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1.
Zhonghua Nei Ke Za Zhi ; 58(11): 823-825, 2019 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-31665858

RESUMO

This study was aimed to investigate the association between dyslipidemia and thyroid associated ophthalmopathy (TAO). We evaluated the relationship between dyslipidemia and TAO in 218 patients with Graves' disease (GD) and found that the serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in the GD subjects with TAO (n=110) were significantly increased [(5.32±1.39) mmol/L vs. (3.18±2.12) mmol/L, (2.98±0.75) mmol/L vs. (1.25±0.98) mmol/L] than those in the GD subjects without TAO (n=108). TC and LDL-C were positively correlated with the Clinical disease activity score (CAS) [TC (r=0.7, P=0.03),LDL-C (r=0.82, P=0.03)], and the levels of TC (OR=2.56, P=0.02) and LDL-C(OR=2.01, P=0.015) were positively associated with TAO. These suggested that high serum cholesterol level is a novel risk factor for TAO, and management of blood lipids should be included in the treatment of TAO.


Assuntos
Colesterol/sangue , Oftalmopatia de Graves/diagnóstico , Hipercolesterolemia/diagnóstico , LDL-Colesterol , Oftalmopatia de Graves/sangue , Humanos , Hipercolesterolemia/sangue , Fatores de Risco
4.
N Engl J Med ; 381(12): 1114-1123, 2019 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-31532959

RESUMO

BACKGROUND: Persons with low socioeconomic status and nonwhite persons in the United States have high rates of cardiovascular disease. The use of combination pills (also called "polypills") containing low doses of medications with proven benefits for the prevention of cardiovascular disease may be beneficial in such persons. However, few data are available regarding the use of polypill therapy in underserved communities in the United States, in which adherence to guideline-based care is generally low. METHODS: We conducted a randomized, controlled trial involving adults without cardiovascular disease. Participants were assigned to the polypill group or the usual-care group at a federally qualified community health center in Alabama. Components of the polypill were atorvastatin (at a dose of 10 mg), amlodipine (2.5 mg), losartan (25 mg), and hydrochlorothiazide (12.5 mg). The two primary outcomes were the changes from baseline in systolic blood pressure and low-density lipoprotein (LDL) cholesterol level at 12 months. RESULTS: The trial enrolled 303 adults, of whom 96% were black. Three quarters of the participants had an annual income below $15,000. The mean estimated 10-year cardiovascular risk was 12.7%, the baseline blood pressure was 140/83 mm Hg, and the baseline LDL cholesterol level was 113 mg per deciliter. The monthly cost of the polypill was $26. At 12 months, adherence to the polypill regimen, as assessed on the basis of pill counts, was 86%. The mean systolic blood pressure decreased by 9 mm Hg in the polypill group, as compared with 2 mm Hg in the usual-care group (difference, -7 mm Hg; 95% confidence interval [CI], -12 to -2; P = 0.003). The mean LDL cholesterol level decreased by 15 mg per deciliter in the polypill group, as compared with 4 mg per deciliter in the usual-care group (difference, -11 mg per deciliter; 95% CI, -18 to -5; P<0.001). CONCLUSIONS: A polypill-based strategy led to greater reductions in systolic blood pressure and LDL cholesterol level than were observed with usual care in a socioeconomically vulnerable minority population. (Funded by the American Heart Association Strategically Focused Prevention Research Network and the National Institutes of Health; ClinicalTrials.gov number, NCT02278471.).


Assuntos
Anti-Hipertensivos/administração & dosagem , Combinação de Medicamentos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Hipercolesterolemia/tratamento farmacológico , Hipertensão/tratamento farmacológico , Área Carente de Assistência Médica , Adesão à Medicação/estatística & dados numéricos , Adulto , Alabama , Anlodipino/administração & dosagem , Atorvastatina/administração & dosagem , LDL-Colesterol/sangue , Centros Comunitários de Saúde , Feminino , Humanos , Hidroclorotiazida/administração & dosagem , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hipertensão/complicações , Losartan/administração & dosagem , Masculino , Pessoa de Meia-Idade
5.
High Blood Press Cardiovasc Prev ; 26(4): 345-350, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31352663

