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1.
Int J Med Sci ; 18(15): 3533-3543, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34522180

RESUMO

Importance: Despite the availability of a vaccine against the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), humans will have to live with this virus and the after-effects of the coronavirus disease 2019 (COVID-19) infection for a long time. Cholesterol plays an important role in the infection and prognosis of SARS-CoV-2, and the study of its mechanism is of great significance not only for the treatment of COVID-19 but also for research on generic antiviral drugs. Observations: Cholesterol promotes the development of atherosclerosis by activating NLR family pyrin domain containing 3 (NLRP3), and the resulting inflammatory environment indirectly contributes to COVID-19 infection and subsequent deterioration. In in vitro studies, membrane cholesterol increased the number of viral entry sites on the host cell membrane and the number of angiotensin-converting enzyme 2 (ACE2) receptors in the membrane fusion site. Previous studies have shown that the fusion protein of the virus interacts with cholesterol, and the spike protein of SARS-CoV-2 also requires cholesterol to enter the host cells. Cholesterol in blood interacts with the spike protein to promote the entry of spike cells, wherein the scavenger receptor class B type 1 (SR-B1) plays an important role. Because of the cardiovascular protective effects of lipid-lowering therapy and the additional anti-inflammatory effects of lipid-lowering drugs, it is currently recommended to continue lipid-lowering therapy for patients with COVID-19, but the safety of extremely low LDL-C is questionable. Conclusions and Relevance: Cholesterol can indirectly increase the susceptibility of patients to SARS-CoV-2 and increase the risk of death from COVID-19, which are mediated by NLRP3 and atherosclerotic plaques, respectively. Cholesterol present in the host cell membrane, virus, and blood may also directly participate in the virus cell entry process, but the specific mechanism still needs further study. Patients with COVID-19 are recommended to continue lipid-lowering therapy.


Assuntos
COVID-19/complicações , Hipercolesterolemia/complicações , Enzima de Conversão de Angiotensina 2/metabolismo , Antivirais/uso terapêutico , Aterosclerose/fisiopatologia , COVID-19/diagnóstico , COVID-19/tratamento farmacológico , COVID-19/terapia , Membrana Celular/metabolismo , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Endocitose , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/terapia , Inflamação , Macrófagos/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/sangue , Prognóstico , SARS-CoV-2 , Receptores Depuradores Classe B/metabolismo
2.
Nutrients ; 13(9)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34579005

RESUMO

There is an increasing number of nutraceutical combinations (NCs) on the market for hypercholesterolemia, although clinical trials to verify their safety and efficacy are scarce. We selected fourteen randomized, placebo-controlled clinical trials (RCTs) on different lipid-lowering NCs in hypercholesterolemic subjects. We described each compound's mechanism of action and efficacy in the mixtures and summarized the clinical trials settings and NCs safety and efficacy results. Almost all NCs resulted efficient against hypercholesterolemia; only one reported no changes. Interestingly, red yeast rice (RYR) was present in eleven mixtures. It is not clear whether the lipid-lowering efficacy of these combinations derives mainly from the RYR component monacolin K "natural statin" single effect. Up to now, few RCTs have verified the efficacy of every single compound vs. NCs to evaluate possible additive or synergistic effects, probably due to the complexity and the high resources request. In conclusion, to manage the arising nutraceutical tide against hypercholesterolemia, it could be helpful to increase the number and robustness of clinical studies to verify the efficacy and safety of the new NCs.


Assuntos
Suplementos Nutricionais , Hipercolesterolemia/terapia , Hipolipemiantes/uso terapêutico , Adulto , Idoso , Produtos Biológicos/uso terapêutico , LDL-Colesterol/sangue , Feminino , Humanos , Hipercolesterolemia/sangue , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Vitaminas/uso terapêutico
3.
Clin Investig Arterioscler ; 33 Suppl 1: 25-32, 2021 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33966809

RESUMO

The lipid theory of atherosclerosis dates back more than a century. Despite this, some authors have questioned the relevance of hypercholesterolaemia in its development. Multiple experimental, epidemiological, and clinical evidence underpins this association. Atherosclerotic cardiovascular disease remains as the major cause of mortality in the world. Recent genetic studies of Mendelian randomisation and randomised clinical trials aimed at LDL cholesterol reduction, are summarised in this article. They, unequivocally ratify the aetiological role of LDL cholesterol in the development of atherosclerosis. Thus, LDL cholesterol lowering is the cornerstone of lipid lowering therapy for the reduction of cardiovascular complications of atherosclerosis.


