Heparin and insulin in the management of acute hypertriglyceridemic pancreatitis / Heparina e insulina en el manejo de pancreatitis aguda asociada a hipertrigliceridemia

Abstract Hypertriglyceridemic pancreatitis (HTGP) is the third cause of acute pancreatitis in most studies, with a triglyceride (TG) risk value of more than 1000 mg/dL. The pathophysiological mechanism involves triglyceride hydrolysis by pancreatic lipase and the release of fatty acids which cause damage by producing free radicals. The reduction of TGs below 500 mg/dL is the treatment goal, based on increased lipoprotein lipase activity and chylomicron degradation. We present the case of a patient with HTGP with an adequate response to concomitant insulin and heparin therapy. (Acta Med Colomb 2020; 45. DOI: https://doi.org/10.36104/amc.2020.1491).

Resumen La pancreatitis secundaria a hipertrigliceridemia (PASHT) es la tercera causa de pancreatitis aguda en la mayoría de series, teniendo como factor de riesgo un valor de triglicéridos (TG) mayor a 1000 mg/dL. El mecanismo fisiopatológico involucra la hidrólisis de triglicéridos por la lipasa pancreática y la liberación de ácidos grasos que inducen el daño por la generación de radicales libres. La reducción de los TG a niveles menores de 500 mg/dL es el objetivo del tratamiento, basado en el aumento de la actividad de la lipoproteinlipasa y degradación de quilomicrones. Presentamos un caso de un paciente que presenta PASHT con adecuada respuesta al manejo concomitante de insulina y heparina.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1491).

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81−48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Impact of 1 25(OH) 2 D 3 on TG content in liver of rats with type 2 diabetes

Abstract Purpose: To evaluate the effects of 1,25 dihydroxy vitamin D3 (1,25(OH)2D3) on the content of triglyceride (TG), as well as on the gene and protein expressions of adiponectin receptor 2 (AdipoR2), p38 mitogen-activated protein kinase (P38MAPK), and lipoprotein lipase (LPL) in the liver of rats with type 2 diabetes mellitus (T2DM) so as to provide theoretical basis for exploring the mechanism by which 1,25(OH)2D3 regulates TG. Methods: Wistar rats were divided into four groups (n=25), with different treatments and detected the gene and protein expressions of AdipoR2, p38MAPK, and LPL in the liver tissue by reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. Meanwhile, the content of TG in the liver tissue was detected by the Enzyme-linked immunosorbent assay. Results: The expression of AdipoR2, p38MAPK, LPL gene and protein in the liver of VitD intervention group was significantly higher than that in T2DM group (P <0.05), while the TG content was significantly lower than that in T2DM group (P <0.05). Conclusion: 1,25(OH)2D3 can decrease the content of TG in the liver, and its mechanism may be achieved by upregulating the expressions of AdipoR2, p38MAPK, and LPL in the liver.

Heparin and insulin in the management of hypertriglyceridemia-associated pancreatitis: case series and literature review

SUMMARY Severe hypertriglyceridemia accounts for up to 7% of all cases of acute pancreatitis. Heparin and insulin activate lipoprotein lipase (LPL), thereby reducing plasma triglyceride levels. However, the safety and efficacy of heparin and insulin in the treatment of hypertriglyceridemia-associated acute pancreatitis have not been well established yet. We successfully used heparin and insulin as first-line therapy in four consecutive patients with acute pancreatitis secondary to hypertriglyceridemia. In a literature search, we revised almost all reports published to date of patients managed successfully with this combination. Heparin and insulin appear to be a safe, effective, and inexpensive first-line therapy for hypertriglyceridemia-associated acute pancreatitis.

Adiponectina determinaría el predominio de VLDL alteradas en el síndrome metabólico / Adiponectin would determine the predominance of altered VLDL in metabolic syndrome / Adiponectina iria determinar o predomínio de VLDL alteradas na síndrome metabólica

El objetivo del trabajo fue evaluar si la reducción de adiponectina (ADP) en el síndrome metabólico (SMet), influencia las características aterogénicas de VLDL. Se estudiaron 45 pacientes con SMet y 15 controles sanos. En suero en ayunas se midió perfil lipídico, ácidos grasos libres (AGL), ADP, se aisló VLDL (d<1,006 g/L) caracterizándola en su composición química y tamaño (HPLC-exclusión molecular). En plasma post-heparínico se determinó la actividad de lipoproteína lipasa (LPL). En SMet VLDL mostró incremento de masa, número de partículas, contenido en triglicéridos-VLDL y mayor proporción de VLDL grandes (p<0,05). El incremento de AGL correlacionó con la masa de VLDL (r=0,36; p=0,009), número de partículas-VLDL (r=0,45; p=0,0006) y %-VLDL grandes (r=0,32; p=0,02). SMet mostró descenso en ADP (7,4±4,8 vs. 15,5±7,2 μg/mL, p=0,01) y en actividad de LPL (p=0,01), que correlacionaron entre si (r=0,38; p=0,01; ajustado por HOMA-IR y cintura: β=0,35; p=0,02). ADP correlacionó negativamente con AGL y %-VLDL grandes (p<0,03). Se concluye que en SMet la disminución de ADP favorecería la secreción de VLDL sobre-enriquecidas en triglicéridos y de mayor tamaño, y además retardaría el catabolismo de VLDL mediado por LPL, resultando en la acumulación de VLDL alteradas en circulación con características aterogénicas.