RESUMO

INTRODUCION: Treatment strategies for patients with pre-hypertension and low-moderate cardiovascular (CV) risk may include nutraceutical compounds (NCs). AIM: To investigate the efficacy and safety of a new-generation of NC in lowering BP values and improving metabolic profile, in a group of hyper-cholesterolemic subjects with pre-hypertension. METHODS: 131 subjects with pre-hypertension (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg) without organ damage and history of CV diseases were enrolled. 66 subjects were treated with a once-daily oral formulation of a NC (red yeast rice, Berberine, Coenzyme Q10, folic acid and chrome) added to diet for 3 months, while 65 patients followed a diet only. Differences in serum total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDLC and HDLC), triglycerides (TG), glycemia, creatine phosphokinase (CPK), aspartate aminotransferase (AST) alanine aminotransferase (ALT) and body mass index (BMI) were evaluated. RESULTS: At the end of treatment, significant reductions of TC, LDLC, TG glucose levels were observed in both treatment groups, while HDLC values increased in the active treatment group only. A greater reduction of TC, LDLC and glycemia was observed in the treatment group. TG levels were not different within the two groups. BP and BMI levels remained unchanged, as well AST, ALT; CPK slightly increased in both groups, but it remained in the normal range. CONCLUSIONS: In patients with pre-hypertension, NC supplementation was safe, well tolerated and effective in improving lipid pattern and glucose levels and in preventing the progression to overt hypertension.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Suplementos Nutricionais , Hipercolesterolemia/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Hipolipemiantes/uso terapêutico , Lipídeos/sangue , Pré-Hipertensão/tratamento farmacológico , Idoso , Anti-Hipertensivos/efeitos adversos , Biomarcadores/sangue , Glicemia/metabolismo , Suplementos Nutricionais/efeitos adversos , Progressão da Doença , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/diagnóstico , Hipoglicemiantes/efeitos adversos , Hipolipemiantes/efeitos adversos , Itália , Masculino , Pessoa de Meia-Idade , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/fisiopatologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
6.
Internist (Berl) ; 60(8): 871-877, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31254003

RESUMO

Sitosterolemia or phytosterolemia is a rare autosomal recessive hereditary lipid storage disorder. It is caused by homozygous or compound heterozygous mutations in one of the two ABCG5 and ABCG8 genes encoding the intestinal and hepatic heterodimer ABCG5 (sterolin 1)/ABCG8 (sterolin 2) efflux transporters. These mutations lead to intestinal hyperabsorption and reduced hepatic secretion of cholesterol and plant sterols with subsequent accumulation of phytosterols and cholesterol in plasma and deposition in tissue (xanthoma). Phytosterols are found mainly in vegetable oils, margarine, nuts, grains, soybeans and avocados. Patients with sitosterolemia show extreme phenotypic heterogeneity from almost asymptomatic individuals to those with combined severe hypercholesterolemia at a young age, leading to increased atherosclerosis and premature cardiac death. Early abnormalities include hemolytic anemia with stomatocytosis, macrothrombocytopenia and splenomegaly. In addition to strict avoidance of phytosterol-containing foods, the use of the sterol absorption inhibitor ezetimibe, possibly in combination with the bile acid-binding resin cholestyramine, is the most effective treatment option.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Hipercolesterolemia/patologia , Enteropatias/patologia , Erros Inatos do Metabolismo Lipídico/genética , Mutação/genética , Fitosteróis/efeitos adversos , Fitosteróis/sangue , Membro 5 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Membro 8 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Humanos , Hipercolesterolemia/sangue , Erros Inatos do Metabolismo Lipídico/complicações , Erros Inatos do Metabolismo Lipídico/patologia
8.
Prensa méd. argent ; 105(5): 284-292, jun 2019. tab, fig
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1024554

RESUMO

Diabetes remains unique among the main non-communicable ailments (NCDs) recognized by the World Health Organization (WHO), apart from the circulatory diseases, tumours, and long-lasting respiratory ailments. The current study aimed to determine the correlation between ABCA1 gene polymorphismo and lipid profile in type 2 diabetes mellitus patients. Serum samples from 100 type 2 diabetes mellitus patients (46 males and 54 females) and 50 standard subjects (26 males and 24 females) were colected from Najaf province/Irak. Fasting blood sugar (FBS), and lipid profiles (total cholesterol (TC), triglycerides (TH), HDL, LDL, and VLDL) were meassured. Plymerase chain reaction (PCR) with the Taq1 enzye was used for the amplification of the ABCA1 gene, which contains 525bp of the AABCA1 gene in the locus V825I. The present study revaled a positive corrrelation between FBS and body mass index (BMI) (r= 0.2390, p= 0.0463), TG (r = 0.1836, p= .01743), and VLDL (r = 0.1836, p = 0.1839). The frequencies of the GG genotype and the G allele were higher in the normal groups compared to the patientes (58% vs. 56% and 70% vs. 67%, respectively); conversely, the frequencies of the AA genotype (18% vs. 22%) and the A allele (30% vs. 33%) were higher in the patients compared to the normal groups. The data also showed a significant relationship between ABCA1 gene polymorphim and both TG and VLDL (P=0.007 for cach). There is relationship between the ABCA1 gene and HDL level. Additiionally, the G allele could be a defensive factor against diabetes mellitus in Iraqi peole (AU)