Assuntos
Aterosclerose/sangue , LDL-Colesterol/sangue , Hipercolesterolemia/complicações , Aterosclerose/mortalidade , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Humanos , Hipercolesterolemia/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Int J Mol Sci ; 22(3)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525627

RESUMO

Hypercholesterolemia is an independent risk factor of cardiovascular disease, which is among the major causes of death worldwide. The aim of this study was to explore whether Bifidobacterium longum strains exerted intra-species differences in cholesterol-lowering effects in hypercholesterolemic rats and to investigate the potential mechanisms. SD rats underwent gavage with each B. longum strain (CCFM 1077, I3, J3 and B3) daily for 28 days. B. longum CCFM 1077 exerted the most potent cholesterol-lowering effect, followed by B. longum I3 and B3, whereas B. longum B3 had no effect in alleviating hypercholesterolemia. Divergent alleviation of different B. longum strains on hypercholesterolemia can be attributed to the differences in bile salt deconjugation ability and cholesterol assimilation ability in vitro. By 16S rRNA metagenomics analysis, the relative abundance of beneficial genus increased in the B. longum CCFM 1077 treatment group. The expression of key genes involved in cholesterol metabolism were also altered after the B. longum CCFM 1077 treatment. In conclusion, B. longum exhibits strain-specific effects in the alleviation of hypercholesterolemia, mainly due to differences in bacterial characteristics, bile salt deconjugation ability, cholesterol assimilation ability, expressions of key genes involved in cholesterol metabolism and alterations of gut microbiota.


Assuntos
Bactérias/classificação , Bifidobacterium longum/fisiologia , Colesterol/efeitos adversos , Hipercolesterolemia/terapia , Análise de Sequência de DNA/métodos , Animais , Bactérias/genética , Bactérias/isolamento & purificação , Bifidobacterium longum/classificação , Colesterol/análise , DNA Bacteriano/genética , DNA Ribossômico/genética , Modelos Animais de Doenças , Fezes/microbiologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Hipercolesterolemia/induzido quimicamente , Hipercolesterolemia/genética , Hipercolesterolemia/microbiologia , Metagenômica , RNA Ribossômico 16S/genética , Ratos , Ratos Sprague-Dawley , Especificidade da Espécie
6.
Int J Biol Macromol ; 173: 66-78, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33482208

RESUMO

Lactobacilli probiotics have been suggested to reduce cholesterol with low side effects to host. Bacteriocins and exopolysaccharides (EPSs) production are two meaningful examples of functional applications of lactobacilli in the food industry. Eight Lactobacillus strains were isolated from some Egyptian fermented food and tested for their probiotic properties. Analysis of the monosaccharide composition by thin layer chromatography showed the presence of glucose, galactose and unknown sugar. The main functional groups of EPSs were elucidated by Fourier-Transform Infrared Spectroscopy. Their fermentation cultures displayed powerful antioxidant activities extending from 97.5 to 99%, 40-75% for their EPSs and free cells, respectively, and exhibited in vitro cholesterol downgrading from 48 to 82% and 72 to 91% after 48 and 120 h, respectively. Their EPSs showed good anticancer activities against carcinoma cells with low IC50 values for HCT-116, PC-3 and HepG-2 cells. To the best of our knowledge, there have been no previous reports on the potential of Lactobacillus EPSs activity against PC-3. The selected strains, L. plantarum KU985433 and L. rhamnosus KU985436 produced two different bacteriocins as detected by gel permeation chromatography with good antimicrobial activities. In vivo study demonstrated that feeding Westar rats with fermented milk exhibited greater cholesterol, LDL and blood triglyceride reduction for both strains. Whereas, HDL was increased by about 43 and 38%, respectively, and the atherogenic indices decreased.