The aim of the work was to evaluate whether the reduction of adiponectin (ADP) in metabolic syndrome (MetS) affects the atherogenic features of VLDL. A total of 45 patients with MetS (ATPIII) and 15 healthy controls were studied. In fasting serum, lipid profile, free fatty acids (FFA) and ADP were determined. VLDL was isolated (d<1.006 g/L) and characterized in chemical composition and size (size exclusion-HPLC). In post-heparin plasma, lipoprotein lipase (LPL) activity was measured. In MetS, VLDL showed increased total mass, particle number, VLDL-triglyceride content and higher large-VLDL proportion (p<0.05). The increase in FFA correlated with VLDL mass (r=0.36; p=0.009), VLDL particle number (r=0.45; p=0.0006) and large-VLDL proportion (r=0.32; p=0.02). MetS patients showed a decrease in ADP (7.4±4.8 vs. 15.5±7.2 μg/mL, p=0.01) and in LPL activity (p=0.01), that positively correlated between them (r=0.38; p=0.01; adjusted by HOMA-IR and waist: β=0.35; p=0.02). ADP inversely correlated with FFA and large-VLDL% (p<0.03). It can be concluded that in MetS, decreased ADP would favour the secretion of triglyceride over-enriched and larger VLDL particles, and also would delay VLDL catabolism mediated by LPL, resulting in the accumulation of altered VLDL with atherogenic characteristics.

O objetivo do trabalho foi avaliar se a redução da adiponectina (ADP) na síndrome metabólica (SM), afeta as características aterogênicas das VLDL. Foram estudados 45 indivíduos com SM e 15 controles saudáveis. Em jejum, foi medido em soro o perfil lipídico, ácidos graxos livres (AGL) e ADP. Foram isoladas as VLDL (d <1,006 g / L) caracterizando-as em relação a sua composição química e tamanho (HPLC- exclusão molecular). No plasma pós-heparina foi medida a atividade da lipoproteína lipase (LPL). Em indivíduos com SM, as VLDL apresentaram aumento de massa, número de partículas, conteúdo de triglicerídeos -VLDL e maior proporção de VLDL grandes (p<0,05). O aumento de AGL correlacionou com a massa de VLDL (r=0,36; p=0,009), número de partículas -VLDL (r=0,45; p=0,0006) e percentual -VLDL grandes (r=0,32; p=0,02). A SM mostrou uma diminuição em ADP (7,4±4,8 vs. 15,5±7,2 μg/mL, p=0,01) e em atividade de LPL (p=0,01), que correlacionaram entre eles (r=0,38; p=0,01; ajustada por HOMA-IR e cintura: β=0,35; p=0,02). A ADP correlacionou em forma negativa com AGL e %-VLDL grandes (p<0,03). A conclusão é que em indivíduos com SM, a diminuição da ADP iria favorecer a secreção de VLDL super-enriquecidas em triglicerídeos e de maior tamanho, e também atrasaria o catabolismo das VLDL mediado por LPL, resultando na acumulação de VLDL alteradas em circulação com características aterogênicas.

Polymorphisms of the lipoprotein lipase gene as genetic markers for stroke in colombian population: a case control study / Polimorfismos en el gen lipoproteína lipasa como marcadores genéticos para enfermedad cerebrovascular en la población colombiana: estudio de casos y controles

Abstract Objective: To analyze if there is an association between the presence of polymorphisms in the LPL gene (rs320, rs285 and rs328) with development of acute ischemic stroke in Colombian population. Methods: In a case control design, 133 acute ischemic stroke patients (clinical diagnosis and x-ray CT) and 269 subjects without stroke as controls were studied. PCR -RFLP technique was used to detect rs320, rs285 and rs328 polymorphisms in the LPL gene. Results: In the present research was not found any association between any of the LPL gene polymorphism and acute ischemic stroke in the population studied; the allele and genotypic frequencies of the studied polymorphisms were similar in cases and controls and followed the Hardy-Weinberg equilibrium. The study was approved by the IRB and each subject signed the informed consent. Conclusion: LPL gene polymorphisms are not genetic markers for the development of stroke in the Colombian sample used.

Resumen Objetivo: Determinar la asociación entre los polimorfismos en el gen LPL (rs320, rs285 y rs328), y la enfermedad cerebrovascular isquémica aguda en una muestra de población colombiana. Métodos: A partir de un diseño de casos y controles, se estudiaron 133 casos con enfermedad cerebrovascular isquémica aguda (diagnóstico clínico y TAC), y 269 controles sin enfermedad cerebrovascular. Se examinó los polimorfismos rs320, rs285 y rs328 en el gen LPL con la técnica PCR-RFLP. Resultados: En el presente estudio no se encontró asociación entre rs320, rs285 y rs328 con la enfermedad cerebrovascular isquémica aguda en la muestra analizada; siendo las frecuencias alélicas y genotípicas de los polimorfismos similares entre casos y controles, y se encontró en equilibrio de Hardy-Weinberg. El estudio fue avalado por el comité de ética de las instituciones vinculadas y todos los pacientes dieron consentimiento informado. Conclusión: Los polimorfismos en el gen de la LPL no tienen utilidad como marcadores genéticos asociados con la presentación de la enfermedad cerebrovascular isquémica aguda en la muestra analizada.

Interaction of lipoprotein lipase polymorphisms with body mass index and birth weight to modulate lipid profiles in children and adolescents: the CASPIAN-III Study / Interação de polimorfismos da lipoproteína lipase com índice de massa corporal e peso ao nascer para modular o perfil lipídico em crianças e adolescentes: o estudo CASPIAN-III

CONTEXT AND OBJECTIVE: Interactions between body mass index (BMI), birth weight and risk parameters may contribute to diseases rather than the individual effects of each factor. However this hypothesis needs to be confirmed. This study aimed to determine to what extent variants of lipoprotein lipase (LPL) might interact with birth weight or body weight in determining the lipid profile concentrations in children and adolescents. DESIGN AND SETTING: Substudy of the third survey of a national surveillance system (CASPIAN-III Study) in Iran. METHODS: Whole blood samples (kept frozen at -70 °C) were randomly selected from 750 students aged 10-18 years. Real-time polymerase chain reaction (PCR) and high-resolution melt analysis were performed to assess S447X (rs328), HindIII (rs320) and D9N (rs1801177) polymorphisms. RESULTS: The AG/GG genotype in D9N polymorphism was associated with higher LDL-C (low-density lipoprotein cholesterol) and lower HDL-C (high-density lipoprotein cholesterol) concentration. Significant interactions were found for D9N polymorphism and birth weight in association with plasma HDL-C concentration, and also for D9N polymorphism and BMI in association with plasma triglyceride (TG) and HDL-C levels. HindIII polymorphism had significant association with birth weight for HDL-C concentration, and with BMI for TG and HDL-C levels. Significant interactions were found for S447X polymorphism and BMI in association with plasma TG and HDL-C concentrations. CONCLUSION: We found significant interactive effects from LPL polymorphisms and birth weight on HDL-C concentration, and also effects from LPL polymorphisms and BMI on TG and HDL-C concentrations.