Assuntos
Humanos , Polimorfismo Genético , Glicemia/análise , Diabetes Mellitus Tipo 2 , Transportador 1 de Cassete de Ligação de ATP/genética , Frequência do Gene , Hipercolesterolemia/sangue
9.
Food Funct ; 10(5): 2888-2893, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31070609

RESUMO

The aim of this study was to investigate whether supplementation with nattokinase, which is considered one of the most active functional ingredients found in natto, alters hemostatic factors. Subjects presenting with hypercholesterolemia (serum cholesterol: 200-280 mg dL-1) were randomly divided into nattokinase and placebo groups (n = 50, respectively). No significant between-group differences were found at baseline in collagen-epinephrine closure time (C-EPI CT), prothrombin time (PT), or activated partial thromboplastin time (aPTT). After 8 weeks of treatment, the nattokinase group exhibited significant increases in C-EPI CT, PT, and aPTT. The nattokinase group showed significantly greater increases in C-EPI CT (P = 0.001) and aPTT (P = 0.016) than the placebo group. Moreover, at 8 weeks, the nattokinase group showed a significantly higher C-EPI CT than the placebo group (P = 0.001). Additionally, a significant correlation between PT and aPTT was observed (r = 0.491, P < 0.001). In conclusion, nattokinase supplementation was associated with prolonged C-EPI CT and aPTT in nondiabetic and borderline-to-moderate hypercholesterolemic subjects.


Assuntos
Colágeno/metabolismo , Suplementos Nutricionais/análise , Epinefrina/metabolismo , Hipercolesterolemia/tratamento farmacológico , Alimentos de Soja/análise , Subtilisinas/administração & dosagem , Adulto , Idoso , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/metabolismo , Masculino , Pessoa de Meia-Idade , Tempo de Tromboplastina Parcial , Tempo de Protrombina
10.
Acta Med Indones ; 51(1): 19-25, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31073102

RESUMO

BACKGROUND: the use of statin to lower blood cholesterol is often associated with bothersome adverse effects such as myopathy and liver dysfunction. NC120 is herbal lipid lowering drug containing red yeast rice (RYR) extract, guggulipid, and chromium picolinate, and expected to have better safety profile. The aim of this study was to evaluate the efficacy and safety profiles of NC120 in lowering blood lipid. METHODS: this was a double blind randomized clinical trial comparing NC120 with placebo in subjects with hypercholesterolemia. Two capsules of NC120 or placebo were administered twice a day for 28 days. Blood total-cholesterol, LDL-cholesterol, and triglyceride were measured on day-0, day-7, and day-28. Unpaired t-test was used to compare study parameter between groups, and one-way ANOVA was used to compare within group. RESULTS: 25 subjects received NC120 and 24 subjects received placebo. Significant decrease of total cholesterol and LDL-cholesterol were observed since day-7 in NC120 group, while the changes in placebo group were not significant at all time of observation. No significant decrease of triglyceride was observed in NC120 group and in placebo group. Side effects were minor and comparable between the two groups. CONCLUSION: NC120 is effective in reducing total cholesterol and LDL-cholesterol, but not triglyceride. This drug shows a good safety profile, and thus can be considered for patients who can not tolerate statin drugs.


Assuntos
Produtos Biológicos/uso terapêutico , LDL-Colesterol/sangue , Colesterol/sangue , Hipercolesterolemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Ácidos Picolínicos/uso terapêutico , Extratos Vegetais/uso terapêutico , Gomas Vegetais/uso terapêutico , Adulto , Método Duplo-Cego , Feminino , Humanos , Hipercolesterolemia/sangue , Indonésia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Triglicerídeos/sangue
11.
J Avian Med Surg ; 33(1): 7-14, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31124606