Assuntos
Anticolesterolemiantes/farmacologia , Antineoplásicos/farmacologia , Antioxidantes/farmacologia , Hipercolesterolemia/terapia , Polissacarídeos Bacterianos/farmacologia , Probióticos/farmacologia , Animais , Anticolesterolemiantes/isolamento & purificação , Antineoplásicos/isolamento & purificação , Antioxidantes/isolamento & purificação , Bacteriocinas , Sobrevivência Celular/efeitos dos fármacos , HDL-Colesterol/agonistas , HDL-Colesterol/metabolismo , LDL-Colesterol/antagonistas & inibidores , LDL-Colesterol/metabolismo , Modelos Animais de Doenças , Egito , Alimentos e Bebidas Fermentados/microbiologia , Células HCT116 , Células Hep G2 , Humanos , Hipercolesterolemia/metabolismo , Hipercolesterolemia/patologia , Lactobacillus plantarum/química , Lactobacillus plantarum/metabolismo , Lactobacillus rhamnosus/química , Lactobacillus rhamnosus/metabolismo , Masculino , Células PC-3 , Polissacarídeos Bacterianos/isolamento & purificação , Probióticos/isolamento & purificação , Ratos , Ratos Wistar , Triglicerídeos/antagonistas & inibidores , Triglicerídeos/metabolismo
7.
Appl Microbiol Biotechnol ; 105(1): 287-299, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33128611

RESUMO

Gut microbiota modulation by a probiotic is a novel therapy for hypercholesterolemia mitigation. This study initially investigated the potential hypocholesterolemic effect of Bacillus sp. DU-106 in hypercholesterolemic rats and explored its potential relation with gut microbiota. Sprague-Dawley rats received a high-fat diet, or a high-fat diet supplemented with 7.5 × 109 and 1.5 × 1010 CFU/kg bw/day Bacillus sp. DU-106 (low-dose and high-dose groups). At the end of 9 weeks, Bacillus sp. DU-106 treatment significantly decreased the body weight, liver index, and total cholesterol. 16S rRNA sequencing showed that Bacillus sp. DU-106 intervention significantly increased bacterial richness and particularly increased the genus abundance of Turicibacter, Acinetobacter, Brevundimonas, and Bacillus and significantly decreased the abundance of Ralstonia. Metabolomic data further indicated that the supplementation of Bacillus sp. DU-106 remarkably changed the gut metabolic profiles of hypercholesterolemic rats and, in particular, elevated the metabolites of indole-3-acetate, methylsuccinic acid, creatine, glutamic acid, threonine, lysine, ascorbic acid, and pyridoxamine. Spearman's correlation analysis showed the close relation between the different genera and metabolites. In conclusion, Bacillus sp. DU-106 supplement ameliorated high-fat diet-induced hypercholesterolemia and showed potential probiotic benefits for the intestine. KEY POINTS: • A novel potential probiotic Bacillus sp. DU-106 ameliorated hypercholesterolemia in rats. • Bacillus sp. DU-106 supplement regulated gut microbiome structure and richness. • Bacillus sp. DU-106 supplement changed metabolic profiles in high-fat diet rats. • Significant correlations were observed between differential genera and metabolites.


Assuntos
Bacillus , Microbioma Gastrointestinal , Hipercolesterolemia , Animais , Dieta Hiperlipídica/efeitos adversos , Suplementos Nutricionais , Disbiose , Hipercolesterolemia/terapia , RNA Ribossômico 16S/genética , Ratos , Ratos Sprague-Dawley
8.
Clin Exp Nephrol ; 25(1): 1-8, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32857255

