (negative control) was injected by (0.1ml/animal) from physiological normal saline (0.9% Nacl),the second group(Arthritis group) was injected by (0.1ml/animal) formaldehyde, the third group (normal group) was injected by bee venom(i.p) (1mg / kg of B.W), the fourth group (normal group) was treated orally with prednisolone (5mg / kg of B.W), the fifth group (Arthritis group) was injected by bee venom(i.p) (1mg / kg of B.W), the sixth group (Arthritis group) was treated orally by prednisolone (5 mg / kg of B.W) and seventh group (Arthritis group) was injected by bee venom (1 mg/ kg of B.W) and treated orally with prednisolone (5mg / kg of B.W).Results: Our results showed that 2nd group (Arthritis) significantly increased (p≤ 0.05) in the number of WBCs and platelets compared with control group, while the 3rd and 4th groups showed a significant decrease in WBCs and PLT compared with 2nd group. The 5th, 6th and 7th groups showed a significant decrease (P≤0.05) in the number of WBCs and platelets compared with 2nd group. On the other hand, the present study demonstrated a significant decrease (p≤ 0.05) in RBCs, hemoglobin (Hb) and hematocrit (HCT) in the 2nd group (Arthritis group) compared with control group, while the 3rd and 4th groups showed a significant increase in RBCs, Hb and HCT compared with 2nd group. The 5th, 6th and 7th groups showed increase (p≤ 0.05) in RBCs, Hb and HCT compared with 2nd group. The results showed also, a significant increase in levels of cholesterol, triglycerides, LDL and a significant decrease in HDL level in 2nd group compared with control group, while 3rd,4th, 5th, 6th and 7th groups showed a significant decrease (P≤0.05) in cholesterol, triglycerides, LDL and a significant increase in HDL level compared with 2nd group.Conclusion: We conclude from the present study that bee venom attenuates development of Arthritis by improving some Blood and Biochemical parameters.

Metabolic effects caused by sodium levothyroxine in subclinical hypothyroidism patients with low HDL

IntroductionSubclinical hypothyroidism (SH) is an autoimmune thyroid disorder characterized by elevated TSH with values of T3, T4, free T3 and free T4 within the reference range. High TSH levels are associated with lipid alteration. MethodA total of 21 patients aged between 18 and 80 years were recruited. The sample was composed of 17 females and 4 males, all of whom had TSH values ranging from 5.0 to 9.9 (mlU/L) and normal free T4 levels. They were followed up for 26 months while undergoing sodium levothyroxine replacement therapy (12.5–25 mcg/day). Throughout this period, TSH, free T4 HDL, LDL, triglyceride, total cholesterol and glucose levels were evaluated. ResultsA significant improvement in HDL cholesterol levels was observed. There was also a decrease in fasting glucose. No significant changes were seen in triglyceride levels. ConclusionAs observed throughout this study, SH patients with low HDL under therapy showed a significant increase in HDL levels after TSH levels were normalized. Therefore, it is quite clear that thyroid hormones affect lipid metabolism, and, as a result, metabolic syndrome components.

Employing Central Composite Design for Evaluation of Biomass Production by Fusarium venenatum: In Vivo Antioxidant and Antihyperlipidemic Properties.

The present study deals with the cost effective production of biomass from Fusarium venenatum using different carbon sources (cane sugar, brown sugar, malt and fructose). Optimization of selected carbon sources and seed size using Central Composite Response Surface Design (CCRSD) indicated that sucrose (1.64g/100mL) and seed size (10% v/v) were optimal in maximizing biomass yield (0.5602g/100mL, p<0.0001) and protein yield (49.99%, p<0.01) of Fusarium venenatum. The acetonitrile and methanolic extracts of biomass showed promising antioxidant activity (DPPH assay, 59.7 and 51.9% respectively, 250μg/mL). The mycoprotein, in the Triton-X 100-induced hyperlipidemic model in rats, exhibited significant reduction of serum lipids levels (p<0.01 at 100, 200 and 400mg/kg body weight) with significant increase in HDL level. It also exhibited antibacterial activity against S. aureus. LC-MS analysis of ACN extract of biomass showed two major peaks (Compound 3: m/e 701.4941 and Compound 2: m/e 651.4984). Spectral matching with standard MS libraries indicated that compound 3 may be structurally similar to sterol glycoside (m/e 716.99) with absence of methyl group. Also, compound 2 may be cholest-5-en-3-ol (3β)-, 9-octadecenoate. These results showed that Fusarium venenatum can act as a source of natural antioxidant along with acting as a valuable protein source. It may also prove to be beneficial in treatment of hyperlipidemia and other cardiovascular conditions. Further bioactivity-guided fractionation and isolation will help to obtain bioactives that may serve as leads for design of new class of therapeutic agents.