RESUMO

Hypercholesterolemia is common in captive Psittaciformes. A point-of-care cholesterol analyzer would be useful to monitor hypercholesterolemia in psittacine birds. We compare a point-of-care cholesterol analyzer (PTS-Diagnostics CardioChek) with a reference laboratory analyzer (Roche Cobas c501) and provide initial assessment of precision and accuracy. A prospective method comparison study was designed to compare the CardioChek and Cobas c501 by assessment of clinical and analytical agreement using Passing-Bablock regression analysis and difference plots. Initial accuracy was assessed by running cholesterol standards, and initial precision was assessed by calculating between-run coefficient of variation on samples from selected birds. A total of 42 psittacine birds were sampled. No significant constant bias was found between the Cobas and CardioChek. However, a significant negative proportional bias was evident, suggesting that the point-of-care analyzer tended to underestimate cholesterol values. Lipemia and hemolysis had strong effects on increasing bias. Hematocrit, glucose level, and genus had no significant impact on bias, controlling for lipemia and hemolysis. Accuracy of the CardioCheck was suboptimal to that of the Cobas, but precision was good. When defining hypercholesterolemia as >8 mmol/L (309 mg/dL), the CardioChek had a sensitivity of 57% and specificity of 96%. There was neither analytical nor clinical agreement between the CardioChek and Cobas c501. Values obtained from the CardioChek cannot be used to determine or monitor hypercholesterolemia in parrots in the absence of analyzer-specific reference intervals.


Assuntos
Doenças das Aves/diagnóstico , Colesterol/sangue , Técnicas de Laboratório Clínico/veterinária , Hipercolesterolemia/veterinária , Sistemas Automatizados de Assistência Junto ao Leito , Psittaciformes , Animais , Doenças das Aves/sangue , Hipercolesterolemia/sangue , Hipercolesterolemia/diagnóstico , Animais de Estimação , Estudos Prospectivos , Análise de Regressão
12.
Int J Mol Med ; 43(6): 2451-2461, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31017253

RESUMO

Ischemic postconditioning (IPoC) has been demonstrated to prevent myocardial ischemia­reperfusion injury (MIRI), but its cardioprotective effect is abrogated by hypercholesterolemia. The aim of the present study was to determine whether lycopene (LP), a type of carotenoid, can restore the cardioprotective effect of IPoC in hypercholesterolemic rats. Male Wistar rats were fed a cholesterol­enriched diet for 12 weeks to establish a hypercholesterolemic model. The rat hearts were isolated and subjected to 30 min ischemia and 60 min reperfusion using a Langendorff apparatus. LP was administered to the rats intraperitoneally for 5 consecutive days prior to ischemia and reperfusion. Myocardial pathological changes, infarct size and cell apoptosis were measured by hematoxylin and eosin, triphenyltetrazolium chloride and TUNEL staining, respectively. The changes in endoplasmic reticulum (ER) stress markers, the reperfusion injury salvage kinase (RISK) pathway and mitochondrial apoptosis­related proteins were detected by western blotting. Overall, the results demonstrated that low­dose LP in combination with IPoC ameliorated myocardial histopathological changes, reduced the infarct size and release of cardiac enzymes, and decreased cardiomyocyte apoptosis in hypercholesterolemic rats, but no beneficial effects were achieved by the same dose of LP or IPoC treatment were used alone. Furthermore, the combination of LP and IPoC inhibited the expression of glucose­regulated protein 78 and C/EBP homologous protein, increased the phosphorylation levels of AKT, ERK1/2 and glycogen synthase kinase­3ß, repressed mitochondrial permeability transition pore opening, and reduced the expression of cytochrome c, cleaved caspase­9 and cleaved caspase­3. Collectively, these findings demonstrated that LP can restore the cardioprotective effects of IPoC on MIRI in hypercholesterolemic rats, and this restoration by LP was mediated by inhibition of ER stress and reactivation of the RISK pathway in hypercholesterolemic rat myocardium.


Assuntos
Hipercolesterolemia/complicações , Pós-Condicionamento Isquêmico , Licopeno/uso terapêutico , Traumatismo por Reperfusão Miocárdica/complicações , Traumatismo por Reperfusão Miocárdica/terapia , Substâncias Protetoras/uso terapêutico , Animais , Hipercolesterolemia/sangue , Hipercolesterolemia/patologia , Pós-Condicionamento Isquêmico/métodos , Lipídeos/sangue , Masculino , Infarto do Miocárdio/sangue , Infarto do Miocárdio/complicações , Infarto do Miocárdio/patologia , Infarto do Miocárdio/terapia , Traumatismo por Reperfusão Miocárdica/sangue , Traumatismo por Reperfusão Miocárdica/patologia , Miocárdio/patologia , Ratos Wistar
13.
Biomed Res Int ; 2019: 4805926, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30937311