RESUMO CONTEXTO E OBJETIVO: Interações entre índice de massa corporal (IMC), peso ao nascer e parâmetros de risco podem contribuir para doenças, em vez de efeitos individuais de cada fator. No entanto, essa hipótese precisa de confirmação. Este estudo visou determinar o quanto variantes de lipoproteína lipase (LPL) podem interagir com peso de nascimento ou peso corporal na determinação das concentrações do perfil lipídico em crianças e adolescentes. DESENHO E LOCAL: Sub-estudo da terceira pesquisa de sistema nacional de vigilância (Estudo CASPIAN-III) no Irã. MÉTODOS: Foram selecionadas aleatoriamente amostras de sangue total (mantidas congeladas a -70 °C) de 750 estudantes com idades entre 10-18 anos. Reação de polimerase em cadeia (PCR) em tempo real e análise de fusão de alta resolução foram realizados para avaliar polimorfismo de S447X (rs328), HindIII (rs320) e D9N (rs1801177). RESULTADOS: Genótipo AG/GG em polimorfismo D9N foi associado com concentração maior de LDL-C (colesterol do tipo lipoproteína de baixa densidade) e menor de HDL-C (colesterol do tipo lipoproteína de alta densidade). Interações significativas foram encontradas para polimorfismo D9N e peso ao nascer em associação com concentração plasmática de HDL-C, bem como para polimorfismo D9N e IMC em associação com níveis plasmáticos de triglicérides (TG) e HDL-C. Polimorfismo HindIII teve associação significativa com peso de nascimento para concentração de HDL-C, e com IMC para níveis de TG e HDL-C. Interações significativas foram encontradas para polimorfismo S447X e IMC em associação com concentrações plasmáticas de TG e HDL-C. CONCLUSÃO: Encontramos efeitos interativos significativos de polimorfismo LPL e peso de nascimento sobre concentração de HDL-C, bem como efeitos de polimorfismos LPL e IMC sobre concentrações de TG e HDL-C.

Efeito da administração In Bolus da heparina sódica no remodelamento de partículas lepoprotéicas associadas ao transporte reverso do colesterol / In bolus administration the effect of heparin sodium in remodeling lepoprotéicas particles associated with reverse cholesterol transport

Introdução: as doenças cardiovasculares acometem milhares de pessoas no mundo. Destas, a doença arterosclerótica está entre as de maior morbimortalidade. Para a avaliação da necessidade de intervenções hemodinâmicas e/ou revascularização miocárdica, há a necessidade da realização do cateterismo (CATE), procedimento de imagem indicado para evidenciar pontos de obstrução e determinar a melhor estratégia cirúrgica. Para a realização do CATE utiliza-se heparina sódica (5000 UI) in bolus. Atualmente, sabe-se que a heparina interfere no remodelamento de partículas lipoproteicas por liberação da lipoproteína lipase (LPL) e da lipase hepática (LH), essa ação pode alterar o transporte reverso do colesterol (TRC), em função de modificações no metabolismo das lipoproteínas. Métodos: foram selecionados por conveniência 20 pacientes, 10 do sexo masculino e 10 do sexo feminino, ambos os sexos, entre 45 e 73 anos, admitidos no Hospital Ana Neri, submetidos à cineangiocoronariografia (CATE)...

Introduction: cardiovascular diseases affect thousands of people worldwide. Of these, the atherosclerotic disease is one of the most morbidity and mortality. To evaluate the need for hemodynamic interventions and / or CABG, the catheterization (CATE) is performed, an imaging procedure to evidence obstruction and to determine the best surgical strategy. To perform CATE, is necessary to use in bolus sodium heparin (5000 IU). Currently, it is known that heparin interferes with the remodeling of the lipoprotein particles by releasing lipoprotein lipase (LPL) and hepatic lipase (HL), this action may alter the reverse cholesterol transport (TRC), by changes in lipoprotein metabolism. Methods: were selected by convenience 20 patients, 10 male and 10 female, both gender, between 45 and 73 years old, admitted to the Hospital Ana Neri, who underwent coronary angiography (CATE)...

¿ Es útil la prueba de lipemia predonación para la selección de donantes de sangre? / Is the pre-donation lipemia test useful for blood donor selection?

En el Banco de Sangre Provincial de Cienfuegos se incluye, además de las pruebas reguladas en Cuba para la selección de los donantes de sangre, la prueba de lipemia predonación. Un plasma con apariencia turbia es causa de exclusión transitoria del donante. A fin de evaluar la eficacia diagnóstica de esta prueba se realizaron dos estimaciones visuales del plasma en busca de turbidez, la primera antes de donar y la segunda en la unidad de plasma obtenida a partir de la sangre total colectada, esta última utilizada como prueba de referencia para este estudio. Ambas observaciones fueron realizadas por el mismo observador siguiendo un protocolo establecido. Como parte del estudio, la presencia de una prueba de lipemia positiva predonación no constituyó causa de exclusión de donantes. Se calculó la sensibilidad y especificidad diagnóstica, el valor predictivo positivo (VPP) y el valor predictivo negativo (VPN), además la eficiencia de la prueba dentro de un intervalo de confianza del 95 por ciento. Se obtuvo el 98,4 por ciento de especificidad, el 80 por ciento de sensibilidad, así como el 66,6 por ciento de valor predictivo positivo y el 99,0 por ciento de valor predictivo negativo, con el 95,7 por ciento de eficiencia diagnóstica. La prueba resulta útil en la selección de donantes de sangre y se recomienda su uso en todas las dependencias de colecta de sangre que cuenten con las condiciones técnicas para su realización...

