Significant Reduction In Total Cholesterol Research Articles

Comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone for simple obesity: A systematic review and meta-analysis.

This study aimed to assess the comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone in patients with simple obesity. The PubMed, Embase, Cochrane Library, CNKI, VIP Database, and Wanfang Data were searched. Meta-analysis was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Primary outcomes were body weight (BW) and body mass index (BMI). Secondary outcomes were waist circumference (WC), hip circumference (HC), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS), and homeostasis model assessment-insulin resistance (HOMA-IR) and adverse events. Thirteen randomized controlled trials were included. The meta-analysis showed that massage combined with lifestyle intervention significantly decreased BW (mean difference [MD]: -4.85; 95% confidence interval [CI]: -8.25 to -1.46; P = .005), BMI (MD: -2.65; 95% CI: -4.05 to -1.24; P = .0002), WC (MD: -3.63; 95% CI: -6.28 to -0.98; P = .007), TC (MD: -0.52; 95% CI: -0.84 to -0.20; P = .001), TG (MD: -0.23; 95% CI: -0.45 to -0.02; P = .003), LDL-C (MD: -0.48; 95% CI: -0.54 to -0.42; P < .00001), HDL-C (MD: -0.11; 95% CI: -0.17 to -0.05; P = .0004), FINS (MD: -1.64; 95% CI: -3.16 to -0.12; P = .03), and HOMA-IR (MD: -0.42; 95% CI: -0.65 to -0.18; P = .0005) compared with lifestyle intervention alone. In subgroup analyses, more obvious reduction in BMI (P = .02, I2 = 80.3%) for the children and adolescents subgroup, more obvious reduction in HC (P = .04, I2 = 76.1%) for the adults subgroup, more significant reduction in TC (P < .00001, I2 = 98.3%), LDL-C (P < .00001, I2 = 95.6%), and HDL-C (P < .0001, I2 = 94.1%) for intermittent treatment subgroup and more significant reduction in TC (P < .00001, I2 = 95.9%) and HDL-C (P < .0001, I2 = 94.1%) for treatment times ≤30 subgroup were detected. Compared with lifestyle intervention alone, massage combined with lifestyle intervention significantly decreased BW, BMI, WC, TC, TG, LDL-C, FINS, and HOMA-IR, but produced less effect in increasing HDL-C. And different ages, treatment intervals, and treatment times can all affect treatment outcomes.

Effect of a yoga and naturopathy-based lifestyle intervention with nine-month follow-up on lipid profile in patients with hypertension: A two-arms parallel group randomized controlled trial.

Hypertension is recognized as a modifiable risk factor for cardiovascular diseases, alongside dyslipidemia. Studies have revealed that between 15% to 31% of individuals have both hypertension and dyslipidemia. However, emerging evidence suggests that natural therapies and yoga can help manage mild increases in blood pressure. This study aims to evaluate the impact of yogic and naturopathy treatments on lipid profiles in hypertensive patients, thereby contributing to the existing literature. A randomized controlled experiment was conducted, involving 262 hypertensive patients randomly assigned to either the study group (SG) or control group (CG). The SG, consisting of 131 individuals, received yoga and naturopathic treatments for 10 days, while the CG (n=131) did not. The lipid profile was measured at the beginning and end of the 10 days and they were followed-up and reassessed after 9 months. The study involved a total of 262 individuals, with 111 in the SG and 125 in the CG. After the 10-day intervention period, the SG showed significant reductions in Total cholesterol (TC), Triglycerides (TG), High-density lipoprotein (HDL-C), Low-density lipoprotein (LDL-C), Very-low density lipoprotein (VLDL), Apolipoprotein-A (Apo-A), Apolipoprotein-B (Apo-B), and Lipoprotein-A(Lp-A) (p<0.001) compared to the CG. Also, the change was observed after 9 months in Apo-A, Apo-B, and Lp-A significantly (p<0.001). These findings underscore the potential of naturopathic and yogic interventions in improving lipid profiles in hypertensive patients, thereby contributing to the current literature. In conjunction with conventional management, these specific interventions could be considered as a safer form of complementary therapy in the treatment of dyslipidemia among hypertensive patients. Thus, these findings hold promise for the integration of naturopathic and yogic therapies in the standard care of hypertensive patients.

A randomized, double-blind, placebo controlled study to evaluate the effect of alpha-lipoic acid on inhibition of ADP-and collagen-induced platelet aggregation ex vivo in diabetic neuropathy patients on gabapentin or pregabalin.

Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication in diabetic mellitus patients due to chronic hyperglycemia, resulting in platelet hyperactivity and dyslipidemia. Alpha-lipoic acid (ALA) is a potent antioxidant which has antiplatelet activity and lipid-modulating characteristics and plays a major role in the prevention of disease progression. To evaluate the effect of ALA on inhibition of platelet aggregation and lipid profile. This was a prospective, randomized, double-blind, placebo-controlled study conducted at the Department of Clinical Pharmacology and Therapeutics at a tertiary care hospital. We recorded efficacy parameters including changes in inhibition of platelet aggregation, lipid profile, blood sugars, and glycated hemoglobin over 12 weeks of ALA (600 mg once daily orally) supplementation in DPN patients on gabapentin (300 mg twice daily [BD]) or pregabalin (75 mg BD) compared to placebo. We used Student's t-test paired and unpaired for within-group and between-group comparisons, respectively. A total of 52 study participants (males = 22, females = 30) with a mean age 55.63 ± 7.5 years were randomized to receive either ALA or placebo. Between-group analysis at 12 weeks showed that ALA significantly inhibited both collagen-induced platelet aggregation (from 32.61 ± 8.00 to 24.88 ± 5.30; P < 0.001) and adenosine diphosphate-induced platelet aggregation (from 34.00 ± 6.97 to 25.96 ± 6.45; P < 0.001) compared to placebo. Significant reduction in total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, and triglycerides was found in the ALA group at 12 weeks compared to baseline. No serious adverse events were reported. ALA, an antioxidant, demonstrated a protective effect against DPN by the virtue of its inhibitory effect on platelet aggregation and lipid-modulating effects and was found to have good safety.

Anti-Diabetic Effects of &lt;i&gt;Cordyceps Militaris&lt;/i&gt; Extract on Weight, Blood Glucose, and Insulin Resistance in Diabetic Model Mice

Objectives: This study investigates the anti-diabetic effects of &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract on diabetic model mice (db/db mouse).Methods: Diabetic mice (db/db) were compared to normal control group (NC). The positive control group received Metformin (Met), while other groups received &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract, including &lt;i&gt;ARA301_L&lt;/i&gt;. Body weight, fasting blood glucose levels (FBGL), oral glucose tolerance tests (OGTT), insulin tolerance tests (ITT), blood lipid profiles, and tissue analysis were conducted.Results: Diabetic mice showed significantly higher body weight compared to normal mice. The positive control group maintained stable weight over 56 days, while the &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract groups showed slight weight decreases, with a marked reduction in the &lt;i&gt;ARA301_L&lt;/i&gt; group. FBGLs were significantly lower in treated groups than in control groups. OGTT indicated better glucose regulation in treated groups, though differences among them were not significant. ITT showed lower blood glucose levels in treated groups, indicating improved insulin resistance. Blood lipid profiles revealed significant reductions in total cholesterol (TC) and AST in the &lt;i&gt;ARA301_L&lt;/i&gt; group. Liver tissue analysis showed decreased expression of lipid metabolism and inflammation-related genes, particularly PPAR&lt;i&gt;γ&lt;/i&gt; and SREBP-1c. Muscle and adipose tissues displayed increased GLUT4 protein and reduced inflammatory gene expression.Conclusions: &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract has more positive effects than metformin on body weight, insulin resistance, sugar metabolism, fatty liver, and inflammation in diabetic mice. It also has a similar positive effect as metformin on blood lipid concentration and liver damage. This suggests the potential of diabetes management in &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract.

Investigating the Antibacterial, Antioxidant, and Cholesterol-lowering Properties of Yogurt Fortified with Postbiotic of Lactobacillus acidophilus and Lactiplantibacillus plantarum in the Wistar Rat Model

Postbiotics have gained attention in the food industry due to their functional properties and ease of use compared to their live parent cells. Postbiotics are the metabolic byproducts of probiotic microorganisms, offering advantages such as antimicrobial and anti-diabetic effects. The study aimed to explore the potential antibacterial, antioxidant, and cholesterol-lowering effects of postbiotics from Lactobacillus acidophilus (LA) and Lactiplantibacillus plantarum (LbP) through in vitro and in vivo studies. Freeze-dried postbiotics from L. acidophilus BLAC 258 and L. plantarum were used in yogurt to inhibit foodborne pathogens over a 21-day storage period at 4 °C. The cholesterol-lowering effects of the postbiotic yogurt were assessed in Wistar rats fed with Normal Basal Diet (NBD) and High Cholesterol Diet (HCD). All experiments were performed in triplicate, and the collected data were analyzed with a one-way ANOVA using SPSS v.20 (2021) software. The Tukey Honestly Significant Difference (HSD) test was used for means differences at the 95% confidence interval. The results showed that postbiotic-fortified yogurt exhibited significant antioxidant and antibacterial effects. The antioxidant capacity of the yogurt increasingly peaked at 48.81% on day 14. Also, Listeria monocytogenes counts in the postbiotic yogurt decreased by approximately 2 Log10 on day 3. High-cholesterol-fed rats receiving postbiotic yogurt experienced significant reductions in total cholesterol, triglycerides, and LDL levels. Overall results indicate that postbiotics functional yogurt might be a safe and effective strategy for managing cholesterol levels and inhibiting foodborne pathogens.