RESUMO

Shuangyu Tiaozhi Granule (STG) is composed of two kinds of Chinese medicinal herbs in dioscorea, which are used for managing cholesterol levels in patients with hypercholesterolemia in traditional Chinese medicine (TCM). However, the potential molecular mechanisms of administration of STG in hypercholesterolemia remain unknown. In this study, we investigated the effects of STG on hepatic cholesterol metabolism in high cholesterol (HC) diet-induced hypercholesterolemic rat models and simvastatin was used as a positive control. Male Sprague Dawley (SD) rats were fed general or HC diet, respectively. After 4 weeks of feeding, HC diet-induced hypercholesterolemic rats were fed HC diet, STG at 5% (w/w) or 10% (w/w) mixed in the HC diet, or HC diet combined with simvastatin gavages (4 mg·kg-1·d-1) for 4 or 8 weeks. STG treatment decreased body weight gain, liver weight ratio, serum lipids levels and hepatic lipids accumulation in rats fed a HC diet. Moreover, the effects of STG on decreasing body weight and lowering liver cholesterol levels were in dose- and time-dependent. Furthermore, STG or simvastatin treatment decreased the mRNA and protein levels of HMGCR and SREBP-2 in liver. The ACAT-2 and CYP7A1 mRNA expression were significantly decreased in HC diet supplemented with STG, while the mRNA levels of LDLR were markedly increased. STG attenuates hypercholesterolemia via inhibiting SREBP-2 signaling pathway activation and increasing hepatic uptake genes expression, providing a novel idea of TCM keeping cholesterol levels down for the clinical application.


Assuntos
Colesterol na Dieta/administração & dosagem , Colesterol/biossíntese , Medicamentos de Ervas Chinesas/uso terapêutico , Comportamento Alimentar , Hipercolesterolemia/tratamento farmacológico , Animais , Peso Corporal/efeitos dos fármacos , Fígado Gorduroso/tratamento farmacológico , Fígado Gorduroso/patologia , Hidroximetilglutaril-CoA Redutases/metabolismo , Hipercolesterolemia/sangue , Fígado/efeitos dos fármacos , Fígado/patologia , Masculino , Modelos Biológicos , Tamanho do Órgão/efeitos dos fármacos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos Sprague-Dawley , Proteína de Ligação a Elemento Regulador de Esterol 2/metabolismo
14.
Nutrients ; 11(4)2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31013851

RESUMO

We evaluated the effects of Cynanchum wilfordii (CW) ethanolic extract on blood cholesterol levels in adults with high low-density lipoprotein cholesterol (LDL-C) levels. In a double-blind, randomized, placebo-controlled, parallel trial, 84 subjects were recruited. Participants were randomly divided into two groups with a low-dose (300 mg/d) or high-dose (600 mg/d) of CW. Levels of very low-density lipoprotein (p = 0.022) and triglycerides (p = 0.022) were significantly lower in the low-dose CW group than in the placebo group after 8 weeks. In a subgroup of participants with LDL-C≥ 150 mg/dL (n = 33), there was a significant decrease in total cholesterol (low-dose, p = 0.012; high-dose, p = 0.021), apolipoprotein B (low-dose, p = 0.022; high-dose, p = 0.016), and cholesteryl ester transfer protein (low-dose, p = 0.037; high-dose, p = 0.016) after 8 weeks of CW. The correlation between changes in total cholesterol and baseline LDL-C levels was significant in the groups that received both doses of CW (low-dose, p = 0.010; high-dose, p = 0.015). These results show that the CW ethanolic extract can regulate blood cholesterol in subjects with LDL-C≥ 150 mg/dL.


Assuntos
Anticolesterolemiantes/uso terapêutico , Colesterol/sangue , Cynanchum , Hipercolesterolemia/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Anticolesterolemiantes/farmacologia , Apolipoproteínas B/sangue , Proteínas de Transferência de Ésteres de Colesterol/sangue , LDL-Colesterol/sangue , Método Duplo-Cego , Feminino , Humanos , Hipercolesterolemia/sangue , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/farmacologia , Triglicerídeos/sangue
15.
Nutrients ; 11(4)2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30991629

