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1.
Braz. j. biol ; 83: e248755, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1350303

RESUMO

Abstract Consuming a high-fat diet causes a harmful accumulation of fat in the liver, which may not reverse even after switching to a healthier diet. Different reports dealt with the role of purslane as an extract against high-fat diet; meanwhile, it was necessary to study the potential role of fresh purslane as a hypolipidemic agent. This study is supposed to investigate further the potential mechanism in the hypolipidemic effect of fresh purslane, by measuring cholesterol 7a-hydroxylase (CYP7A1) and low-density lipoprotein receptor (Ldlr). Rats were divided into two main groups: the first one is the normal control group (n=7 rats) and the second group (n=28 rats) received a high fat diet for 28 weeks to induce obesity. Then the high fat diet group was divided into equal four subgroups. As, the positive control group still fed on a high fat diet only. Meanwhile, the other three groups were received high-fat diet supplemented with a different percent of fresh purslane (25, 50 and 75%) respectively. At the end of the experiment, rats were sacrificed and samples were collected for molecular, biochemical, and histological studies. Current study reported that, supplementation of fresh purslane especially at a concentration of 75% play an important role against harmful effects of high-fat diet at both cellular and organ level, by increasing CYP7A1 as well as Ldlr mRNA expression. Also, there were an improvement on the tested liver functions, thyroid hormones, and lipid profile. Fresh purslane plays the potential role as a hypolipidemic agent via modulation of both Ldlr and Cyp7A, which will point to use fresh purslane against harmful effects of obesity.


Resumo O consumo de uma dieta rica em gordura causa um acúmulo prejudicial de gordura no fígado, que pode não reverter mesmo após a mudança para uma dieta mais saudável. Diferentes relatórios trataram do papel da beldroega como um extrato contra uma dieta rica em gordura; entretanto, foi necessário estudar o papel potencial da beldroega fresca como agente hipolipemiante. Este estudo pretende investigar mais profundamente o mecanismo potencial no efeito hipolipidêmico da beldroega fresca, medindo o colesterol 7a-hidroxilase (CYP7A1) e o receptor de lipoproteína de baixa densidade (Ldlr). Os ratos foram divididos em dois grupos principais: o primeiro é o grupo controle normal (n = 7 ratos) e o segundo grupo (n = 28 ratos) recebeu dieta rica em gorduras por 28 semanas para induzir a obesidade. Em seguida, o grupo de dieta rica em gordura foi dividido em quatro subgrupos iguais. Como, o grupo de controle positivo ainda se alimentava apenas com dieta rica em gordura. Enquanto isso, os outros três grupos receberam dieta rica em gordura suplementada com diferentes porcentagens de beldroegas frescas (25%, 50% e 75%), respectivamente. Ao final do experimento, os ratos foram sacrificados e amostras coletadas para estudos moleculares, bioquímica e histológicos. O estudo atual relatou que a suplementação de beldroegas frescas, especialmente a uma concentração de 75%, desempenha papel importante contra os efeitos prejudiciais da dieta rica em gordura em nível celular e orgânico, aumentando a expressão de CYP7A1 e Ldlr mRNA. Além disso, houve melhora nas funções hepáticas testadas, nos hormônios tireoidianos e no perfil lipídico. Beldroegas frescas desempenham papel potencial como agente hipolipemiante por meio da modulação de Ldlr e Cyp7A, o que apontará para o uso de beldroegas frescas contra os efeitos nocivos da obesidade.


Assuntos
Animais , Ratos , Portulaca , Dieta Hiperlipídica/efeitos adversos , Hipolipemiantes , Colesterol 7-alfa-Hidroxilase , Ratos Sprague-Dawley , Fígado
2.
Diabetes Metab J ; 46(4): 517-532, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35929170

RESUMO

Statins are the cornerstone of the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). However, even under optimal statin therapy, a significant residual ASCVD risk remains. Therefore, there has been an unmet clinical need for novel lipid-lowering agents that can target low-density lipoprotein cholesterol (LDL-C) and other atherogenic particles. During the past decade, several drugs have been developed for the treatment of dyslipidemia. Inclisiran, a small interfering RNA that targets proprotein convertase subtilisin/kexin type 9 (PCSK9), shows comparable effects to that of PCSK9 monoclonal antibodies. Bempedoic acid, an ATP citrate lyase inhibitor, is a valuable treatment option for the patients with statin intolerance. Pemafibrate, the first selective peroxisome proliferator-activated receptor alpha modulator, showed a favorable benefit-risk balance in phase 2 trial, but the large clinical phase 3 trial (PROMINENT) was recently stopped for futility based on a late interim analysis. High dose icosapent ethyl, a modified eicosapentaenoic acid preparation, shows cardiovascular benefits. Evinacumab, an angiopoietin-like 3 (ANGPTL3) monoclonal antibody, reduces plasma LDL-C levels in patients with refractory hypercholesterolemia. Novel antisense oligonucleotides targeting apolipoprotein C3 (apoC3), ANGPTL3, and lipoprotein(a) have significantly attenuated the levels of their target molecules with beneficial effects on associated dyslipidemias. Apolipoprotein A1 (apoA1) is considered as a potential treatment to exploit the athero-protective effects of high-density lipoprotein cholesterol (HDL-C), but solid clinical evidence is necessary. In this review, we discuss the mode of action and clinical outcomes of these novel lipid-lowering agents beyond statins.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Dislipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases , Proteína 3 Semelhante a Angiopoietina , Proteínas Semelhantes a Angiopoietina , Aterosclerose/tratamento farmacológico , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/complicações , LDL-Colesterol , Dislipidemias/complicações , Dislipidemias/tratamento farmacológico , Fatores de Risco de Doenças Cardíacas , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/uso terapêutico , Pró-Proteína Convertase 9/uso terapêutico , Fatores de Risco
3.
Pak J Pharm Sci ; 35(3): 777-784, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35791476