RESUMO

BACKGROUND: Patients with diabetes mellitus and severe proteinuria present with poor renal prognoses, despite improvements in diabetes and kidney disease therapies. In this study, we designed a low-density lipoprotein (LDL)-cholesterol apheresis treatment for patients with diabetic nephropathy (DN)/diabetic kidney disease and severe proteinuria. This was a multicenter prospective LICENSE study to confirm the impact of LDL apheresis on proteinuria that exhibited hyporesponsiveness to treatment. In addition, we sought to determine the efficacy and safety of LDL apheresis by comparing the outcomes to those of historical controls in patients with diabetes, refractory hypercholesterolemia, and severe proteinuria. METHODS: This was a prospective, multicenter study, including 40 patients with diabetes, severe proteinuria, and dyslipidemia. LDL apheresis was performed 6-12 times over a 12-week period. The primary endpoint was the proportion of patients with a decrease in proteinuria excretion of at least 30% in the 6 months after starting therapy. The secondary endpoints included serum creatinine levels and laboratory variables, which were evaluated 4, 6, 12, 18, and 24 months after therapy initiation. RESULTS: LDL apheresis was performed on 40 registered patients with diabetes. The proportion of cases in which proteinuria decreased by 30% or more after 6 months of LDL apheresis was 25%, which was similar to that of historical controls. The overall survival and end-stage kidney disease-free survival rates were significantly higher in the LICENSE group compared to those in historical controls. CONCLUSION: Our results suggest that LDL apheresis may be effective and safe for patients with diabetes, proteinuria, and dyslipidemia. TRIAL REGISTRATION: Trial registration number: jRCTs042180076.


Assuntos
Remoção de Componentes Sanguíneos , Nefropatias Diabéticas/terapia , Hipercolesterolemia/terapia , Proteinúria/terapia , Proteinúria/urina , Idoso , Remoção de Componentes Sanguíneos/efeitos adversos , LDL-Colesterol/sangue , Creatinina/sangue , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/complicações , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Proteinúria/sangue , Proteinúria/etiologia , Taxa de Sobrevida
9.
Life Sci ; 264: 118633, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33190783

RESUMO

AIMS: Hypercholesterolemia remains a critical risk factor for cardiovascular diseases and there is an urgent need to develop effective alternative therapeutics. Herein, we investigated the effects of miR-128-3p inhibition on serum cholesterol levels using a hypercholesterolemic mouse model. MATERIALS AND METHODS: Five injections of anti-miR-128-3p (AM-128) treatment were given, and the cholesterol profile in serum and liver was quantified. We validated the underlying gene network using qRT-PCR, western blotting, ELISA, and dual luciferase assays. KEY FINDINGS: AM-128 treatment inhibits cholesterol biosynthesis by upregulating INSIG1 and downregulating HMGCR (3-hydroxy-3-methylglutaryl-CoA reductase) expression. The serum cholesterol clearance by SR-B1 (scavenger receptor class B member 1) and LDLR (low density lipoprotein receptors) was also increased. Furthermore, the catabolism of cholesterol by CYP7A1 (cytochrome P450 family 7 subfamily A member 1) was increased. SIGNIFICANCE: Our results confirmed a critical role of miR-128-3p inhibition in lowering serum cholesterol and suggest its potential therapeutic implications in reversing hypercholesterolemia.


Assuntos
Hipercolesterolemia/genética , MicroRNAs/genética , Animais , Doenças Cardiovasculares/prevenção & controle , Linhagem Celular Tumoral , Colesterol/sangue , Colesterol/metabolismo , Colesterol 7-alfa-Hidroxilase/metabolismo , Modelos Animais de Doenças , Fibrose/metabolismo , Células Hep G2 , Humanos , Hipercolesterolemia/metabolismo , Hipercolesterolemia/terapia , Interferon gama/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Lipídeos/química , Fígado/metabolismo , Masculino , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/antagonistas & inibidores , Fatores de Risco
10.
Clin Investig Arterioscler ; 33(1): 41-52, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33309071