Abstract 4116298: Once Weekly Utreglutide (GL0034), a Glucagon-like Peptide-1 Receptor Agonist, at 4 × 450 µg Doses Reduces Blood Pressure, Lipids, and Body Weight in Post-menopausal Females: A Phase I Study

Background: Utreglutide (GL0034), a novel, once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA), previously demonstrated significant reductions in body weight (BW) after a single dose ascending study in individuals with obesity . BW reductions after pharmacological treatment of obesity with GLP-1RA is associated with blood pressure (BP) lowering effects. Aim: This phase I study assessed the safety, tolerability, and cardio-metabolic effects of utreglutide after multiple ascending doses in post-menopausal female volunteers with overweight and obesity. Methods: In this randomized, double-blind, placebo-controlled study 12 post-menopausal female volunteers with overweight/obesity, aged 18 to 65 years old with a body mass index (BMI) ≥26 kg/m 2 were randomized (9:3) to subcutaneous utreglutide fixed doses (4 × 450 µg); or placebo once weekly for four weeks. Safety, tolerability, and key cardio-metabolic parameters were assessed. Biomarker measurements included oral glucose tolerance test (OGTT) insulin and glucose area under the curve (AUC), systolic- and diastolic BP, lipid profile (triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL), and non-high-density lipoprotein (non-HDL), creatinine, potassium, BW and leptin. Results: Utreglutide was generally well tolerated and related adverse effects were mainly gastrointestinal with dose-dependent nausea, vomiting and decreased appetite. Reductions in OGTT AUCs of insulin ( p &lt;0.05) and glucose ( p &lt;0.01) were noted on Day 23 after four weeks treatment with Utreglutide. This was accompanied by a decrease ( p &lt;0.001) in mean systolic and diastolic BP on Day 23 from baseline (BL). On Day 23, significant reductions in TC ( p &lt;0.01), LDL ( p &lt;0.05) and non-HDL ( p &lt;0.05) were observed. BW reduction versus BL ( p &lt;0.001) was 2.0 kg and 1.8 kg respectively on Day 29 and End of Study (EoS). Leptin levels significantly reduced from BL on Day 23 ( p&lt; 0.01) and EoS ( p &lt;0.001). No significant changes were observed for TG, creatinine and potassium (Table). Conclusions: Once weekly utreglutide dosing for four weeks at a dose of 450 µg in post-menopausal females with overweight and obesity, demonstrated clinically relevant reductions of systolic and diastolic BP. This was associated with improved performance of OGTT AUC of insulin and glucose, lipids, BW and leptin with an overall good tolerability and with potential to demonstrate cardio-metabolic benefits.

Synergistic Effects of Turmeric, Strawberry and Broccoli in Improving Lipid Profile in Adult Patients with Hypercholesterolemia.