RESUMO

It remains unclear whether cholesterol intake can increase serum cholesterol. Therefore, the present study aimed to investigate the hypothesis that the risk for hypercholesterolemia was not associated with intake of dietary cholesterol after adjusting for saturated fatty acid (SFA). Based on the data from the 2012-2016 KNHANES, dietary cholesterol was positively associated with the risk for abnormalities in total cholesterol (TC) (odds ratio (OR): 1.153, 95% confidence interval (CI): 0.995-1.337; p = 0.028) and low-density lipoprotein cholesterol (LDL-C) (OR: 1.186, 95% CI: 1.019-1.382; p = 0.018) levels before adjusting for SFA; after adjusting for SFA, no significant associations were found between these variables. The mediation analysis showed that dietary cholesterol had no direct effects on the serum levels of TC and LDL-C; in contrast, SFA had significant indirect effects on the association between dietary cholesterol and serum levels of TC and LDL-C. Furthermore, processed meats, but not eggs and other meats, were positively associated with the risk for abnormalities in both TC (OR: 1.220, 95% CI: 1.083-1.374; p = 0.001) and LDL-C (OR: 1.193, 95% CI: 1.052-1.354; p = 0.004) levels. The present study suggested that higher intake of processed meats with high SFA, but not dietary cholesterol was associated with higher risk for abnormalities in TC and LDL-C levels.


Assuntos
Colesterol na Dieta/efeitos adversos , Dieta , Comportamento Alimentar , Hipercolesterolemia/etiologia , Adulto , Colesterol na Dieta/sangue , LDL-Colesterol/sangue , Ingestão de Energia , Ácidos Graxos/efeitos adversos , Feminino , Humanos , Hipercolesterolemia/sangue , Masculino , Carne , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , República da Coreia
16.
Mol Med Rep ; 19(6): 4603-4612, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30957178

RESUMO

As the incidence of osteoporosis (OP) and hypercholesterolaemia in men has increased, male OP has drawn more attention from clinicians worldwide. The present study sought to investigate the effects of cholesterol on male bone. Between July 2015 and October 2015, 216 men (aged ≥18 years) were recruited for this cross­sectional study. To test our clinical hypothesis, we designed two male animal models: Exogenous hypercholesterolaemia induced by a high­cholesterol diet (HCD) and endogenous hypercholesterolaemia induced by apolipoprotein E (ApoE) knockout. Finally, the direct effects of cholesterol on osteoblasts were observed in cell experiments. In our clinical studies, men with hypercholesterolaemia displayed a lower bone mineral density (BMD) and increased beta collagen cross­linking (beta­CTX) and type I anterior collagen amino terminal peptide (PINP) levels compared to those of the control subjects. Serum cholesterol levels were a significant independent predictor of BMD, beta­CTX and PINP and were negatively correlated with BMD and positively correlated with beta­CTX and PINP levels. Our animal experimental results validated our clinical results, as they also indicated that hypercholesterolaemia damages bone microstructure and reduces bone strength. Cholesterol directly increased osteoblast functional gene expression in vitro. Hypercholesterolaemia increases the risk of high­turnover osteoporosis in men at least in part by excessively promoting the activity of the remodelling pathway. In addition, hypercholesterolaemia damages the bone microstructure, resulting in osteopenia or OP and reduced bone strength, leading to a higher risk of fracture in men. We emphasize the importance of preventing and treating hypercholesterolaemia as well as monitoring bone metabolic markers and BMD in men with hypercholesterolemia for the effective prevention of bone loss and subsequent fracture. In addition, our findings provide a theoretical basis for the development of treatments for high cholesterol­induced osteoporosis in men.


Assuntos
Remodelação Óssea , Hipercolesterolemia/sangue , Osteoporose/sangue , Adulto , Animais , Biomarcadores/sangue , Reabsorção Óssea/sangue , Osso e Ossos/metabolismo , Colágeno Tipo I/sangue , Estudos Transversais , Modelos Animais de Doenças , Humanos , Hipercolesterolemia/complicações , Masculino , Pessoa de Meia-Idade , Osteoporose/etiologia , Fragmentos de Peptídeos/sangue , Ratos , Ratos Sprague-Dawley
17.
Pharmacol Rep ; 71(3): 417-421, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31003151