RESUMO

Globally, cardiovascular diseases (CVD) are one of the most significant cause of organ failure, mortality and substantial escalation of health care cost. Dyslipidemia and hypertension poses significant risks in cardiovascular diseases and morbidity and mortality can be minimized by altering risks factors. Dyslipidemia is one of the major leading cause of rise of global incidences and socioeconomic burden which necessitates to explore the pharmacological options of significant antilipemic activity with minimal untoward effects at affordable price. Allium Sativum (Garlic) proved medicinally effective in different clinical trials, but further investigations are required to investigate its effects on diabetes, hypertension and dyslipidemia based on variable doses and duration. In this study dose and duration dependent effects of Garlic were evaluated on hypertensive patients with dyslipidemia. Study was randomized, single blind and placebo controlled. Effects of tablets of garlic (KWAI) 300 mg in doses of daily 0.3g, 0.6g, 0.9g, 1.2g and 1.5g for 24 weeks were compared in humans. Each tablet contains 1.3 percent of alliin and 0.6 % of allicin. Results showed remarkable improvements in different serum lipid levels (Cholesterol, Triglycerides, Low density lipoproteins and High density lipoproteins) based on different doses and duration as compared to placebo and standard Lipid-lowering agent simvastatin.


Assuntos
Produtos Biológicos , Doenças Cardiovasculares , Dislipidemias , Alho , Doenças Hematológicas , Hipertensão , Antioxidantes , Dislipidemias/tratamento farmacológico , Hipertensão Essencial , Humanos , Hipertensão/tratamento farmacológico , Hipolipemiantes , Lipoproteínas HDL , Método Simples-Cego
4.
Front Biosci (Landmark Ed) ; 27(7): 206, 2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35866393

RESUMO

INTRODUCTION: Boesenbergia rotunda is a famous culinary/medicinal herb native to Southeast Asia region and it is traditionally used in the treatment of several diseases. This study investigated the anti-diabetic properties of Boesenbergia rotunda polyphenol extract (BRE) in high fructose/streptozotocin-induced diabetic rats. METHOD: The in vitro antioxidant activity was evaluated using DPPH and ABST colorimetric assays, while the Folin-Ciocalteu method was used for the total phenolic content of BRE. For diabetes induction, a combination of high fructose solution and streptozotocin was administered to the rats and diabetic rats were orally administrated with BRE (100 and 400 mg/kg) for 5 weeks. The fasting blood glucose, body weight gain, food and water consumption were determined during the treatment period. RESULTS: BRE showed excellent in vitro DPPH and ABTS scavenging activity with high phenolic content. BRE significantly lowered fasting blood glucose level, HbA1c, lipid profile, hepatorenal biochemical parameters and ameliorated the IPGTT in diabetic rats. Additionally, BRE reversed body weight loss, attenuated food and water intake, serum insulin level, pancreatic ß-cell function and pancreatic cell morphology. Furthermore, fructose 1,6 biphosphatase, glucose-6-phosphatase, malondialdehyde (MDA) and proinflammatory cytokines levels were also ameliorated in the BRE-treated diabetic rats, while pancreatic antioxidant enzymes activities (GSH, SOD and CAT) were significantly increased in the treated rats. CONCLUSIONS: In conclusion, the results showed that BRE effectively displayed antidiabetic effects and has possible value for antidiabetic oral medication.