RESUMO

During pregnancy there is a physiological increase in total cholesterol (TC) and triglycerides (TG) plasma concentrations, due to increased insulin resistance, oestrogens, progesterone, and placental lactogen, although their reference values are not exactly known, TG levels can increase up to 300mg/dL, and TC can go as high as 350mg/dL. When the cholesterol concentration exceeds the 95th percentile (familial hypercholesterolaemia (FH) and transient maternal hypercholesterolaemia), there is a predisposition to oxidative stress in foetal vessels, exposing the newborn to a greater fatty streaks formation and a higher risk of atherosclerosis. However, the current treatment of pregnant women with hyperlipidaemia consists of a diet and suspension of lipid-lowering drugs. The most prevalent maternal hypertriglyceridaemia (HTG) is due to secondary causes, like diabetes, obesity, drugs, etc. The case of severe HTG due to genetic causes is less prevalent, and can be a higher risk of maternal-foetal complications, such as, acute pancreatitis (AP), pre-eclampsia, preterm labour, and gestational diabetes. Severe HTG-AP is a rare but potentially lethal pregnancy complication, for the mother and the foetus, usually occurs during the third trimester or in the immediate postpartum period, and there are no specific protocols for its diagnosis and treatment. In conclusion, it is crucial that dyslipidaemia during pregnancy must be carefully evaluated, not just because of the acute complications, but also because of the future cardiovascular morbidity and mortality of the newborn child. That is why the establishment of consensus protocols or guidelines is essential for its management.


Assuntos
Hipercolesterolemia/epidemiologia , Hipertrigliceridemia/epidemiologia , Complicações na Gravidez/epidemiologia , Colesterol/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Dislipidemias/terapia , Feminino , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/terapia , Hipertrigliceridemia/diagnóstico , Hipertrigliceridemia/terapia , Recém-Nascido , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Resultado da Gravidez , Triglicerídeos/sangue
11.
J Alzheimers Dis ; 78(3): 1011-1017, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33074232

RESUMO

BackgroundEngagement in behaviors aimed at reducing the risk of developing dementia is a leading recommendation in most National Dementia Strategy programs. OBJECTIVE: In an effort to advance knowledge regarding the implementation of this recommendation, the current study examined the perceptions and engagement of the adult population in Israel regarding behaviors aimed at reducing the risk of developing dementia, and its correlates. METHODS: A cross-sectional survey was conducted among 502 Israeli adults aged 40 and over. Approximately half of the participants (51.2%) were female, and the majority (80.1%) were Jewish. RESULTS: Overall, while the percentage of participants reporting that the examined activities were important for brain health was moderate, percentages reporting engaging in these behaviors were low. The most important correlate of engagement in health behaviors was participants' perceptions about the importance of these behaviors for their brain health. Increased age, being Jewish, and enhanced perceived susceptibility to develop dementia were also significantly associated with increased engagement in behaviors to reduce the risk of dementia. CONCLUSION: The results of this study emphasize the need to develop intervention programs aimed at promoting engagement in behaviors to reduce the risk of dementia development. These programs will benefit from assessing participants' perceived importance of these behaviors, and from identifying the needs of unique groups, such as older persons and those pertaining to ethno-cultural groups.


Assuntos
Demência/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Comportamento de Redução do Risco , Adulto , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas , Árabes , Peso Corporal , Demência/epidemiologia , Dieta , Suscetibilidade a Doenças , Exercício Físico , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Hipercolesterolemia/terapia , Hipertensão/terapia , Israel/epidemiologia , Judeus , Masculino , Pessoa de Meia-Idade , Percepção , Risco , Abandono do Hábito de Fumar/estatística & dados numéricos
14.
Food Funct ; 11(8): 7217-7230, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32760938

RESUMO

Citrus peel essential oil (CPEO) contains abundant volatile compounds and exhibits fragrance properties and beneficial pharmacological effects on humans. Herein, we aimed to investigate the effects of CPEO on the prevention of hypercholesterolemia and hepatic steatosis in high-fat diet-fed rats and identify its possible regulatory mechanisms in lipid metabolism by combining lipidomics with gene expression analysis. CPEO at effective supplementation levels of 0.5% and 0.75% significantly ameliorated hypercholesterolemia and hepatic steatosis, including decreased serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), hepatic TC and triglyceride (TG) levels, and hepatic lipid droplet accumulation. Lipidomics analysis revealed that the total levels of fatty acid (FFA), TG and cholesteryl ester (CE) classes in the liver tissue were remarkably decreased after 0.75% CPEO supplementation some of which (3 TGs and 4 CEs) might emerge as potential lipid biomarkers in response to the effects of CPEO. Furthermore, these lipidomics findings were associated with downregulation of lipogenesis-related genes SREBP-1c, ACC and FAS and upregulation of bile acid biosynthesis-related genes LXRα, CYP7A1 and CYP27A1 in the liver. This study indicated that CPEO could effectively prevent hypercholesterolemia and hepatic steatosis, possibly because of its mediation of lipid and cholesterol homeostasis by altering liver lipid metabolites and regulating lipid metabolism-related genes.