RESUMO

BACKGROUND: Individuals with non-classic congenital adrenal hyperplasia (NC-CAH) often show evidence of hyperandrogenism, including premature pubarche, accelerated linear growth velocity, short final height, hirsutism, acne, alopecia, impaired ovulation, menstrual dysfunction and subfertility. Although statins were found to reduce elevated levels of androgens in subjects with this disorder, no previous study has investigated whether 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors affect cardiometabolic risk factors in patients with NC-CAH. METHODS: We studied 12 women with NC-CAH, 6 of whom because of coexisting hypercholesterolemia received atorvastatin (20-40 mg daily). Circulating levels of lipids, glucose homeostasis markers, plasma levels of androgens, 17-hydroxyprogesterone, high-sensitivity C-reactive protein (hsCRP), uric acid, fibrinogen, homocysteine and 25-hydroxyvitamin D, as well as urinary albumin-to-creatinine ratio (UACR) were determined at the beginning of the study and 12 weeks later. RESULTS: Beyond affecting plasma lipids, atorvastatin reduced circulating levels of testosterone, dehydroepiandrosterone sulphate, androstenedione and 17-hydroxyprogesterone, and decreased free androgen index. Moreover, atorvastatin caused a decrease in plasma levels/urinary loss of uric acid, hsCRP, homocysteine and UACR, and insignificantly increased circulating levels of 25-hydroxyvitamin D. The drug produced no effect on plasma fibrinogen. The effect of atorvastatin on hsCRP, uric acid, homocysteine, 25-hydroxyvitamin D and UACR correlated with the magnitude of reduction in 17-hydroxyprogesterone and androgens. CONCLUSION: Our results suggest that statin therapy reduces cardiometabolic risk in women with NC-CAH.


Assuntos
Hiperplasia Suprarrenal Congênita/tratamento farmacológico , Atorvastatina/farmacologia , Doenças Cardiovasculares/induzido quimicamente , Hiperplasia Suprarrenal Congênita/sangue , Hiperplasia Suprarrenal Congênita/metabolismo , Adulto , Androgênios/sangue , Androgênios/metabolismo , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Sulfato de Desidroepiandrosterona/sangue , Feminino , Fibrinogênio/metabolismo , Homocisteína/sangue , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Hipercolesterolemia/sangue , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/metabolismo , Projetos Piloto , Fatores de Risco , Testosterona/sangue , Ácido Úrico/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue
18.
Chin Med J (Engl) ; 132(9): 1079-1086, 2019 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-30870265

RESUMO

BACKGROUND: Endothelial dysfunction, the initial pathogenic factor in atherosclerosis, can be alleviated via transient limb ischemia. We observed the effects of regular transient limb ischemia (RTLI) on atherosclerosis in hypercholesterolemic rabbits. METHODS: Twenty-eight rabbits were randomized to control, cholesterol, sham, ischemia groups (n = 7 each) between October 2010 and March 2011. They were fed a normal diet in the control group and hypercholesterolemic diet in other groups for 12 weeks. Six cycles of RTLI were performed once per day on the ischemia group. Serum samples were prepared to measure the total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) before the experiment (W0), at the end of weeks 4, 8, 12 (W4, W8, W12). The whole aorta was harvested at W12 and stained using Sudan IV to identify the plaque. The plaque area was measured using Image J. Results were analyzed by analysis of variance or rank sum test. RESULTS: Concentrations of TC in the cholesterol group were higher than those in the control group at W4 (29.60 [23.75, 39.30] vs. 1.00 [0.80, 1.55], Z = -2.745, P = 0.006), W8 (41.78 [28.08, 47.37] vs. 0.35 [0.10, 0.68], Z = -2.739, P = 0.006), W12 (48.32 [40.04, 48.95] vs. 0.61 [0.50, 0.86], Z = -2.739, P = 0.006). Similar results were obtained for HDL-C and LDL-C. Serum concentrations of TC, HDL-C, and LDL-C in the hypercholesterolemic groups had no differences (all P > 0.05). The percentage of plaque area in the cholesterol group was higher than that in the control group (47.22 ±â€Š23.89% vs. 0, Z = -2.986, P = 0.003). Square root of the percentage of plaque area was smaller in the ischemia group than that in the cholesterol (0.44 ±â€Š0.13 vs. 0.67 ±â€Š0.18, P = 0.014) or sham groups (0.44 ±â€Š0.13 vs. 0.61 ±â€Š0.12, P = 0.049). CONCLUSION: In hypercholesterolemic rabbits, RTLI might prevent atherosclerosis progression by reducing the percentage of plaque area.


Assuntos
Aterosclerose/sangue , Aterosclerose/prevenção & controle , Extremidades/patologia , Hipercolesterolemia/sangue , Ataque Isquêmico Transitório/sangue , Pós-Condicionamento Isquêmico/métodos , Animais , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Masculino , Coelhos , Triglicerídeos/sangue
19.
Atheroscler Suppl ; 36: 6-11, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30876532