&lt;b&gt;Background and Objective:&lt;/b&gt; Turmeric, strawberries and broccoli are popular in the community for their beneficial effects in improving lipid profile, but poor bioavailability and absorption of their phytochemical compounds might reduce their effects while given separately. Therefore, their combination might provide a synergistic enhancement of their property as hypolipidemic agents. This study aims to examine the effects of turmeric, strawberry and broccoli in improving lipid profile in adult patients with hypercholesterolemia. &lt;b&gt;Materials and Methods:&lt;/b&gt; Twenty hypercholesterolemic adult patients from Unggul Karsa Medika Hospital in Bandung, Indonesia were recruited for the study, they were given 600 mg/day of turmeric/curcuminoid, 100 g of fresh strawberry and 100 g of boiled broccoli for 30 days. The measurement of the patient's characteristics (body weight, height, BMI) and biochemical parameters in the blood (total cholesterol, triglyceride, LDL-C, HDL-C, SGOT, SGPT, urea and creatinine) were conducted before and after the treatment. &lt;b&gt;Results:&lt;/b&gt; The mean age of the patients was 49.15±1.9 years old, with mean height 1.56±0.014 m, weight 61.43±1.96 kg and mean body mass index 25.25±0.87 kg/m&lt;sup&gt;&lt;a href="86677_op"&gt;2&lt;/a&gt;&lt;/sup&gt;. Lipid profile before the treatment: Total cholesterol 239.75±6.56 mg/dL, LDL-C 172.9±6.53 mg/dL, HDL-C 66.55±3.37 mg/dL and triglyceride 193.7±18.45 mg/dL; after the treatment: Total cholesterol 220.7±9.39 mg/dL, LDL-C 153.95±9.98 mg/dL, HDL-C 59.2±2.45 mg/dL and triglyceride 145±16.55 mg/dL. The result showed a significant reduction of total cholesterol (p = 0.014), LDL-C (p = 0.036), HDL-C (p = 0.001) and triglyceride (p = 0.015) after the treatment. Other biochemical parameters (SGOT, SGPT, urea and creatinine) showed normal levels before and after the treatment. &lt;b&gt;Conclusion:&lt;/b&gt; In summary, supplementation of turmeric, strawberry and broccoli improves lipid profile in adult patients with hypercholesterolemia.

Cardiovascular Safety of Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate in Virologically Suppressed PLWHIV: A Comparative Analysis of CVD Scores.

The Aim of this study is to assess the cardiovascular safety of doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF). We analyzed data from 37 virologically suppressed people living with HIV starting DOR/3TC/TDF, collecting viro-immunological and metabolic parameters as well as the 10-year risk of cardiovascular disease (10Y-CD) using both the Framingham risk score and D:A:D score.After 48 weeks, we observed a significant reduction in 10Y-CD both via the Framingham score (-0.7, p = .021) and the D:A:D score (-0.41, p = .012). After 96 weeks, we registered a significant reduction in 10Y-CD calculated via the D:A:D score (-0.98, p = .009). Regarding serum lipid markers, after 48 weeks we observed a significant reduction in total cholesterol (-17 mg/dL, p < .001), triglycerides (-21 mg/dL, p = .015), and LDL cholesterol (-8 mg/dL, p = .022). After 96 weeks, we registered a significant reduction in total cholesterol (-19 mg/dL, p < .001). DOR/3TC/TDF has shown a favorable metabolic profile, with a significant reduction in 10Y-CD, independently from the use of lipid-lowering drugs.

The impact of integrated health Qigong and dance exercise on cardiovascular function in middle-aged and elderly women.

The aim of this study was to evaluate the impact of health Qigong on vascular elasticity, blood lipid levels, and cardiac function in middle-aged and elderly women. By comparing various indicators preintervention and postintervention, the research provides valuable insights into the effectiveness of health Qigong in enhancing cardiovascular health within this demographic. A total of 40 middle-aged and elderly women were randomly assigned to 2 groups. The experimental group, consisting of 20 women, practiced health Qigong combined with Tibetan dance for 12 weeks, 3 times per week, with each session lasting 60 minutes. The control group, also consisting of 20 women, continued their regular routines without any exercise intervention. Cardiovascular function metrics were subsequently compared between the 2 groups. (1) Pulse wave velocity: in the experimental group, significant improvements were observed, particularly in the right ankle (P =.02 for left ankle, P =.00 for right ankle). The control group showed no significant differences (P =.08 for both ankles); (2) blood lipid levels: the experimental group demonstrated significant reductions in total cholesterol and triglyceride levels (P =.00 for both), while the control group showed no significant changes (P =.59 for total cholesterol, P =.71 for triglycerides). There were significant differences in high-density lipoprotein levels between the experimental and control groups (P =.00 and .01, respectively); (3) cardiac function: significant improvements were noted in cardiac output (Teich) and stroke volume (Teich) in the experimental group (P =.00 for both), while the control group showed no significant differences (P =.71 for cardiac output, P =.06 for stroke volume). Health Qigong, integrated with dance exercise effectively enhances pulse wave velocity, blood lipid levels, and cardiac function in middle-aged and elderly women. These findings suggest that incorporating such exercises may contribute to the prevention or delay of atherosclerosis and cardiovascular disease in this population.

Plant Sterol-Enriched Palm Oil Intervention to Improve Lipid Profile and Inflammation Status in Hyperlipidemic Individuals.