In addition to the Cuban regulated tests for donor selection, the Cienfuegos provincial blood bank uses a predonation lipemia test. The present study evaluates the diagnostic efficacy of this test. Two visual estimates of plasma for turbidity were performed: the first before donation and the second one to the plasma unit obtained from the whole blood collected, this one used as a reference test for this study. Both observations were made by the same observer following an established protocol. As part of the study, the presence of a positive test predonation lipemia was not cause for excluding donors. Diagnostic sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) and efficiency of the test within a confidence interval of 95 percent were calculated. We obtained 98,4 percent specificity, 80 percent sensitivity and 66,6 percent positive predictive value and 99,0 percent negative predictive value, with 95,7 percent diagnostic accuracy. The test is useful for the selection of blood donors and we recommended its use in all blood collection services having technical conditions for its fulfillment...

Ausencia de asociación entre la variante S447X del gen de la lipoproteína lipasa y lípidos plasmáticos: Estudio preliminar / Lack of association between the S447X variant of the lipoprotein lipase gene and plasma lipids: A preliminary study

El aumento en los valores de los lípidos sanguíneos, constituye un importante factor de riesgo cardiovascular. La lipoproteína lipasa (LPL) juega un papel importante en el metabolismo lipoproteico. Factores metabólicos y genéticos pueden influir en la función de la LPL. La variante S447X de la LPL se ha asociado con cambios en el perfil lipídico en diferentes poblaciones. El objetivo de esta investigación fue analizar la relación entre la variante S447X del gen de la LPL y lípidos plasmáticos de individuos del Estado Zulia, Venezuela. Se estudiaron 75 individuos entre 20 y 60 años, 34 hombres y 41 mujeres. A cada individuo se le realizó una historia clínica con antecedentes familiares, características antropométricas, estado nutricional y pruebas bioquímicas. Para el estudio molecular, se extrajo el ADN genómico, se utilizó la reacción en cadena de la polimerasa (RCP) seguida de digestión enzimática para polimorfismos de longitud de fragmentos de restricción utilizando la enzima Hinf I. Los individuos estudiados presentaron niveles normales de glicemia, triglicéridos, colesterol total, lipoproteínas de baja densidad (C-LDL) y niveles ligeramente disminuidos de las lipoproteínas de alta densidad (C-HDL). La distribución genotípica dela variante S447X del gen LPL fue 90,6% para el genotipo homocigoto 447SS y 9,4% para el genotipo heterocigoto 447SX; no se identificó el genotipo 447XX. La población se ajustó al equilibrio genético de Hardy Weinberg. No se encontró relación entre el polimorfismo S447X del gen LPL y los valores lipídicos plasmáticos.

The increase in lipid plasma values is an important cardiovascular risk factor. Lipoprotein lipase (LPL) plays an important role in the lipoprotein metabolism and metabolic and genetic factors may influence its levels and functions. The S447X variant of the lipoprotein lipase gene is associated with changes in plasma lipids in different populations. The objective of this research was to analyze the S447X variant of the LPL gene and its relation with plasma lipids of individuals in Zulia state, Venezuela. With this purpose, we studied 75 individuals (34 men and 41 women) between 20 and 60 years of age. Each subject had a medical history which included family history, anthropometric characteristics, nutritional status evaluation and biochemical tests. Genomic DNA was extracted for the molecular study and the polymerase chain reaction was used, followed by enzyme digestion, for restriction fragments length polymorphisms using the Hinf I enzyme. The individuals studied had normal levels of blood glucose, triglycerides, total cholesterol and low density lipoproteins (LDL-C) and slightly decreased levels of high density lipoproteins (HDL-C). The genotypic distribution of the LPL gene S447X variant in the studied population was 90.6% for the homozygous genotype SS447 and 9.4% for the heterozygote SX447. The genotype 447XX was not identified. The population was found in Hardy Weinberg genetic equilibrium. No association between the S447X polymorphism of lipoprotein lipase gene and plasma lipids was observed.

Postprandial lipemia and cardiovascular diseases: the beneficial role of strength exercise / Lipemia pós-prandial e doenças cardiovasculares: o papel benéfico dos exercícios de força

Development of cardiovascular diseases (CVD) has been linked with changes to the lipid profile that can be observed during the postprandial period, a phenomenon known as postprandial lipemia (PL). Physical exercise is currently the number one non-pharmacological intervention employed for prevention and reduction of risk factors for the development of CVD. This in turn has created a growing interest in the effects of physical exercise on regulation and equilibrium of lipid metabolism. In this review we compare the results of studies that have investigated the beneficial effects of strength training on PL. We analyzed articles identified in the PubMed, Scopus and EBSCO databases published from 1975 to 2013 in international journals. Studies were selected for review if they covered at least two of four keywords. The results of these studies lead to the conclusion that strength training is effective for reduction of postprandial lipemia because it increases baseline energy expenditure. This type of training can be prescribed as an important element in strategies to treat chronic diseases, such as atherosclerosis...

O desenvolvimento de doenças cardiovasculares (DCV) tem sido associado a alterações no perfil lipídico encontradas no período pós-prandial, fenômeno conhecido como lipemia pós-prandial (PL). O exercício fisico é atualmente a principal intervenção não farmacológica utilizada na prevenção e na redução de fatores de risco para o desenvolvimento de DCV. Por esta razão, há um interesse crescente acerca dos efeitos do exercício físico sobre a regulação e o equilíbrio do metabolismo lipídico. Nesta revisão, procuramos comparar os resultados de artigos que abordaram os efeitos benéficos do treinamento de força sobre a PL. Utilizamos artigos que foram selecionados nas bases de dados PubMed, Scopus e EBSCO, no período entre os anos 1975 e 2013, e publicados em revistas internacionais. Os estudos selecionados foram aqueles que contemplassem pelo menos duas das quatro palavras-chave do estudo. Com base nos estudos selecionados, conclui-se que o treinamento de força revela-se eficaz na redução da lipemia pós-prandial por induzir uma melhoria da demanda de energia basal. Este tipo de treinamento pode ser indicado como uma estratégia importante para o tratamento de doenças crônicas, como a aterosclerose...