Assuntos
Diabetes Mellitus Experimental , Zingiberaceae , Animais , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico , Glicemia/metabolismo , Metabolismo dos Carboidratos , Frutose , Hipoglicemiantes/farmacologia , Hipolipemiantes/farmacologia , Fenóis/efeitos adversos , Polifenóis/farmacologia , Ratos , Estreptozocina/efeitos adversos , Zingiberaceae/metabolismo
5.
Kardiologiia ; 62(6): 57-62, 2022 Jun 30.
Artigo em Russo | MEDLINE | ID: mdl-35834343

RESUMO

Inclisiran is a novel hypolipidemic drug that inhibits synthesis of the PCSK9 protein through the process called RNA interference. Inclisiran is a double-stranded, modified RNA bound to the N-acetylgalactosamine (GalNAc) carbohydrate molecule, a ligand of the acialoglycoprotein receptor, that is expressed by hepatocytes. After entering hepatocytes, inclisiran cleaves matrix RNA and, thereby, reduces the PCSK9 protein synthesis. This, in turn, enhances the uptake of circulating low-density lipoproteins (LDL) by specific receptors on hepatocytes, thereby lowering LDL levels in circulation. Efficacy and safety of inclisiran for lowering LDL cholesterol (C) in blood and its effect on the risk of clinical complications of atherosclerosis have been studied in the ORION program that includes multiple clinical trials. According to results of this program, inclisiran effectively reduces both LDL-C levels and the incidence of cardiovascular complications in the absence of clinically significant adverse reactions. An important advantage of inclisiran compared with other lipid-lowering drugs is the administration schedule (twice a year), which allows a considerable improvement of patients' compliance with the treatment and also of the effectiveness of the hypolipidemic treatment.


Assuntos
Anticolesterolemiantes , Pró-Proteína Convertase 9 , Anticolesterolemiantes/efeitos adversos , LDL-Colesterol , Humanos , Hipolipemiantes/efeitos adversos , RNA Interferente Pequeno/efeitos adversos
6.
Chin J Physiol ; 65(3): 125-135, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35775531

RESUMO

Cajanus cajan (L.) Millsp., known as pigeon pea, is one of the major grain legume crops of the tropical world. It recognizes as an ethnomedicine to possess various functions, such as helping in healing wound and cancer therapy. We investigated whether 95% ethanol extracts from C. cajan root (EECR) protect against methylglyoxal (MGO)-induced insulin resistance (IR) and hyperlipidemia in male Wistar rats and explored its possible mechanisms. The hypoglycemic potential of EECR was evaluated using α-amylase, α-glucosidase activities, and advanced glycation end products (AGEs) formation. For in vivo study, the rats were divided into six groups and orally supplemented with MGO except for Group 1 (controls). Group 2 was supplemented with MGO only, Group 3: MGO + metformin, Group 4: MGO + Low dose-EECR (L-EECR; 10 mg/kg bw), Group 5: MGO + Middle dose-EECR (M-EECR; 50 mg/kg bw), and Group 6: MGO + High dose-EECR (H-EECR; 100 mg/kg bw). EECR possessed good inhibition of α-glucosidase, α-amylase activities, and AGEs formation (IC50 = 0.12, 0.32, and 0.50 mg/mL), respectively. MGO significantly increased serum levels of blood glucose (GLU), glycosylated hemoglobin, homeostasis model assessment of IR, AGEs, lipid biochemical values, and atherogenic index, whereas EECR decreased these levels in a dose-dependent manner. EECR can also act as an insulin sensitizer, which significantly decreased (47%, P < 0.05) the blood GLU levels after intraperitoneal injection of insulin in the insulin tolerance tests. The hypoglycemic and antihyperlipidemic mechanisms of EECR are likely through several possible pathways including the inhibition of carbohydrate-hydrolyzing enzymes (α-glucosidase and α-amylase) and the enhancement of MGO-trapping effects on inhibition of AGEs formation.


Assuntos
Cajanus , Diabetes Mellitus Experimental , Animais , Cajanus/metabolismo , Diabetes Mellitus Experimental/tratamento farmacológico , Produtos Finais de Glicação Avançada/metabolismo , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Hipolipemiantes/farmacologia , Hipolipemiantes/uso terapêutico , Insulina , Óxido de Magnésio , Masculino , Aldeído Pirúvico/metabolismo , Aldeído Pirúvico/farmacologia , Ratos , Ratos Wistar , alfa-Amilases , alfa-Glucosidases
8.
J Feline Med Surg ; 24(8): e251-e257, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35713593

RESUMO

OBJECTIVES: The aim of this study was to assess the short-term safety and efficacy of fenofibrate in controlling secondary hypertriglyceridemia in cats. METHODS: This was a prospective cohort study. Seventeen adult cats with hypertriglyceridemia (serum triglycerides [TG] >160 mg/dl) were enrolled. Cats received a median dose of 5 mg/kg (range 3.2-6) fenofibrate (q24h PO) for 1 month. Serum TG, total cholesterol (TC), creatine kinase and liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) were evaluated before (t0) and after 1 month (t1) of fenofibrate treatment. RESULTS: The causes of secondary hypertriglyceridemia were diabetes mellitus (DM; 29.4%), obesity (29.4%), hyperadrenocorticism (HAC) and DM (11.7%), HAC without DM (5.9%), hypersomatotropism (HST) and DM (5.9%), hypothyroidism (5.9%), long-term treatment with glucocorticoids (5.9%) and chylothorax (5.9%). Serum TG (t0 median 920 mg/dl [range 237-1780]; t1 median 51 mg/dl [range 21-1001]; P = 0.0002) and TC (t0 median 278 mg/dl [range 103-502]; t1 median 156 mg/dl [range 66-244]; P = 0.0001) concentrations showed a significant decrease after 1 month of fenofibrate treatment. Fifteen cats normalized their TG concentration at t1 (88.2%). Of the eight cats that were hypercholesterolemic at t0, six (75%) normalized their TC concentrations at t1. One of 17 cats (5.9 %) presented with diarrhea; the remaining 16 did not show any adverse effects. CONCLUSIONS AND RELEVANCE: DM and obesity are the most common endocrine causes of secondary hyperlipidemia, although it can also be found in cats with HAC, HST or hypothyroidism. This study suggests that fenofibrate treatment was associated with reduction and normalization of TG and TC concentrations in cats with moderate and severe hypertriglyceridemia, regardless of the cause of secondary hypertriglyceridemia. Further work should focus on controlled studies with a greater number of cases.