Background: Cardiovascular diseases, including coronary heart disease (CHD), are currently positioned among the leading causes of mortality globally. Risk factors of CHD include, among others, hypercholesterolemia and elevations in systemic inflammation. Functional foods enriched with compounds showing cholesterol-lowering effects are considered one among various dietary and lifestyle intervention strategies to tackle this problem. A CHD-preventive effect of dietary plant sterols has been broadly discussed, not only due to their ability to reduce blood cholesterol level, but also to their proven anti-inflammatory potential. Palm oil is one of the most widely consumed edible oils in the world. Despite its widespread use, especially in Asian countries, no study has been conducted using palm oil as a vehicle for plant sterols. Methods: The aim of the placebo-controlled double-blinded trial presented here was, therefore, to evaluate the effect of palm oil enriched with plant sterols, used as a cooking oil, on lipid profile and systemic inflammation marker in 100 adult hyperlipidemic residents of Bogor, Indonesia. Results: The study has shown a significant reduction in total cholesterol and LDL cholesterol level in study subjects consuming plant sterol-enriched palm oil as a replacement for usual palm oil for cooking, with no similar effect on CRP levels. Conclusions: The study suggests that, along with a healthy diet and lifestyle promotion, incorporating plant sterols in palm oil used for cooking may be an effective strategy to reduce cardiovascular risks in hyperlipidemic individuals.

Effects of switching to dolutegravir/lamivudine from tenofovir alafenamide fumarate/emtricitabine/dolutegravir or abacavir/lamivudine/dolutegravir on body weight and lipid profile in Japanese people living with HIV

BackgroundThe two-drug regimen of dolutegravir/lamivudine (DTG/3TC) is currently an optional antiretroviral therapy (ART). Despite its reported advantages on body weight and lipid profile, the same effects have not yet been reported for Asian population. MethodsWe conducted a single-center retrospective study involving Japanese people living with HIV (PLWH). They were divided into four groups: those who had received abacavir/lamivudine/dolutegravir (ABC/3TC/DTG) and continued the same (ABC-ON group) or switched to DTG/3TC (ABC-OFF group), those who had received tenofovir alafenamide fumarate/emtricitabine/dolutegravir (TAF/FTC/DTG) and continued the same (TAF-ON group) or switched to DTG/3TC (TAF-OFF group). We compared changes in viral load, CD4⁺ cell count, CD4⁺/CD8⁺ ratio, body weight, BMI, lipid profiles, estimated glomerular filtration rate (eGFR), and fibrosis index based on four factors (FIB4-index) between the pre-switch and post-switch period. ResultsOf the 541 PLWH on DTG-based ART, 165, 94, 264 and 18 constituted the ABC-ON, ABC-OFF, TAF-ON, and TAF-OFF groups, respectively. Neither viral rebound nor CD4+decline was observed in the post-switch period in all groups. Multivariate analysis showed significant reduction in total cholesterol, LDL-C and HDL-C in the ABC-OFF group (−6.280, −6.957 and −2.268, p = 0.040, 0.012 and 0.022, respectively), but not in the TAF-OFF group (−3.000, 6.708 and 0.046, p = 0.607, 0.276 and 0.983, respectively). No significant changes were observed in body weight, eGFR, or FIB4-index at 72 weeks after the discontinuation of ABC or TAF. ConclusionsSwitching from ABC/3TC/DTG to DTG/3TC lowered lipids significantly, but not with TAF/FTC/DTG. Neither switch affected body weight or other markers.

Assessing the effect of high-dose rosuvastatin in elderly patients over 75 with acute coronary syndrome

Backgrounds and objectiveStatins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase, are pivotal in managing hypercholesterolemia and reducing cardiovascular risk. While rosuvastatin demonstrates superior efficacy and tolerability compared to other statins, its safety profile in elderly patients older than 75 years old with acute coronary syndrome (ACS) remains underexplored. So, the objective of this study is to evaluate the frequency of adverse reactions and investigate the efficacy of high-dose rosuvastatin on lipid profiles in elderly patients aged over 75 with ACS.MethodsIn this observational study, 110 consecutive elderly ACS patients attending Modarres Hospital in Tehran, Iran, in 2019 were enrolled. The effects of high-dose rosuvastatin were assessed in elderly patients older than 75 years old by comparison of the adverse effects, lipid profile, cardiac function, and other biomarkers at the baseline and after 6 weeks of rosuvastatin therapy with a dose of 40 mg.ResultsFollowing 6 weeks of treatment, there was a significant reduction in total cholesterol (136.2 ± 24.3 to 115.5 ± 24.0, p = 0.001) and LDL levels (72.6 ± 17.5 to 50.9 ± 18.9, p = 0.001), accompanied by a notable increase in HDL levels (38.3 ± 7.1 to 47.2 ± 7.4, p = 0.001). Cardiac function, as measured by ejection fraction (EF), significantly improved from 43.4 ± 8.8 to 48.5 ± 8.5 (p = 0.001). Adverse effects such as cramps (N = 12, p = 0.001), weakness (N = 28, p = 0.001), and anorexia (N = 12, p = 0.001) were reported but did not warrant discontinuation of therapy. Notably, no cases of jaundice were observed. Two deaths occurred due to major adverse cardiac events (MACE) during the study period, unrelated to stroke or recurrent myocardial infarction.ConclusionTotally, high-dose rosuvastatin therapy effectively improved lipid profiles, cardiac function, and liver enzyme levels in elderly ACS patients, with manageable adverse effects. These findings underscore the importance of rosuvastatin in optimizing cardiovascular health in this vulnerable population.