Effects of Laparoscopic Mini Gastric Bypass (MGB) on Weight Loss and Biomarker Parameters in Morbidly Obese Patients: A 6-Month Follow-Up.

Mini-gastric bypass is a bariatric surgical procedure prevalent in many focuses because of shorter length, simpler system, and fabulous weight reduction comes about. The point of this review was to assess the weight reduction and biomarker parameter changes amid 6-months time frame taking after MGB in Iraqi excessively fat patients. The study was conducted on 30 subjects (18 females and 12 males), age 34± 7.5 years, with BMI 51.7 ± 7.1 Kg/m² presented for MGB during the period from July 2016 until the end of February 2017. FBG, HbA1c, total cholesterol, TG and HDL were measured before, 2 and 6 months after MGB procedure. Six months after surgery caused a significant reduction in body weight and BMI (p< 0.001). The mean weight of the participants decreased to 88.1 Kg, mean BMI decreased to 32.55 Kg/m2. The mean loss in the EBL percent was 74.6 % and %WL was 34.9%. There was a significant reduction in FBG, HbA1c, cholesterol, TG, LDL and VLDL (p < 0.001). Meanwhile use of MGB procedure caused a significant increase in HDL level (p< 0.001). Conclusion: MGB has all the earmarks of being a protected and compelling technique in extremely obese patients. Six month after strategy brings about weight reduction, lessening in obesity comorbidities, enhance glucose homeostasis and lipid profile, expanding HDL, and diminishing other measured biochemical parameters.

Evaluation of Acute Toxicity and Hypoglycaemic and Hypolipidaemic Effects of Cyathula prostata (Linn.) Blume Weeds on Adult Rats

Objectives: The study aimed at evaluating the acute toxicity and hypoglycaemic and hypolipidaemic effects of Cyathula prostata plant used locally in the treatment of various diseases including diabetes. Materials and Methods: The toxicity of the extract was evaluated in Swiss albino mice by feeding the animals with the graded doses of the extract between 1.0 to 20.0 g/kg body weight (bwt) and continuously observed for the first 4 h, then hourly for the next 12 hand 6 hourly for the next 56 h (72 h, acute toxicity). Diabetes was induced in the male and female Wistar rats with alloxan monohydrate, at the dose of 150 mg/kg, dissolved in normal saline and administered intraperitoneally (i.p). The plasma glucose levels of the induced animals were monitored with a Glucometer (MERCK) after 72 h. The animals with plasma glucose level ≥200 mg/dl were classified as diabetic and were included in the study. The diabetic animals were randomly distributed into five groups of 5 animals each. The first group was normal not treated but received acacia 2% w/v solution. The second group was induced but not treated while the remaining four groups were treated with the reference drug, glibenclamide, (600 µg-1 kg bwt)/ the extract in graded doses of 75, 150 and 250 mg/kg bwt respectively for 30 days. Results: The animals that received 20 g/kg bwt of the extract survived beyond 24 hrs, therefore the LD50 could be assumed to be above 20 g -1 kg bwt. The plasma level of alanine aminotransferase (ALT) was found to have significantly (p≤0.05) increased in the extract treated compared to the negative control whereas aspartate aminotransferase (AST) level showed marked decrease with dose. However, hepatic tissue histology at the highest extract dose treatment showed mild portal hepatitis with hepatocytes vacuolization and sinusoidal congestion. There were no significant changes (p≥0.05) in protein and creatinine levels. There were significant (p≤0.05) reduction in the plasma glucose, cholesterol, triglycerides and LDL levels while a significant increase in HDL levels was observed. The tissue histology of pancreas showed significant survivor of beta cells in the extract treated groups. Conclusion: The extract was observed to have beneficial effect on alloxan-damaged pancreas as beta cells showed signs of recovery.

Evaluation of the Effect of Andrographolide on Atherosclerotic Rabbits Induced byPorphyromonas gingivalis

Epidemiologic evidence has demonstrated significant associations between atherosclerosis and Porphyromonas gingivalis (Pg). We had investigated the effect of andrographolide (AND) on atherosclerosis induced by Pg in rabbits. For experimental purpose, we separated thirty male white New Zealand rabbits into 5 groups. Group 1 received standard food pellets; Groups 2–5 were orally challenged with Pg; Group 3 received atorvastatin (AV, 5 mg/kg), and Groups 4-5 received 10 and 20 mg/kg of AND, respectively, over 12 weeks. Groups treated with AND showed significant decrease in TC, TG, and LDL levels (P < 0.05) and significant increase in HDL level in the serum of rabbits. Furthermore, the treated groups (G3–G5) exhibited reductions in interleukins (IL-1β and IL-6) and C-reactive protein (CRP) as compared to atherogenicgroup (G2). The histological results showed that the thickening of atherosclerotic plaques were less significant in treated groups (G3–G5) compared with atherogenicgroup (G2). Also, alpha-smooth muscle actin (α-SMA) staining decreased within the plaques of atherogenicgroup (G2), while it was increased in treated groups (G3–G5). Lastly, groups treated with AV and AND (G3–G5) showed significant reduction of CD36 expression (P < 0.05) compared to atherogenicgroup (G2). These results substantially proved that AND contain antiatherogenic activity.