Assuntos
Doenças do Gato , Fenofibrato , Hipertrigliceridemia , Hipotireoidismo , Obesidade , Animais , Doenças do Gato/induzido quimicamente , Doenças do Gato/tratamento farmacológico , Gatos , Fenofibrato/uso terapêutico , Humanos , Hipertrigliceridemia/tratamento farmacológico , Hipertrigliceridemia/veterinária , Hipolipemiantes/uso terapêutico , Hipotireoidismo/complicações , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/veterinária , Obesidade/veterinária , Estudos Prospectivos , Triglicerídeos
9.
Stroke ; 53(7): 2161-2170, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35658483

RESUMO

Hyperlipidemia is common in patients with intracerebral hemorrhage (ICH). Accumulating evidence indicates that patients with ICH are at risk for future hemorrhage recurrence, cardiovascular disease, and ischemic stroke and highlights the importance of secondary prevention of vascular events after ICH. Although the benefits of intensive treatment of hyperlipidemia for reducing ischemic cardiac and vascular events in patients with ischemic stroke are well established, the benefit versus harm in patients with ICH are less clear. Epidemiological studies suggest that hyperlipidemia is protective against ICH and that intensive lowering of lipids is associated with increased risk for ICH. Similarly, although currently available lipid-lowering treatments have been thoroughly studied in patients with ischemic cardiac and vascular disease, only few randomized trials of these therapies included a very small number of patients with history of ICH. Thus, limiting any definitive conclusions regarding the safety and net benefit of these treatments in ICH populations. Currently, there is no consensus regarding the optimal strategy for management of hyperlipidemia after ICH. In this article, we review relevant literature to outline the competing risks and benefits of lipid-lowering treatments in this vulnerable patient population. We suggest a treatment paradigm based on available data but note that data from dedicated randomized trials are needed to build the necessary evidence to guide optimal lipid-lowering strategy in patients with a history of ICH.


Assuntos
Hiperlipidemias , AVC Isquêmico , Acidente Vascular Cerebral , Hemorragia Cerebral/epidemiologia , Humanos , Hiperlipidemias/complicações , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Lipídeos/uso terapêutico , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
10.
PLoS One ; 17(6): e0269953, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35737711

RESUMO

BACKGROUND: Individuals with hyperlipidemia are two times more likely to develop atherosclerotic cardiovascular disease (ASCVD) as opposed to those with controlled serum total cholesterol (TC) levels. Considering the documented adverse events of the current lipid-lowering medications which ultimately affect patient's compliance, substantial efforts have been made to develop new therapeutic strategies. Probiotics, on the other hand, are reported to have lipid-lowering activity with the added benefit of being generally well-tolerated making it an appealing adjuvant therapy. METHODS: A total of fifty Lactic acid bacteria (LAB) were isolated from raw milk (human and animal) and dairy products. Isolates demonstrating promising in vitro cholesterol removal capabilities were morphologically and biochemically characterized. Lastly, two bacterial candidates were selected for evaluation of their potential hypolipidemic activity using a laboratory animal model. Statistical differences between the means were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. A p-value < 0.05 was considered statistically significant. RESULTS: Most of the isolates demonstrated an in vitro cholesterol removal activity. The six LAB isolates showing the highest cholesterol removal activity (36.5-55.6%) were morphologically and biochemically identified as Lactobacillus, Pediococcus, and Lactococcus species. The results demonstrated two promising antihyperlipidemic candidates, a Lactococcus lactis ssp. lactis with an in vivo significant reduction of serum triglycerides (TG) levels by 34.3%, and a Pediococcus sp. that was able to significantly reduce both the serum TC and TG levels by 17.3% and 47.0%, respectively, as compared to the diet-induced hyperlipidemic animal group. CONCLUSION: This study further supports the growing evidence regarding the antihyperlipidemic activity among probiotics, presenting them as a promising therapeutic approach for the management of hyperlipidemia.