Relación entre el polimorfismo Hind III de la lipoproteinlipasa y lípidos sanguíneos en un grupo de pacientes colombianos con enfermedad obstructiva coronaria / Relationship between Lipoprotein Lipase HindIII Polymorphism and Lipids in a Group of Colombian Patients with Obstructive Coronary Disease / Relação entre o polimorfismo Hind III da lipoprnoteína lipase e lipídios sanguíneos em um grupo de pacientes colombianos com doença obstrutiva coronária

El polimorfismo Hind III es la variante más común en el gen de la lipoproteinlipasa; sin embargo, su asociación con enfermedad cardiovascular es controversial. Objetivo: Establecer la frecuencia del polimorfismo Hind III y su relación con el perfil lipídico y la enfermedad obstructiva coronaria (EOC) en pacientes colombianos. Materiales y métodos: La muestra la constituyeron pacientes que asistieron a un centro de hemodinamia del Quindío, por necesidad de una angiografía coronaria. El polimorismo Hind III fue evaluado por la reacción en cadena de la polimerasa y restricción enzimática. Resultados: 389 pacientes fueron divididos en individuos con EOC>50%, (60,4%) e individuos con EOC<50%, (39,6%). El colesterol en las lipoproteínas de baja densidad (c-LDL), fue normal en ambos grupos, pero significativamente mayor en EOC≥50%. El colesterol en las lipoproteínas de alta densidad (c-HDL) fue bajo en ambos grupos. La frecuencia del genotipo Hind+/+ y el alelo Hind+ fue 55% y 76%, respectivamente, para los genotipos Hind+/- y Hind-/- y el alelo Hind- fue 41,1%, 3,85% y 24%, respectivamente sin diferencias significativas entre los grupos. En EOC≥50%, el colesterol total y c-LDL fueron mayores en el alelo Hind-, mientras que el c-HDL fue más bajo en el alelo Hind+, con diferencias significativas con respecto a EOC<50% y los mismos alelos. Se encontraron diferencias claras en triglicéridos y colesterol en lipoproteínas de muy baja densidad (c-VLDL) entre los genotipos del grupo EOC<50%. Conclusión: Este trabajo muestra que aun con valores normales de perfil lipídico, se presenta EOC significativa, que no parece estar asociada a las bajas concentraciones de c-HDL, ni al polimorfismo Hind III de la LPL por sí solo, pero podría estar relacionada a la influencia de estos sobre los lípidos.

HindIII polymorphism is the most common variant in the lipoprotein lipase gene, however, its association with cardiovascular disease is controversial. Objective: To establish the frequency of the HindIII polymorphism and its relationship with lipid profile and coronary arterial disease (CAD) in Colombian patients. Materials and Methods: The sample comprised patients attending a central hemodynamics of Quindío, by necessity of coronary angiography. HindIII polymorphism was evaluated by polymerase chain reaction and enzyme restriction. Results: 389 patients were divided into individuals with CAD ≥ 50% (60.4%) and individuals with EOC <50% (39.6%). Low density lipoproteins cholesterol (LDL-C) was normal, but significantly higher in CAD > 50%. High density lipoprotein cholesterol (HDL-C) was low in both groups. Hind+/+ genotype and Hind+ allele frequency were 55% and 76%, respectively; for Hind+/- genotype was 41.1%, and for Hind-/- genotype and Hind- allele was 3.85% and 24%, respectively, without significant differences between groups. In CAD ≥ 50%, total cholesterol (TC) and LDL-C were higher in allele Hind-, while HDL-C was lower in the Hind+ allele, with significant differences regarding cad <50% and the same alleles. There were significant differences in triglyceride and very low density lipoprotein cholesterol) (VLDL-C) between genotypes in CAD < 50% group. Conclusion: This work shows that even with a normal lipid profile, this population presents coronary obstructive disease, which does not seem to be associated with low levels of HDL-C or the LPL HindIII polymorphism alone, but may be related to the influence of these on lipids.

O polimorfismo Hind III é a variante mais comum no gene da lipoproteína lípase; no entanto, sua associação com doença cardiovascular é controversa. Objetivo: estabelecer a frequência do polimorfismo Hind III e sua relação com o perfil lipídico e a doença obstrutiva coronária (EOC) em pacientes colombianos. Materiais e métodos: a amostra a constituíram pacientes que assistiram a um centro de hemodinâmica de Quindío, por necessidade de uma angiograia coronária. O polimorismo Hind III foi avaliado pela reação em cadeia da polimerase e restrição enzimática. Resultados: 389 pacientes foram divididos em indivíduos com EOC≥50%, (60,4%) e indivíduos com EOC>50%, (39,6%). O colesterol nas lipoproteínas de baixa densidade (c-LDL) foi normal em ambos os grupos, mais significativamente maior em EOC≥50%. O colesterol nas lipoproteínas de alta densidade (c-HDL) foi baixo em ambos os grupos. A frequência do genótipo Hind+/+ e o alelo Hind+ foi 55% e 76%, respectivamente, para o genótipo Hind+/- foi 41,1%, e para genótipo Hind-/- e o alelo Hind- foi 3,85% y 24%, respectivamente, sem diferenças significativas entre os grupos. Em EOC≥50%, o colesterol total e c-LDL foram maiores no alelo Hind-, enquanto que o c-HDL foi mais baixo no alelo Hind+, com diferenças significativas com respeito a EOC<50% e os mesmos alelos. Encontraram-se diferenças significativas em triglicerídeos e colesterol em lipoproteínas de muita baixa densidade (c-VLDL) entre os genótipos do grupo EOC<50%. Conclusões: Este trabalho mostra que ainda com valores normais de perfil lipídico, se apresenta EOC significativa, que não parece estar associada às baixas concentrações de c-HDL, nem ao polimorfismo Hind III da LPL por si só, más poderia estar relacionada à influência destes sobre os lipídios.