Anti-hyperlipidemic effects of 500 mg spilanthol (SA3X) supplementation in people with dyslipidemia- a randomized, parallel-group placebo-controlled trial.

Dyslipidemia is a critical risk factor for cardiovascular disease. This study investigated the impact of 500 mg of spilanthol (SA3X) supplementation on lipid profiles in men with dyslipidemia using a randomized, parallel-group, placebo-controlled design. A total of 279 male participants were randomly allocated to one of four groups: SA3X without exercise, placebo without exercise, SA3X with exercise, and placebo with exercise. After a one-month control period, participants received SA3X capsules or placebo for three months. The exercise groups undertook standardized weight-lifting exercises four times weekly. Lipid profiles, biochemical parameters, and anthropometric measurements were monitored throughout and after the intervention. Both SA3X groups exhibited significant reductions in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) compared to the placebo groups. By day 90, the SA3X-no-exercise group showed a 16.78 % decrease in TC, while the SA3X-plus-exercise group demonstrated a 52.87 % decrease compared to placebo. Significant reductions in TG and LDL-C were noted at days 60 and 90 (p=0.01 and p=0.03, respectively). The SA3X-plus-exercise group also exhibited decreased random blood sugar levels at days 60 and 90 compared to placebo-plus-exercise. Moreover, decreases in C-reactive protein, creatine kinase, and serum creatinine levels were observed. SA3X supplementation, particularly when combined with exercise, effectively improved lipid profiles and various health markers in men with dyslipidemia. Adverse events, primarily taste disturbance, were mild. These findings suggest SA3X may be a promising adjunctive therapy for managing dyslipidemia, emphasizing its potential cardiovascular health benefits and supporting further investigation. CTRI/2021/05/033694; May 2021.

Inclisiran Usage in Very High-Risk Patients with Dyslipidemia Resistant to Statins and Ezetimibe Therapy

Background. Complications of systemic atherosclerosis (myocardial infarction, ischemic stroke) are the main causes of mortality and disability in the modern world. The relevance of this problem is determined by its scale: the number of deaths from cardiovascular disease has gradually increased from 12.1 million in 1990 to 18.6 million in 2019 and is on the rise. Today, the standard treatment regimen for dyslipidemia includes statins and ezetimibe. For patients who do not achieve the required lipid lowering, intensification of therapy with a relatively new group of drugs – PCSK9 inhibitors – is available. The aim. To study the effectiveness of inclisiran in the complex therapy of dyslipidemia in patients with very high cardiovascular risk. Materials and methods. The study design was a series of clinical cases, the data of which are described for comparison in dynamics. On the basis of the Department of Cardiometabolic Diseases of the Ukrainian Children’s Cardiac Center, a group of 7 patients with very high cardiovascular risk who did not achieve the target lipid parameters on standard therapy with rosuvastatin and ezetimibe was selected. Results. All the patients in the study group of very high cardiovascular risk with dyslipidemia resistant to standard combination treatment who took inclisiran as part of complex lipid-lowering therapy achieved a significant reduction in total cholesterol, but more importantly, they reached the target low-density lipoprotein cholesterol values. We did not find any side effects when using inclisiran. Conclusions. The present series of clinical cases demonstrates high efficacy of inclisiran as part of complex lipid-lowering therapy in patients with very high cardiovascular risk, who have a combination of coronary heart disease and type 2 diabetes mellitus. These results suggest the possibility of wider use of inclisiran in patients with very high cardiovascular risk to reduce cardiovascular morbidity and mortality.