Assuntos
Hiperlipidemias , Lactobacillales , Lactococcus lactis , Probióticos , Animais , Colesterol , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/farmacologia , Hipolipemiantes/uso terapêutico , Pediococcus , Probióticos/uso terapêutico
11.
J Ethnopharmacol ; 296: 115473, 2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-35718052

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Loquat (Eriobotrya japonica (Thunb.) Lindl.) is an evergreen tree native to China, which is introduced in many Mediterranean countries. As in many ancient medical systems, loquat leaves have been used in Moroccan traditional medicine to treat diabetes and its complications. AIM OF THE STUDY: This study aims to determine the nutritional and polyphenol composition and to evaluate the in vivo antidiabetic, and antihyperlipidemic properties and oral toxicity of a leaf aqueous extract (LLE) derived from loquat grown in Morocco. MATERIALS AND METHODS: Energy value and fiber, fatty acids, minerals, vitamins, total carbohydrate, sugar, lipid, and protein contents were determined according to international methods committee guidelines. Polyphenol profiling was carried out using the HPLC-DAD method. Mice fed a high-fat and high-glucose (HFG) diet for 10 weeks were used as a model to assess the antidiabetic and antihyperlipidemic effects of a daily administration of LLE at three different doses (150, 200, 250 mg/kg body weight (BW)/day), in comparison with metformin (50 mg/kg BW/day) and pravastatin (20 mg/kg BW/day). The oral toxicity was determined following OECD 425 Guideline. RESULTS: Loquat leaves were found to be rich in fiber, minerals (potassium, calcium, magnesium, iron, and sodium), and vitamins (B2, B6, and B12) and lower in energy, sugar, and fat. Ten different phenolic compounds were characterized. Naringenin, procyanidin C1, epicatechin, and rutin were the more abundant compounds in LLE. The administration of the LLE dose-dependently ameliorated hyperglycemia, insulin resistance, oxidative stress, and hyperlipidemia in HFG diet-fed mice. The median lethal dose of LLE was higher than 5000 mg/kg BW. CONCLUSIONS: Loquat leaves are a potential source of micronutrients and polyphenols with beneficial effects on diabetes and its complications.


Assuntos
Eriobotrya , Animais , Hipoglicemiantes/uso terapêutico , Hipoglicemiantes/toxicidade , Hipolipemiantes/uso terapêutico , Hipolipemiantes/toxicidade , Camundongos , Minerais , Valor Nutritivo , Folhas de Planta , Polifenóis/uso terapêutico , Polifenóis/toxicidade , Açúcares , Vitaminas
12.
Ars pharm ; 63(2)abr.-jun. 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202810

RESUMO

Introducción: La alfabetización en salud es una medida de la capacidad de los pacientes de leer, comprender y tomar decisiones en base a instrucciones médicas. La inadecuada alfabetización se asocia a un peor estado de salud en pacientes con enfermedades crónicas. El momento de la dispensación podría ser una oportunidad para evaluar esta condición por el farmacéutico de atención primariaEl objeto de este estudio fue evaluar la relación de alfabetización en salud y los valores de colesterol total y comorbilidades en personas con prescripción de hipolipemiantes atendidos en un centro de jubilados.Método:Se diseñó un estudio prospectivo donde se evaluó la relación de la alfabetización utilizando Short Assessment of Health Literacy for Spanish-speaking Adults y el valor de colesterol , medicamentos , factores de riesgo y comorbilidades. Todas estas variables se analizaron en forma integrada en un análisis multivariado. Resultados: Participaron 178 pacientes, 63% mujeres. El puntaje promedio de SAHLSA fue 43,4 ± 5,5. Se encontró una inadecuada alfabetización en 24%. pacientes El valor promedio de colesterol en estre grupo de pacientes fue 235,17mg/dl vs 193,53mg/dl quienes tenian adecuada alfabetización en salud.Se realizó un análisis multivariado que mostró asociación entre inadecuada alfabetización en salud, bajo nivel de educación y conocimiento del paciente . El número de internaciones y la aparición de eventos coronarios fueron significativamente mayor en los pacientes con alfabetización en salud insuficiente. Conclusiones: Se encontró relación directa entre el grado de alfabetización en salud y los valores de colesterol total en pacientes en tratamiento por hipercolesterolemia (AU)


Introduction: Health literacy is a measure of the ability of patients to read, understand and make decisions based on medical instructions. Inadequate health literacy is associated with poorer health in patients with chronic diseases. Time of dispensing could be an opportunity for the primary care pharmacist to evaluate this condition by the. The purpose of this study was to evaluate the relationship of Health literacy and the values of total cholesterol and comorbidities in people with a prescription of lipid-lowering drugs treated in a retirement center. Method: A prospective study was designed where the relationship of Health literacy was evaluated using Short Assessment of Health Literacy for Spanish-speaking Adults and the value of cholesterol, medications, risk factors and comorbidities. All these variables were analyzed in an integrated manner in a multivariate analysis.Results:178 patients participated, 63% women. The mean SAHLSA score was 43.4 ± 5.5. Inadequate HL was found in 24%. patients.The mean cholesterol value in patients with inadequate Health literacy was 235.17mg / dl vs 193.53mg / dl among those with adequate Health literacy.A multivariate analysis was performed that showed an association between inadequate Health literacy, the level of education and the patient’s knowledge of normal values of total cholesterol. The number of hospitalizations and the occurrence of coronary events were significantly higher in patients with insufficient Health literacy. Conclusions: A direct relationship was found between the degree of Health literacy and total cholesterol values in patients undergoing treatment for hypercholesterolemia (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Letramento em Saúde , Atenção Primária à Saúde , Hipolipemiantes/uso terapêutico , Colesterol/sangue , Hipercolesterolemia/tratamento farmacológico , Assistência Farmacêutica , Estudos Prospectivos , Fatores de Risco , Análise Multivariada , Comorbidade , Escolaridade , Estudos Transversais
13.
Rev. esp. cardiol. (Ed. impr.) ; 75(6): 506-514, Jun. 2022. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-205108