RESUMO

BACKGROUND AND AIMS: Achilles tendon lesions have long been associated with genetic defects in lipid metabolism and increased risk of cardiovascular diseases (CVD). With this study we aimed to evaluate the usefulness of Achilles tendon ultrasonography in identifying people at greater risk among subjects with severe hypercholesterolemia (SH) in a high-risk population. METHODS: During the period of 2016-2017 a total of 213 participants were enrolled in this case-control study. Data of 110 patients with SH and 103 age and sex matched controls without dyslipidaeplemia and established CVD was collected. RESULTS: Achilles tendinopathy (AT) was present in 42.7% of subjects with SH and in 29.1% of controls (p = 0.039). Stronger association between SH and AT was seen in women - 24.1% vs 2.0% (p = 0.001). SH increased odds of AT by 1.815 (95% CI, 1.028-3.206). Prevalence of AT was higher in males despite presence (SH+) or absence (SH-) of severe hypercholesterolemia (SH+ 60.7% vs 24.1%, SH- 55.8% vs 2.0%, p < 0.001). AT was associated with higher proportion of subjects exceeding normal mean values of TC (80.5% vs 52.9%, p = 0.001), LDL-C (76.6% vs 52.2%), TG (54.5% vs. 22.1%), ApoB (57.1% vs 22.2%), ApoE (44.0% vs 22.4%) levels and ApoB/ApoA ratio (46.1% vs 21.5%) (p = 0.001) and family history of premature coronary heart disease (CHD). CONCLUSIONS: AT is more prevalent among subjects with SH and is associated with higher levels of TC, TG, LDL-C, ApoB, ApoE, ApoB/ApoA ratio, family history of premature CHD. SH increases the odds of developing AT.


Assuntos
Tendão do Calcâneo/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Hipercolesterolemia/sangue , Tendinopatia/diagnóstico por imagem , Ultrassonografia , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiologia , Lituânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Tendinopatia/epidemiologia
20.
N Engl J Med ; 380(11): 1022-1032, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30865796

RESUMO

BACKGROUND: Short-term studies have shown that bempedoic acid, an inhibitor of ATP citrate lyase, reduces levels of low-density lipoprotein (LDL) cholesterol. Data are limited regarding the safety and efficacy of bempedoic acid treatment in long-term studies involving patients with hypercholesterolemia who are receiving guideline-recommended statin therapy. METHODS: We conducted a randomized, controlled trial involving patients with atherosclerotic cardiovascular disease, heterozygous familial hypercholesterolemia, or both. Patients had to have an LDL cholesterol level of at least 70 mg per deciliter while they were receiving maximally tolerated statin therapy with or without additional lipid-lowering therapy. (Maximally tolerated statin therapy was defined as the highest intensity statin regimen that a patient was able to maintain, as determined by the investigator.) Patients were randomly assigned in a 2:1 ratio to receive bempedoic acid or placebo. The primary end point was safety, and the principal secondary end point (principal efficacy end point) was the percentage change in the LDL cholesterol level at week 12 of 52 weeks. RESULTS: The trial involved 2230 patients, of whom 1488 were assigned to receive bempedoic acid and 742 to receive placebo. The mean (±SD) LDL cholesterol level at baseline was 103.2±29.4 mg per deciliter. The incidence of adverse events (1167 of 1487 patients [78.5%] in the bempedoic acid group and 584 of 742 [78.7%] in the placebo group) and serious adverse events (216 patients [14.5%] and 104 [14.0%], respectively) did not differ substantially between the two groups during the intervention period, but the incidence of adverse events leading to discontinuation of the regimen was higher in the bempedoic acid group than in the placebo group (162 patients [10.9%] vs. 53 [7.1%]), as was the incidence of gout (18 patients [1.2%] vs. 2 [0.3%]). At week 12, bempedoic acid reduced the mean LDL cholesterol level by 19.2 mg per deciliter, representing a change of -16.5% from baseline (difference vs. placebo in change from baseline, -18.1 percentage points; 95% confidence interval, -20.0 to -16.1; P<0.001). Safety and efficacy findings were consistent, regardless of the intensity of background statin therapy. CONCLUSIONS: In this 52-week trial, bempedoic acid added to maximally tolerated statin therapy did not lead to a higher incidence of overall adverse events than placebo and led to significantly lower LDL cholesterol levels. (Funded by Esperion Therapeutics; CLEAR Harmony ClinicalTrials.gov number, NCT02666664.).


Assuntos
LDL-Colesterol/sangue , Ácidos Dicarboxílicos/uso terapêutico , Ácidos Graxos/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , ATP Citrato (pro-S)-Liase/antagonistas & inibidores , Idoso , Apolipoproteínas B/sangue , Proteína C-Reativa/análise , Colesterol/sangue , Ácidos Dicarboxílicos/efeitos adversos , Quimioterapia Combinada , Ácidos Graxos/efeitos adversos , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/sangue , Hipoglicemiantes/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Resultado do Tratamento
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