#1294 The impact of plant-based diet on renal function and metabolic profile in kidney transplant recipients

Abstract Background and Aims Controlling and reducing protein intake is the most used approach to preserve renal function in CKD patients. Compared to protein restriction alone, plant-based diets have received particular attention. However, data on the potential risks and benefits of a plant-based diet in kidney transplant patients remains sparse, and evidence in this population is indirect. The primary purpose of this study was to evaluate if a plant-based diet affects proteinuria and eGFR in renal transplant patients. Establishing whether it influences acid load, glycolipid profile, nutritional status, and performance status were secondary objectives. Method 26 renal transplant recipients with eGFR &amp;gt;20 ml/min/1.73 m², urinary protein excretion &amp;gt;0.5 g/day, and transplant age &amp;gt;1 year were considered eligible for the study. Enrolled subjects underwent dietary assessment and biochemical tests at baseline, three and six months after starting the plant-based diet. All subjects underwent performance tests: sit-to-stand and handgrip tests. Results Only 18 patients were included in the statistical analysis. After six months, no significant changes in levels of proteinuria, urinary anion gap, triglycerides, and grip strength were detected. However, there was a statistically significant reduction in total cholesterol (p=0.03), LDL (p=0.04), and fasting blood sugar levels (p=0.001). A statistically significant reduction in eGFR (p=0.033) was observed, likely the regression of the previous hyperfiltration caused by the animal protein diet. A significant improvement was found in sit-to-stand test performance (p=0.037). Finally, a direct relationship between azoturia and urinary anion gap was observed. Conclusions The work carried out has highlighted how some of the potential benefits of the plant-based diet may also be relevant among kidney transplant patients. The plant-based diet is also associated with improved performance tests.

The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials.

Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2= 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P < 0.05 after Bonferroni correction). Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.

Safety and Efficacy of the Consumption of the Nutraceutical "Red Yeast Rice Extract" for the Reduction of Hypercholesterolemia in Humans: A Systematic Review and Meta-Analysis.

Previous studies have shown encouraging results regarding the efficacy and safety of nutraceuticals, such as "red yeast rice (RYR) extract", on reducing hypercholesterolemia in humans. A systematic review and meta-analysis was conducted from January 2012 to May 2022. The search was strictly focused on clinical trials that examined the association between RYR extract consumption and parameters of the lipid profile in humans. Fourteen double-blinded clinical trials were identified. The interventions lasted 4-24 weeks. In most studies, there was one intervention group and one control group. RYR extract consumption statistically significantly reduced total cholesterol (mean absolute reduction: 37.43 mg/dL; 95% confidence interval [CI]: -47.08, -27.79) and low-density lipoprotein cholesterol (LDL-C; mean absolute reduction: 35.82 mg/dL; 95% CI: -43.36, -28.29), but not high-density lipoprotein cholesterol, triglycerides and apolipoproteins A-I and B. As regards the safety, RYR extract was considered a safe choice with neither threatening nor frequent side effects. The consumption of RYR extract by people with hypercholesterolemia was associated with statistically significant reduction in total cholesterol and LDL-C, whereas it was not associated with an increase in life-threatening side effects. Further research on specific subpopulations and outcomes could establish a consensus on determining the clinical benefits and potential risks, if any, of this nutraceutical.

Comprehensive meta-analysis of the effects of oral medroxyprogesterone acetate plus conjugated equine oestrogens on the lipid profile in women: Insights from randomized controlled trials.