RESUMO

Introducción y objetivos: La puntuación de calcio arterial coronario (CAC) mejora la precisión de la estratificación del riesgo de enfermedad cardiovascular ateroesclerótica (ECVA) en comparación con los factores de riesgo cardiovascular tradicionales. Se evaluó la interacción de la carga ateroesclerótica coronaria determinada por la puntuación de CAC con el beneficio pronóstico de los tratamientos hipolipemiantes en el contexto de la prevención primaria. Métodos: Se revisaron las bases de datos MEDLINE, EMBASE y Cochrane en busca de estudios que incluyeran a individuos sin ECVA previa y con datos sobre la puntuación de CAC y el tratamiento hipolipemiante según los valores de CAC. El objetivo primario fue la aparición de ECVA. Se evaluó el efecto del tratamiento hipolipemiante agrupado y estratificado por grupos de CAC (0, 1-100 y> 100) mediante un modelo de efectos aleatorios. Resultados: Se incluyeron 5 estudios (1 aleatorizado, 2 de cohortes prospectivas y 2 retrospectivas) que incluyeron a 35.640 individuos (el 38,1% mujeres) con medias de edad de 62,2 (rango, 49,6-68,9) años, colesterol unido a lipoproteínas de baja densidad de 128 (114-146) mg/dl y seguimiento de 4,3 (2,3-11,1) años. La aparición de la ECVA aumentó de manera constante en los estratos crecientes de CAC tanto en los pacientes con como en aquellos sin tratamiento hipolipemiante. Al comparar a los pacientes con (34,9%) y sin (65,1%) exposición al tratamiento hipolipemiante, este se asoció con menos aparición de ECVA en los pacientes con CAC> 100 (OR=0,70; IC95%, 0,53-0,92), pero no en aquellos con CAC de 1-100 o 0. Los resultados concordaron al agrupar los datos ajustados. Conclusiones: Entre los individuos sin ECVA previa, una puntuación de CAC> 100 identifica a los sujetos con mayor probabilidad de beneficiarse del tratamiento hipolipemiante, mientras que un CAC indetectable indica ausencia de beneficio (AU)


Introduction and objectives: Coronary artery calcium (CAC) score improves the accuracy of risk stratification for atherosclerotic cardiovascular disease (ASCVD) events compared with traditional cardiovascular risk factors. We evaluated the interaction of coronary atherosclerotic burden as determined by the CAC score with the prognostic benefit of lipid-lowering therapies in the primary prevention setting. Methods: We reviewed the MEDLINE, EMBASE, and Cochrane databases for studies including individuals without a previous ASCVD event who underwent CAC score assessment and for whom lipid-lowering therapy status stratified by CAC values was available. The primary outcome was ASCVD. The pooled effect of lipid-lowering therapy on outcomes stratified by CAC groups (0, 1-100,> 100) was evaluated using a random effects model. Results: Five studies (1 randomized, 2 prospective cohort, 2 retrospective) were included encompassing 35 640 individuals (female 38.1%) with a median age of 62.2 [range, 49.6-68.9] years, low-density lipoprotein cholesterol level of 128 (114-146) mg/dL, and follow-up of 4.3 (2.3-11.1) years. ASCVD occurrence increased steadily across growing CAC strata, both in patients with and without lipid-lowering therapy. Comparing patients with (34.9%) and without (65.1%) treatment exposure, lipid-lowering therapy was associated with reduced occurrence of ASCVD in patients with CAC> 100 (OR, 0.70; 95%CI, 0.53-0.92), but not in patients with CAC 1-100 or CAC 0. Results were consistent when only adjusted data were pooled. Conclusions: Among individuals without a previous ASCVD, a CAC score> 100 identifies individuals most likely to benefit from lipid-lowering therapy, while undetectable CAC suggests no treatment benefit (AU)


Assuntos
Humanos , Calcificação Vascular/tratamento farmacológico , Lipídeos/sangue , Doença da Artéria Coronariana/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Fatores de Risco
14.
J Food Drug Anal ; 30(1): 77-87, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35647727