Assuntos
Citrus , Gorduras Insaturadas na Dieta/farmacologia , Hipercolesterolemia/terapia , Hepatopatia Gordurosa não Alcoólica/terapia , Óleos Voláteis/farmacologia , Animais , Biomarcadores/análise , Colesterol/sangue , Suplementos Nutricionais , Modelos Animais de Doenças , Homeostase/efeitos dos fármacos , Hipercolesterolemia/metabolismo , Lipidômica , Lipídeos/análise , Lipogênese/efeitos dos fármacos , Fígado/metabolismo , Masculino , Hepatopatia Gordurosa não Alcoólica/metabolismo , Ratos , Ratos Sprague-Dawley
15.
Praxis (Bern 1994) ; 109(10): 755-762, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32752965

RESUMO

CME: Primary and Secondary Hypercholesterolemia Abstract. In patients with hypercholesterolemia and an LDL-cholesterol level >5 mmol/l, familial hypercholesterolemia (primary hypercholesterolemia) should be considered. This genetically determined illness should lead to medical therapy and screening for hypercholesterinemia in close relatives. Beside the superelevated LDL-cholesterol levels, additional clinically diagnostic findings and family anamnesis can support the diagnosis of familial hypercholesterolemia. The likelihood of familial hypercholesterolemia can be estimated using the Lipid Clinic Network Score. Additionally, a variety of exogenous factors may have an impact on lipoprotein metabolism and may lead to secondary hypercholesterolemia. Hypothyroidism, cholestasis, nephrotic syndrome or specific medications, among others, should be considered as potential factors leading to high cholesterol levels before familial hypercholesterolemia is suspected or lipid-lowering treatment is started.


Assuntos
Hipercolesterolemia , Hiperlipoproteinemia Tipo II , LDL-Colesterol , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/terapia , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/terapia , Lipídeos , Programas de Rastreamento
16.
G Ital Cardiol (Rome) ; 21(8): 619-628, 2020 Aug.
Artigo em Italiano | MEDLINE | ID: mdl-32686789

RESUMO

The world's population is ageing; however, the prolonged life expectancy is barely associated with an increase of healthy aging, and an important part of this demographic shift is a rising susceptibility to development and progressive accumulation of multiple chronic illness, challenging healthcare systems. Aging, therefore, represents the major risk factor for multimorbidity, a milestone for progressive loss of resilience and age-related multisystem homeostatic dysregulation. Cardiovascular risk factors, time and comorbidities play a vicious role in the development of heart disease. Among the other comorbidities, age itself is one of the most important risk factors for the development of cardiovascular disease and the prevalence and incidence of cardiovascular disease in the elderly are significantly increased. Elderly subjects, particularly when frail and with comorbidities, however, are scarcely represented in primary and secondary prevention trial aimed to treat hypercholesterolemia, diabetes mellitus and arterial hypertension. In particular, concerns exist about whether treatment should more or less intensive according to tolerability and risk of interactions; as well as there is uncertainty about therapeutic targets at different ages.This article reviews the relationship between ageing and cardiovascular disease, focusing on several issues regarding cardiovascular prevention in the elderly.