Effects of high-intensity intermittent training on carnitine palmitoyl transferase activity in the gastrocnemius muscle of rats

We examined the capacity of high-intensity intermittent training (HI-IT) to facilitate the delivery of lipids to enzymes responsible for oxidation, a task performed by the carnitine palmitoyl transferase (CPT) system in the rat gastrocnemius muscle. Male adult Wistar rats (160-250 g) were randomly distributed into 3 groups: sedentary (Sed, N = 5), HI-IT (N = 10), and moderate-intensity continuous training (MI-CT, N = 10). The trained groups were exercised for 8 weeks with a 10% (HI-IT) and a 5% (MI-CT) overload. The HI-IT group presented 11.8% decreased weight gain compared to the Sed group. The maximal activities of CPT-I, CPT-II, and citrate synthase were all increased in the HI-IT group compared to the Sed group (P < 0.01), as also was gene expression, measured by RT-PCR, of fatty acid binding protein (FABP; P < 0.01) and lipoprotein lipase (LPL; P < 0.05). Lactate dehydrogenase also presented a higher maximal activity (nmol·min-1·mg protein-1) in HI-IT (around 83%). We suggest that 8 weeks of HI-IT enhance mitochondrial lipid transport capacity thus facilitating the oxidation process in the gastrocnemius muscle. This adaptation may also be associated with the decrease in weight gain observed in the animals and was concomitant to a higher gene expression of both FABP and LPL in HI-IT, suggesting that intermittent exercise is a "time-efficient" strategy inducing metabolic adaptation.

Primeiro relato de uma criança Brasileira portadora da mutação G188E do gene da lipoproteína lipase / First report of a Brazilian child carrying the G188E mutation of lipoprotein lipase gene

OBJETIVO: Relatar o caso de uma criança com hipertrigliceridemia grave por mutações do gene da lipoproteína lipase. DESCRIÇÃO DE CASO: Menino de três anos que apresentou, com um mês de idade, soro lipêmico. Seu perfil lipídico indicou hipertrigliceridemia grave, com concentrações de triglicerídeos plasmáticos iguais a 25000mg/dL. Foi detectada a mutação G188E no éxon 5 da lipoproteína lipase em homozigose na criança e em heterozigose nos pais. COMENTÁRIOS: A deficiência da lipoproteína lípase é uma doença de herança autossômica recessiva e esses pacientes evoluem com hipertrigliceridemia grave.

OBJECTIVE: To report the case of a child with serious hypertriglyceridemia due to lipase lipoprotein gene mutation. CASE DESCRIPTION: A three-year-old boy presented with lipemic serum at one month of age. His lipid profile revealed serious hypertriglyceridemia with plasma triglycerides levels of 25,000mg/dL. A mutation G188E in éxon 5 of the lipoprotein lipase gene was detected in homozygosis for him and in heterozygosis for his parents. COMMENTS: The deficiency of the lipoprotein lipase is a recessive autossomal disease that causes severe hypertriglyceridemia.

Efeitos de autoanticorpos antilipoproteína lipase, antilipoproteína de baixa densidade e antilipoproteína de baixa densidade oxidada sobre o metabolismo lipídico e aterosclerose no lúpus eritematoso sistêmico / Effects of autoimmune antibodies anti-lipoprotein lipase, anti-low density lipoprotein, and anti-oxidized low density lipoprotein on lipid metabolism and atherosclerosis in systemic lupus erythematosus

INTRODUÇÃO: O desenvolvimento prematuro de aterosclerose em lúpus eritematoso sistêmico tem sido amplamente divulgado. Anticorpo antilipoproteína lipase pode ser uma das causas que contribuem para esta doença. OBJETIVO: Avaliar o grau de risco coronariano devido a autoanticorpos em termos de placa carotídea em pacientes com lúpus. PACIENTES E MÉTODOS: Comparamos 114 pacientes com lúpus documentado e 111 controles normais pareados por sexo e idade. Antilipoproteína lipase (A-LPL), antilipoproteínas de baixa densidade oxidada (A-OXLDL), e antilipoproteínas de baixa densidade (A-LDL) foram medidos pelo teste imunoenzimático - ELISA. LDL-triglicéride (LDL-Trig) e HDL-Trig também foram dosados. A placa foi medida por ultrassom bilateral de carótida. RESULTADOS: 45,6 por cento dos pacientes foram positivos para A-LDL e 34,4 por cento para A-OXLDL; 44 por cento dos controles foram positivos para A-LDL e 20 por cento para A-OXLDL. O risco aumentou acentuadamente nos subgrupos com níveis elevados de anticorpos. Pacientes com A-LDL e A-OXLDL > 0,40 (n = 12) mostraram correlações de risco coronariano de: ALDL vs LDL-Trig = 0,7008, P = 0,0111; ultrassom bilateral vs colesterol = 0,62205, P = 0,0308; LDL-Trig vs infarto do miocárdio (IM) = 0,76562, P =0,0037; triglicerídeos totais vs IM = 0,78191, P = 0.0027); LDL-Trig/LDL-colesterol vs IM = 0,80493, P = 0,0016; A-OXLDL vs USBL = 0,71930, P = 0,0084. Correlações do SLEDAI com as variáveis de risco foram altamente significativas somente nos subgrupos com níveis elevados de anticorpos (SLEDAI x A-OXLDL = 0,70366, P = 0,0107). CONCLUSÃO: A-LPL inicia o desenvolvimento de mutações de LDL, seguido pela produção de anticorpos, formação da placa e do risco coronariano em alguns pacientes com lúpus erimatoso sistêmico (LES).