RESUMO

Since the combinatorial components responsible for the antihyperlipidemic activity of Citrus reticulata 'Chachi' (CRC) peels remains unclear, we herein developed a bioactive equivalence oriented feedback screening method to discover the bioactive equivalent combinatorial components (BECCs) from CRC peels. Using palmitic acid (PA)-stimulated hepatocyte model, a combination of 5 polymethoxyflavones (PMFs) including tangeretin, sinensetin, nobiletin, 5,7,8,4'-tetramethoxyflavone and 3,5,6,7,8,3',4'-heptamethoxyflavone was identified to be responsible for the antihyperlipidemic effect of CRC peels. Via evaluation of combination effect by combination index (CI), these 5 PMFs were found to take effect via a synergistic mode. Our data indicated that the antihyperlipidemic mechanism of PMF combination was associated with the inhibition of fatty acid and cholesterol synthesis, and inflammation. Also, the PMF combination exhibited robust antihyperlipidemic effects in HFD-fed rats in vivo. Our study offers evidence-based data to uncover the pharmacological effect of CRC peels.


Assuntos
Citrus , Animais , Hipolipemiantes/farmacologia , Extratos Vegetais/farmacologia , Ratos
17.
Sci Rep ; 12(1): 10478, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35729323

RESUMO

The aim of the study was to evaluate the prevalence, distribution and correlates of dyslipidaemia among people (15-69 years) in Mongolia. National data were analyzed from 4,895 individuals (15-69 years, median age = 35 years) that took part in the Mongolia cross-sectional STEPS survey in 2019, and had complete lipid measurements. Dyslipidaemia was defined using the guidelines of the Adult Treatment Panel III. The prevalence of dyslipidaemia was 58.6%, 31.7% high triglycerides (TG), 26.9% high low-density lipoprotein cholesterol (LDL-C), 26.9% high total cholesterol (TC) and 14.6% low high-density lipoprotein cholesterol (HDL-C). Among those with dyslipidaemia, 6.2% were aware. Among those who were aware, the proportion of lipid-lowering drug treatment was 18.9% and among those who took lipid-lowering drugs, 21.5% had their dyslipidaemia controlled. In adjusted logistic regression, older age (40-69 years) (AOR: 1.19, 95% CI 1.02-1.40), urban residence (AOR: 1.24, 95% CI 1.04-1.48), obesity call II (AOR: 2.89, 95% CI 2.29-3.66), hypertension (AOR: 1.33, 95% CI 1.11-1.59), and diabetes (AOR: 1.62, 95% CI 1.20-2.18) were positively, and male sex (AOR: 0.84, 95% CI 0.72-1.00) was negatively associated with dyslipidaemia prevalence. Six in ten Mongolians 15 years and older had dyslipidaemia. Several factors associated with dyslipidaemia that can be used to target public health interventions were identified.


Assuntos
Dislipidemias , Adulto , Colesterol , HDL-Colesterol , Estudos Transversais , Dislipidemias/complicações , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia , Humanos , Hipolipemiantes/uso terapêutico , Masculino , Mongólia/epidemiologia , Prevalência , Fatores de Risco , Triglicerídeos
18.
Int J Mol Sci ; 23(11)2022 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-35682613

RESUMO

Bile acid metabolism, involved with the digestion and absorption of nutrients in the gut, is linked to the gut microbiota community, greatly impacting the host's metabolism. We examined the hypothesis that the modulation of bile acid metabolism by dietary fat contents, gallbladder removal (GBX; cholecystectomy), and bile acid sequestrant (BAS; cholestyramine) treatment could alter energy, glucose, and lipid metabolism through the changes in the gut microbiota. Mice were randomly assigned to the following six groups: (1) Sham GBX surgery (Sham) + low fat/high carbohydrate diet (LFD), (2) Sham + high fat diet (HFD), (3) Sham + HFD + BAS, (4) GBX + LFD, (5) GBX + HFD, and (6) GBX + HFD + BAS. BAS groups received 2% cholestyramine. After an 8-week intervention, energy, glucose, and lipid metabolism, and the gut microbiota community were measured. HFD groups exhibited higher body weight gain than LFD, and GBX increased the weight gain comped to Sham groups regardless of BAS in HFD (p < 0.05). Homeostatic model assessment for insulin resistance (HOMA-IR) was higher in HFD than LFD, and GBX increased it regardless of BAS. Serum lipid profiles were worsened in GBX + HFD compared to Sham + LFD, whereas BAS alleviated them, except for serum HDL cholesterol. Hepatic tumor-necrosis-factor-α (TNF-α) mRNA expression and lipid peroxide contents increased with GBX and BAS treatment compared to Sham and no BAS treatment (p < 0.05). Hepatic mRNA expression of sterol regulatory element-binding transcription factor 1c (SREBP1c) and peroxisome proliferator-activated receptor gamma (PPAR-γ) exhibited the same trend as that of tumor necrosis factor-α (TNF-α). The α-diversity of gut bacteria decreased in GBX + HFD and increased in GBX + HFD + BAS. Akkermentia, Dehalobacterium, SMB53, and Megamonas were high in the Sham + LFD, and Veillonella and Streptococcus were rich in the Sham + HFD, while Oscillospira and Olsenella were high in Sham + HFD + BAS (p < 0.05). GBX + LFD increased Lactobacillus and Sutterella while GBX + HFD + BAS elevated Clostridium, Alistipes, Blautia, Eubacterium, and Coprobacillus (p < 0.05). In conclusion, the modulation of bile acid metabolism influences energy, glucose, and lipid metabolisms, and it might be linked to changes in the gut microbiota by bile acid metabolism modulation.