Assuntos
Envelhecimento/fisiologia , Doenças Cardiovasculares/prevenção & controle , Idoso , Doenças Cardiovasculares/etiologia , Diabetes Mellitus/terapia , Fatores de Risco de Doenças Cardíacas , Humanos , Hipercolesterolemia/complicações , Hipercolesterolemia/terapia , Hipertensão/complicações , Hipertensão/terapia , Incidência , Prevalência
17.
Asia Pac J Clin Nutr ; 29(2): 423-433, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32674250

RESUMO

BACKGROUND AND OBJECTIVES: Notable inter-individual differences in cholesterol-lowering effects following oatmeal consumption have been previously reported. Genetic variations may among the reasons for the heterogeneous response to lipid modulations. And to determine whether SNP of cytochrome P450 family 7 subfamily A member 1 gene rs3808607 and isoforms of apolipoprotein E are associated with the inter-individual variations in cholesterol-lowering effects of oatmeal consumption, we did this study. METHODS AND STUDY DESIGN: Data in this study were extracted from a parallel, controlled trial, in which 62 medication-naive hypercholesterolemic patients provided with staple food substitute of either 80 g/d oatmeal (n=31) or 80 g/d refined white rice (n=31) for 45 days. Fasting blood samples were collected at baseline and endpoint of the study for lipid profiling, glycemic testing, and genotyping. RESULTS: Totally, 56 of 62 participants completed the study and were thus included. Genotype- diet interactions were observed between oatmeal consumption and SNP in the cytochrome P450 family 7 subfamily A member 1 gene rs3808607 in regulating LDL cholesterol (p=0.04); rs3808607-TT homozygotes exhibited significantly higher responsiveness to oatmeal (reduction in LDL cholesterol) than G allele carriers (GG/GT) (p=0.02). However, obvious genotype-diet interactions were not observed between oatmeal consumption and apolipoprotein E isoforms in cholesterol and glycemic modulation (p>0.05). CONCLUSIONS: SNP in cytochrome P450 family 7 subfamily A member 1 gene rs3808607 was associated with the extent of LDL cholesterol reduction following oatmeal consumption. Trials with larger sample sizes are required to confirm the findings.


Assuntos
Avena , Colesterol 7-alfa-Hidroxilase/genética , LDL-Colesterol/sangue , Hipercolesterolemia/genética , Adulto , Grupo com Ancestrais do Continente Asiático , China , Feminino , Predisposição Genética para Doença , Humanos , Hipercolesterolemia/terapia , Masculino , Pessoa de Meia-Idade
18.
Am J Cardiol ; 128: 28-34, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32650921

RESUMO

Involvement of atherosclerosis in extracardiac vascular territories may identify coronary artery disease (CAD) patients at higher risk for adverse events. We investigated the long-term prognostic implications of polyvascular disease in patients with CAD, and further analyzed lipid goal attainment and its relation to patient outcomes. The study was a retrospective analysis of 10,297 patients who underwent coronary revascularization, categorized as having CAD alone (83.1%) or with multisite artery disease (MSAD) (16.9%) including cerebrovascular disease (CBVD) and/or peripheral artery disease (PAD). Incidence rates and hazard ratios (HR) for major adverse cardiovascular events (MACE) (myocardial infarction, ischemic stroke, or all-cause death) according to vascular territories involved, and in relation to most-recent lipid levels attained, were analyzed. Patients with MSAD were older with higher burden of co-morbidities. The rate of MACE (myocardial infarction, ischemic stroke, or all-cause death) and its individual components increased with the number of affected vascular beds. Adjusted HR (95% confidence interval) for MACE was 1.41 (1.24 to 1.59) in patients with CAD and CBVD, 1.46 (1.33 to 1.62) in CAD and PAD, and 1.69 (1.49 to 1.92) in those with CAD and CBVD and PAD, compared with CAD alone. Most-recent low-density lipoprotein cholesterol (LDL-C) levels <55 mg/dl and <70 mg/dl were attained by 21.8% and 44.6% of patients with CAD alone, in comparison to 22.7% and 43.3% in MSAD. Compared with patients with most-recent LDL-C > 100 mg/dl, attaining LDL-C < 70 mg/dl had an adjusted HR for MACE of 0.52 (0.47 to 0.57) in CAD only patients and 0.66 (0.57 to 0.78) in MSAD patients. In conclusion, the presence of CBVD and/or PAD in patients with CAD is associated with higher burden of co-morbidities and progressive increase in long-term MACE. More than half of CAD patients with or without MSAD do not achieve lipid goals, which are associated with a significantly lower risk for adverse events.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Doença da Artéria Coronariana/cirurgia , Hipercolesterolemia/terapia , Infarto do Miocárdio/epidemiologia , Revascularização Miocárdica , Doença Arterial Periférica/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Angina Instável/epidemiologia , Angina Instável/cirurgia , Aneurisma da Aorta Abdominal/epidemiologia , Causas de Morte , LDL-Colesterol/sangue , Comorbidade , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/epidemiologia , Incidência , Israel/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Mortalidade , Infarto do Miocárdio sem Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia
19.
Int J Med Mushrooms ; 22(3): 235-244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479018