The effect of run and walk exercise programme on blood lipids and chronic inflammation in sedentary males with metabolic syndrome

The aim of the study was to determine and evaluate the effect of 8-week run-walk exercises on blood lipids and chronic inflammation in sedentary males with metabolic syndrome. 13 volunteer...

Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.

Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.

Adding rosiglitazone to metformin in patients with type 2 diabetes: Effect on diabetes control and metabolic parameters

AimTo evaluate the efficacy and tolerability, any changes in lipid parameters including free fatty acids and effect on weight and blood pressure, of adding Rosiglitazone to patients with type 2 DM who are not adequately controlled on maintenance dose of Metformin. MethodsProspective study of 14 patients with type 2 DM who were maintained on Metformin alone (1.5–2.5g/day). Twelve patients met the inclusion criteria, and received 4mg of Rosiglitazone daily in addition to Metformin. Patients were followed for 24 weeks and seen for 6–7 visits. The dose of Rosiglitazone was increased after 8 weeks if FBG was still ⩾160mg/dl. Full biochemical evaluation was done and safety parameters were observed at base line, at intervals during the study and at the end of the study. All patients completed the study. T test was used for comparison. ResultsEight males and four females were studied. They had the following characteristics: Mean age was (52±6.9) years, weight was (78.2±10.1)kg BMI was (28±4)kg/m2, waist circumference was (97.5±6.5)cm, and duration of DM was (7.3±6) years. Four patients required an increase of Rosiglitazone dose to 8mg after 8 weeks.All patients showed improvement of HbA1c levels by the end of the study. When mean base line parameters were compared to those at the end of study: HbA1c level dropped from (8.9%±1.5) to (7.1%±1.1) (P: 0.00003) and FBG from (205±50.6) to (150±28)mg/dl (P: 0.002). Free Fatty Acids (FFA) dropped from (703±213) to (510±303.6) by 8 weeks and to (574±184.6) μeq/L by the end of the study, (P: 0.01 and 0.06, respectively). Improvement in HbA1c did not however correlate with the level of FFA drop. There was also significant increase in HDL level (1.15±0.14)–(1.27±0.2)mmol/L, (P: 0.02), and weight (78.2±10.1)–(80.1± 10.9)kg (P: 0.01). The changes in LDL (3.02±0.57)–(3.23±0.5)mmol/L, TG (2.16±1.1)–(2.2±1.33)mmol/L, waist circumference (97.5±6.5)–(99±8.1)cm, and BP (132.5±17)–(130.2±18.8)mm Hg (systolic), were not significant.When “Good Responders”, (HbA1c drop of >1.5%), (nine subjects) were compared to those with less than 1.5% drop (three subjects), there were no specific characteristics to define responders. ConclusionRosiglitazone, added to Metformin in type 2 DM patients, was effective and well tolerated. There was a significant decrease in FFA levels with treatment. The response to treatment, however could not be predicted from biochemical or clinical parameters. A larger study may be needed to define responder characteristics.

Effect of pioglitazone and its combination with statins in coronary artery disease patients with hyperinsulinemia

The objective of the study was to demonstrate the effect of pioglitazone and pioglitazone in combination with statin on East Indian patients with hyperinsulinemia and hyperlipidemia. It was a randomized, placebo-controlled, double-blind study with a parallel-group design comprising 83 patients. Patients of either sex with cardiac complications, including hyperlipidemia and (or) diabetes mellitus with or without hyperinsulinemia, were enrolled. Patients over 70 years of age, with renal or hepatic failure, or with severe diabetes mellitus (total glucose >400 mg/dL) were excluded from the study. Enrolled patients were randomly assigned to 4 groups that received placebo, pioglitazone, atorvastatin, or both. Blood samples were collected before and after treatment for analysis of serum glucose, insulin, lipid profile, apolipoprotein (apo) A1, apo B, and fibrinogen. Data were compared with that of patients with normal insulin or hyperinsulinemia. The patients with hyperinsulinemia receiving only pioglitazone showed a significant decrease in insulin levels compared with those with normal insulin levels. These patients also showed a significant increase in HDL levels. However, no significant change was observed in patients treated with both atorvastatin and pioglitazone. Pioglitazone was also found to increase significantly the apo A1 levels in patients with hyperinsulinemia, but there was no significant increase in patients given both atorvastatin and pioglitazone. Our data suggests that pioglitazone should be given preferably to the patients with hyperinsulinemia and statin should not be coadministered.