Menopause is associated with elevated cardiovascular risk due to the loss of the cardioprotective effect of oestrogens. Postmenopausal women are often prescribed hormone replacement therapy (HRT) in order to control menopause symptoms and correct hormone imbalances; however, HRT can impact serum lipids' concentrations. At present, data on the effect of the administration of medroxyprogesterone acetate plus conjugated equine oestrogens (MPACEE) on the lipid profile in females are uncertain, as the investigations conducted so far have produced conflicting results. Thus, we aimed to clarify the impact of MPACEE prescription on the serum lipids' values in women by means of a systematic review and meta-analysis of randomized controlled trials (RCTs). We employed a random-effects model based on the DerSimonian and Laird method to determine the combined estimates of the intervention's impact on the lipid profile. The computation of the weighted mean difference (WMD) and its corresponding 95% confidence interval (CI) relied on the mean and standard deviation values from both the MPACEE and control group, respectively. A total of 53 RCTs were included in the meta-analysis with 68 RCT arms on total cholesterol (TC), 70 RCT arms on low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), and 69 RCT arms on high-density lipoprotein cholesterol (HDL-C). Administration of MPACEE resulted in a significant reduction of TC (WMD = -11.93 mg/dL; 95% CI: -13.42, -10.44; p < .001) and LDL-C (WMD = -16.61 mg/dL; 95% CI: -17.97, -15.26; p < .001) levels, and a notable increase in HDL-C (WMD = 3.40 mg/dL; 95% CI: 2.93, 3.86; p < .001) and TG (WMD = 10.28 mg/dL; 95% CI: 7.92, 12.64; p < .001) concentrations. Subgroup analysis revealed that changes in the lipid profile were influenced by several factors: body mass index (for TC, HDL-C, TG), MPACEE dosages (for TC, LDL-C, HDL-C, TG), age (for TC, LDL-C, HDL-C, TG), durations of the intervention (for TC, LDL-C, HDL-C, TG), continuous/sequential administration of MPACEE (continuous for TC; sequential for LDL-C, TG) administration of MPACEE and serum lipids' concentrations before enrolment in the RCT (for TC, LDL-C, HDL-C, TG). MPACEE administration can influence serum lipids' concentrations in females by raising HDL-C and TG levels and reducing LDL-C and TC values. Therefore, postmenopausal women who suffer from hypercholesterolaemia might benefit from this type of HRT.

The Lipid-Lowering Efficacy of a Nutraceutical Combination Including Leucoselect Phytosome, Red Yeast Rice, Policosanol and Folic Acid in Dyslipidaemia Patients: Real-World Insights.

Cardiovascular disease is a global health concern and reducing plasma LDL-C levels is a major goal in cardiovascular prevention. Our study aimed to evaluate the effectiveness of a nutraceutical formulation including leucoselect® phytosome®, red yeast rice, policosanol and folic acid on LDL-c levels in patients at low cardiovascular risk with dyslipidemia. We prospectively enrolled all consecutive patients with dyslipidemia at low cardiovascular risk who were unresponsive to diet and physical activity. Clinical assessments and laboratory analyses, encompassing lipid profile, hepatic function, and CPK levels, were performed at baseline prior to initiating treatment and repeated at the 12-week mark following administration of the study nutraceutical. Sixty (60) consecutive patients (mean age 48.02 ± 10.1 years; 60% male) were included. At the 12-week follow-up, a statistically significant reduction in Total Cholesterol (13.1%) and LDL-c serum level (20.4%) was observed. Hepatic and muscular function remain stable over the time. The adherence to therapy was 99% and the persistence was maximum. The nutraceutical formulation including leucoselect® phytosome® red yeast rice, policosanol and folic acid significantly reduced the LDL-c plasma levels, consistent with previous research showing that the bioactive component in red yeast rice-lovastatin-is effective in addressing problems with lipid metabolism. Importantly, it was safe and well-tolerated among patients with dyslipidemia in a real-world setting.

Formulation and evaluation of nanobiotherapeutics of Terminalia arjuna through plant tissue culture for atherosclerosis

Abstract Background The study seeks to investigate the therapeutic potential of Terminalia arjuna callus in addressing atherosclerosis. In order to get maximum beneficial phytoconstituents from Terminalia arjuna, it is recommended to harvest the bark from Arjuna trees that are at least 15 years old and a gap of minimum 2 years should be kept before harvesting bark from the same plant. The callus culture technique was employed to expedite the process. The callus culture extract was subsequently converted into a nanosuspension with the aim of improving the efficacy of its phytoconstituents. It was then subjected to a comprehensive series of in vitro and in vivo evaluations to ascertain its potential for treatment of atherosclerosis. Results Liquid chromatography–mass spectrometry analysis of the callus extract confirmed the presence of flavonoids and terpenoids, known for their antioxidant and anti-inflammatory activities. Some terpenoids were even absent in Arjuna tree naturally. TEM images validated successful entrapment of the extract within the nanoparticles. In vitro analysis for antilipase and antioxidant assay confirmed the antiatherosclerotic potential of the extract. In vivo tests on rat blood serum demonstrated a significant reduction in total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and very low-density lipoprotein. Histopathological analysis of rat aortas showed additional confirmation of antiatherosclerotic action. Conclusion In conclusion, the study highlights the potential of nanosuspension derived from Terminalia arjuna callus extract as a comprehensive therapeutic strategy for atherosclerosis treatment. The research highlights antioxidant, anti-inflammatory, and antiatherosclerotic properties of the callus, hinting at its viability as a potential treatment for atherosclerosis. This interdisciplinary investigation emphasizes the promising role of traditional medicinal plants within modern medical paradigms.