Assuntos
Gorduras na Dieta , Microbioma Gastrointestinal , Animais , Ácidos e Sais Biliares/metabolismo , Colecistectomia , Resina de Colestiramina/metabolismo , Resina de Colestiramina/farmacologia , Dieta Hiperlipídica/efeitos adversos , Gorduras na Dieta/farmacologia , Glucose/metabolismo , Hipolipemiantes/farmacologia , Metabolismo dos Lipídeos , Fígado/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , RNA Mensageiro/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Aumento de Peso
19.
J Lipid Res ; 63(7): 100233, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35605678

RESUMO

Saroglitazar, being a dual PPAR-α/γ agonist, has shown beneficial effect in diabetic dyslipidemia and hypertriglyceridemia. Fibrates are commonly used to treat severe hypertriglyceridemia. However, the effect of saroglitazar in patients with moderate to severe hypertriglyceridemia was not evaluated. We conducted a study to compare the efficacy and safety of saroglitazar (4 mg) with fenofibrate (160 mg) in patients with moderate to severe hypertriglyceridemia. This was a multicenter, randomized, double-blinded, double-dummy, active-control, and noninferiority trial in adult patients with fasting triglyceride (TG) levels of 500-1,500 mg/dl. The patients were randomized in a 1:1 ratio to receive daily dose of saroglitazar or fenofibrate for 12 weeks. The primary efficacy end point was the percent change in TG levels at week 12 relative to baseline. The study comprised of 41 patients in the saroglitazar group and 41 patients in the fenofibrate group. We found that the percent reduction from baseline in TG levels at week 12 was significantly higher in the saroglitazar group (least square mean = -55.3%; SE = 4.9) compared with the fenofibrate group (least square mean = -41.1%; SE = 4.9; P = 0.048). Overall, 37 treatment-emergent adverse events (AEs) were reported in 24 patients (saroglitazar: 13; fenofibrate: 11). No serious AEs were reported, and no patient discontinued the study because of AEs. We conclude that saroglitazar (4 mg) is noninferior to fenofibrate (160 mg) in reducing TG levels after 12 weeks of treatment, was safe, and well tolerated.


Assuntos
Fenofibrato , Hiperlipidemias , Hipertrigliceridemia , Fenilpropionatos , Adulto , Método Duplo-Cego , Fenofibrato/efeitos adversos , Humanos , Hipertrigliceridemia/induzido quimicamente , Hipertrigliceridemia/tratamento farmacológico , Hipolipemiantes/efeitos adversos , Fenilpropionatos/efeitos adversos , Pirróis/efeitos adversos , Triglicerídeos
20.
Curr Atheroscler Rep ; 24(7): 547-556, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35499807

RESUMO

PURPOSE OF REVIEW: Despite the elevation of lipid values during pregnancy is mostly physiological, evidence suggest that it may be associated with adverse events. This article reviews the characteristics of lipid disorders and the possible management with dyslipidemia in pregnant women. RECENT FINDINGS: Among many available groups of lipid-lowering drugs, only bile acid sequestrants are approved for the treatment of dyslipidemia during pregnancy. Ezetimibe and fenofibrate might be considered if benefits outweigh the potential risk. Statins are still contraindicated due to the results mainly from animal studies and series of human cases. However, recent systematic reviews and meta-analyses showed that their use may not be detrimental, and in some selected cases may be beneficial. Especially, in some groups of pregnant patients with very high cardiovascular risk-those already after an event, or with established cardiovascular disease, with homozygous familial hypercholesterolemia; in such cases the final decision should weight the potential risk of discontinuation of therapy. Finally, we need to wait for the data with new drugs, including PCSK9 inhibitors and especially inclisiran, which (still hypothetically) might be a very interesting option as it may be used just before the pregnancy and immediately after with the duration of about 9 months between injections. The decisions on lipid-lowering therapy in pregnant patients should be individualized. Despite design and ethical difficulties with such studies, further investigations on dyslipidemia treatment during pregnancy are highly awaited.


Assuntos
Anticolesterolemiantes , Dislipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases , Animais , Anticolesterolemiantes/uso terapêutico , LDL-Colesterol , Dislipidemias/tratamento farmacológico , Ezetimiba/uso terapêutico , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/uso terapêutico , Guias de Prática Clínica como Assunto , Gravidez , Complicações na Gravidez/tratamento farmacológico , Pró-Proteína Convertase 9
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