INTRODUCTION: Premature development of atherosclerosis in systemic lupus erythematosus has been widely reported. Anti-lipoprotein lipase antibody may be one cause contributing to this disorder. OBJECTIVE: To assess the extent of coronary risk due to autoimmune antibodies in terms of carotid plaque in lupus patients. PATIENTS AND METHODS: We compared 114 documented lupus patients with 111 normal controls matched for sex and age. Anti-lipoprotein lipase (A-LPL), anti-oxidized low density lipoprotein (A-OXLDL), and anti-low density lipoprotein (A-LDL) were measured by enzme-linked immunoabsorbent assay. Low density lipoprotein-triglyceride (LDL-Trig) and high density lipoprotein-triglyceride (HDL-Trig) were also measured. Plaque was measured by bilateral carotid ultrasound. RESULTS: 45.6 percent of patients tested positive for A-LPL, and 34.4 percent for A-OXLDL. 44 percent of normal controls tested positive for A-LPL, and 20 percent for A-OXLDL. Risk increased sharply in subgroups with increased antibody levels. Patients with A-LPL and A-OXLDL > 0.40 (n = 12) showed coronary risk correlations of: A-LPL x LDL-Trig = 0.7008, P = 0.0111; bilateral ultrasound vs total cholesterol = 0.62205, P = 0.0308; LDL-Trig vs myocardial infarction (MI) = 0.76562, P = 0.0037; total triglycerides vs MI = 0.78191, P = 0.0027); LDL-Trig/LDL-cholesterol vs MI = 0.80493, P = 0.0016; A-OXLDL vs USBL = 0.71930, P = 0.0084. Correlations of SLEDAI with risk variables were highly significant only in subgroups of elevated antibody levels (SLEDAI x A-OXLDL = 0.70366, P = 0.0107). CONCLUSION: A-LPL initiates the development of LDL mutations, followed by antibody production, plaque formation and coronary risk in some SLE patients.

Uso da Spirulina platensis na recuperação de ratos submetidos à dieta de restrição proteica / Use of Spirulina platensis for recovering rats under protein restriction diet feeding

O presente estudo avaliou a ação da espirulina como fonte protéica na recuperação do estado nutricional de ratos machos adultos. Foram estudados 48 animais, divididos em quatro grupos de acordo com a dieta: grupo controle de caseína (CC) e grupo controle de espirulina (CE), que receberam dieta equilibrada durante todo o experimento; grupo recuperado de caseína (RC) e grupo recuperado de espirulina (RE), que consumiram dieta com restrição protéica durante 60 dias e, a seguir, receberam a dieta equilibrada à base de caseína e espirulina, respectivamente, durante 90 dias. Foram analisadas a composição centesimal e a microbiológica da Spirulina platensis, bem como o ganho em peso dos animais. Após o sacrifício dos animais, foram realizadas as análises para determinação do peso do fígado e do aspecto histopatológico, da gordura corporal e dos constituintes sanguíneos. A espirulina utilizada continha 59,65% de proteína, 3,72% de lipídios, 17,53% de resíduo mineral fixo e 7,81 de umidade, e não apresentou contaminação por microrganismos. Não houve diferenças significativas quanto à gordura corporal e constituintes protéicos séricos entre os quatro grupos de animais. Em relação ao ganho de peso não foi constatada diferença entre os grupos CC e CE, nas diferentes semanas de números 1, 5, 6, 7 e de 10 a 18, contudo esta ocorrência não foi observada nos grupos RC e RE. O peso relativo do fígado diminuiu nos animais com restrição protéica, principalmente no grupo RC, porém sem alterações histopatológicas, e os constituintes lipídios tiveram valores diminuídos. Conclui-se que o uso da Spirulina platensis na recuperação de ratos com dieta de restrição protéica reduz a lipemia.

This investigation aims at evaluating the effects of spirulin as a protein source for recovering the nutritional status of adult male rats. Forty-eight animals were studied and divided by four groups according to the feed diet: casein control (CC) group and spirulin control (SC) group, which received balanced diet during the whole experiment; recovered casein (RC) group and recovered spirulin (RS) group, which received a protein-restriction diet for 60 days and, afterwards, they were fed with balanced diet based on casein and spirulin, respectively, for 90 days. The centesimal and microbiologicalcomposition of Spirulina platensis and animals weight gains could be evaluated. After being euthanized the animal’s liver weight and its histopathologic aspects were analyzed, besides the body fat and blood components. The spirulinused contained 59.65% of protein, 3.72% of lipids, 17.53 of fixed mineral residue and 7.81% of humidity, and showed no microorganism contamination. Significant differences on body fat and serum protein contents could not be observedamong the four animal groups. Regarding the weight gains, there was no difference among the animals of groups CC and SC in different weeks of experiments numbers 1, 5, 6, 7 and from 10 to 18, but these findings were not observed among the RC and RS groups. The relative liver weight decreased in animals under protein restriction, mainly in the group RC, but no histopathological alterations could be observed, and lipid contents decreased. In conclusion, the useof Spirulina platensis for recovering rat on protein restriction diet induces a reduction of lipemia.

Effect of conjugated linoleic acid supplementation on lipoprotein lipase activity in 3T3-L1 adipocyte culture

Supplementation with conjugated linoleic acid may reduce fat body mass and increase lean body mass in various species. Some studies have demonstrated that conjugated linoleic acid reduces body fat, in part, by inhibiting the activity of lipoprotein lipase in adipocytes. The objective of this work was to study the effect of conjugated linoleic acid supplementation on lipoprotein lipase activity in 3T3-L1 adipocyte culture. 3T3-L1 adipocytes received linoleic acid (group C) or conjugated linoleic acid (group AE, supplemented with AdvantEdge® CLA, and group CO, supplemented with CLA One®) in concentrations of 1 mmol/L. Heparin-releasable lipoprotein lipase activity was analyzed by means of a 3T3-L1 adipocyte culture. After 7 days, heparin-releasable lipoprotein lipase activity was lower in the groups AE and CO supplemented with conjugated linoleic acid. These results suggest that one of the mechanisms by which CLA is capable of reducing body fat is by reducing lipoprotein lipase activity.