RESUMO

Consumption of foods rich in dietary fiber has attracted considerable attention for lowering blood cholesterol and triglycerides through attenuation of gut microbiome. Diets rich in fiber may provide substrates for microbes to digest and proliferate. In response, products of microbial digestion enter systemic circulation and support host energy homeostasis. In the present study, rats with hypercholesterolemia (HC) were supplemented with probiotics (PB) and Agaricus bisporus mushroom to examine the antidyslipidemia effects. Forty adult rats were divided into five treatment groups. The rats in the control group were fed only a chow maintenance diet (CON; n = 8), whereas an atherogenic diet (chow diet supplemented with 1.5% cholesterol and 0.5% cholic acid) was offered to the remaining rats to induce hypercholesterolemia (HC group; n = 32). Rats developed HC following a 24-day continuous supplementation with the atherogenic diet. From day 25 onward, the HC group was further divided into HC-CON, HC-PB (supplemented with PB at 1 mg/rat/day), HC-AB (supplemented with A. bisporus at 5% of diet), and HC-AB.PB (supplemented with both A. bisporus and PB). After 6 weeks of supplementation, rats were killed to collect blood to determine serum lipid profile, oxidative stress, and for metagenomics analysis of colon contents. Results showed that all supplementations corrected HC-induced oxidative stress. Furthermore, A. bisporus supplementation corrected HC-induced dyslipidemia (P ≤ .05). Blautia and Bifidobacterium were the most dominant bacterial genera in HC-AB and HC-PB groups, respectively. Phylum Firmicutes and class Clostridia predominantly occupied the gut microbiome in all groups. However, no significant differences were observed in microbiome diversity and clustering patterns among study groups. In conclusion, supplementation of A. bisporus mushroom and probiotics can lower oxidative stress and dyslipidemia with partial effects on the phylogenetic makeup in the gut microbiome.


Assuntos
Agaricus , Suplementos Nutricionais , Dislipidemias/terapia , Microbioma Gastrointestinal , Hipercolesterolemia/terapia , Probióticos/uso terapêutico , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Colesterol/sangue , Dieta Hiperlipídica , Feminino , Masculino , Metagenômica , Estresse Oxidativo , Filogenia , Ratos , Ratos Wistar , Triglicerídeos/sangue
20.
Biomed Pharmacother ; 128: 110310, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32504921

RESUMO

Recent evidence indicates the use of probiotics in the prevention and treatment of diseases. Probiotics are capable of changing the gut microbiota composition and bile acid synthesis to elicit health benefits such as cholesterol-lowering, weight reduction, and improving insulin sensitivity. The aging population is prone to develop diseases because of their decreased physiological and biological systems. Probiotics are one of the promising supplements that may potentially counteract these detrimental effects. This review will discuss the influence of probiotics on bile acids in different populations-the elderly, obese individuals, and those with hypercholesterolemia, type 2 diabetes, hypertension, and non-alcoholic fatty liver disease.


Assuntos
Envelhecimento/metabolismo , Ácidos e Sais Biliares/metabolismo , Microbioma Gastrointestinal , Intestinos/microbiologia , Probióticos/uso terapêutico , Fatores Etários , Amidoidrolases/metabolismo , Animais , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Hipercolesterolemia/metabolismo , Hipercolesterolemia/microbiologia , Hipercolesterolemia/terapia , Hipertensão/metabolismo , Hipertensão/microbiologia , Hipertensão/terapia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/microbiologia , Hepatopatia Gordurosa não Alcoólica/terapia , Obesidade/metabolismo , Obesidade/microbiologia , Obesidade/terapia , Probióticos/efeitos adversos
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