A suplementação com ácido linoléico conjugado pode reduzir a gordura corporal e aumentar a massa magra em diferentes espécies. Alguns estudos têm demonstrado que o ácido linoléico conjugado reduz a gordura corporal, por meio da inibição da atividade de lípase lipoprotéica em adipócitos. O objetivo deste estudo foi avaliar o efeito da suplementação com uma mistura de isômeros do ácido linoléico conjugado sobre a atividade da lípase lipoprotéica em cultura de adipócitos 3T3-L1. Os adipócitos 3T3-L1 receberam ácido linoléico (grupo controle) ou ácido linoléico conjugado (grupo AE, suplementado com AdvantEdge® CLA, e grupo CO, suplementado com CLA One®) na concentração de 1 mmol/L. A atividade de lípase lipoprotéica livre de heparina foi analisada pela média da cultura de adipócitos. Após 7 dias, a atividade da lípase lipoprotéica livre de heparina mostrou menores valores nos grupos AE e CO, suplementados com ácido linoléico conjugado. Estes resultados sugerem que um dos mecanismos pelo qual o ácido linoléico conjugado seja capaz de reduzir a gordura corporal é a partir da redução da atividade da lípase lipoprotéica.

Lipoprotein lipase PvuII polymorphism is associated with variations in serum lipid levels in non-diabetic pregnant women

The aim of the present study was to determine if there is an association between the single nucleotide polymorphisms (SNPs) of the lipoprotein lipase (LPL) and apolipoprotein E (apo E) genes and the serum lipid profile in pregnancy and puerperium. Non-diabetic women of European descent in the third semester of pregnancy (N = 120) were selected. Those with diseases or other condition that could modify their lipid profile were excluded from the study (N = 32). Serum lipids were measured by routine laboratory procedures and genomic DNA was extracted by a salting out method. LPL (PvuII and HindIII) and apo E (HhaI) SNPs were detected by the polymerase chain reaction and restriction fragment length polymorphism. Categorical and continuous variables were compared by the chi-square test and Student t-test or ANOVA, respectively. Women carrying the LPL P1P1 genotype had higher serum LDL cholesterol (N = 21; 155 ± 45 mg/dL) than women carrying the P1P2/P2P2 genotypes (N = 67; 133 ± 45 mg/dL; P = 0.032). During the puerperium period, serum levels of triglycerides and VLDL cholesterol were significantly reduced in women carrying the P1P1 (73 percent, P = 0.006) and P1P2 (51 percent, P = 0.002) genotypes but not in women carrying the P2P2 genotype (23 percent, P > 0.05). On the other hand, serum concentrations of lipids did not differ between the LPL HindIII and apo E genotypes during pregnancy and after delivery. We conclude that LPL PvuII SNP is associated with variations in serum lipids during pregnancy and the puerperal period in non-diabetic women.

Polimorfismo S447X da lipase lipoprotéica: influência sobre a incidência de doença arterial coronariana prematura e sobre os lípides plasmáticos / The S447X polymorphism of lipoprotein lipase: effect on the incidence of premature coronary disease and on plasma lipids

OBJETIVO: O objetivo deste estudo foi avaliar o efeito do polimorfismo S447X sobre os lípides plasmáticos em pacientes com doença arterial coronariana (DAC) prematura. MÉTODOS: Os lípides plasmáticos e a genotipagem foram determinados em 2 grupos: 313 pacientes com DAC prematura (<55 anos) e 150 controles sem DAC. RESULTADOS: A freqüência do polimorfismo S447X foi de 18 por cento nos pacientes com DAC e de 23 por cento no grupo controle. O polimorfismo S447X da lipase lipoprotéica está relacionado com diminuição das concentrações plasmática de triglicérides nos pacientes do sexo masculino com DAC, não havendo essa relação no sexo feminino. CONCLUSÃO: A presença do polimorfismo S447X da lípase lipoprotéica não foi associada à incidência de DAC.

OBJECTIVE: The objective of this study was to evaluate the effect of polymorphism S447X on plasma lipids of patients with premature coronary artery disease (CAD). METHODS: Plasma lipids and genotypes were determined in 2 groups: 313 patients with premature CAD (<55 years of age) and 150 controls without CAD. RESULTS: Frequency of the S447X polymorphism was 18 percent in patients with CAD and 23 percent in the control group. The S447X polymorphism of lipoprotein lipase is related to a decrease in plasma triglyceride concentrations in male patients with CAD, but this correlation is not observed in female patients. CONCLUSION: The presence of the S447X lipoprotein lipase polymorphism was not associated with the incidence of CAD.

Influencia de variables clínicas y lipídicas en la magnitud de la lipemia postradial de sujetos con y sin hipertrigliceridemia / Influence of clinical and lipid variables on the magnitude of postprandial lipemia in subjects with and without hipertriglyceridemia

Introducción. La lipemia postprandial se caracteriza por el aumento de la permanencia en circulación de lipoproteínas ricas en triglicéridos que pueden producir aterosclerosis siendo esta una importante causa de muerte en nuestro medio Objetivo. Evaluar el efecto de variables lipídicas y antropométricas en la magnitud de la lipemia postprandial de sujetos con y sin hipertrigliceridemia Material y métodos. Se estudiaron 48 sujetos de uno y otro género, con triglicéridos basales mayores a 200mg/dL, que ingirieron una carga lipídica estandarizada (desayuno con 30g de grasa) y fueron seguidos durante siete horas recolectando sangre total cada hora para determinar los triglicéridos postprandiales y con estos datos hallar la magnitud de la lipemia postprandial. Este dato se correlacionó con variables clínicas como la edad, el índice de masa corporal, la circunferencia de la cintura, entre otras y con variables lipídicas como colesterol total, colesterol de HDL y LDL y triglicéridos basales Resultados. Se encontró alteración en el aclaramiento de triglicéridos postprandiales en sujetos que tenían una concentración basal de triglicéridos por encima de 186 mg/dl. Las variables clínicas que más correlacionaron con la magnitud de la lipemia postprandial fueron la edad (p=0.009) y el perímetro de la cintura (p=0.043), mientras que las variables lipídicas mejor relacionadas con la lipemia postprandial fueron la concentración de triglicéridos basales (p=<0.001), el colesterol VLDL (p=<0.001) y el colesterol HDL (p=0.041) Conclusión. Las variables que podrían predecir el comportamiento de los triglicéridos postprandiales en los individuos de este estudio son la edad, el perímetro de la cintura, el colesterol VLDL, el colesterol HDL y la concentración de triglicéridos basales.