Effectiveness of early intervention with levothyroxine sodium in pregnancy complicated with hypothyroidism / 中华内分泌外科杂志

Objective:To investigate the effectiveness of early levothyroxine intervention in pregnancy complicated with hypothyroidism.Methods:A retrospective analysis was performed on 132 pregnant patients with hypothyroidism admitted to the Department of Endocrinology, Anyang People’s Hospital from Nov. 2018 to Sep. 2021. Among them, 68 cases with levothyroxine sodium early intervention were included in the intervention group, and 64 cases without intervention were included in the non-intervention group. The differences in vascular endothelial function indexes, thyroid function indexes, and blood lipid indexes before and after treatment in the intervention group were compared with those in the non-intervention group. The incidence of obstetric complications such as preeclampsia, fetal growth restriction, and adverse pregnancy outcomes of abortion and neonatal asphyxia were compared between the two groups. SPSS 21.0 software was used to process data, measurement data were subjected to t test, and enumeration data were subjected to χ 2 test. Results:After treatment, the endothelium-dependent brachial artery blood flow-mediated vasodilation index (FMD) index, nitric oxide (NO) , and endothelin-1 (ET-1) levels in the intervention group were significantly better than those in the non-intervention group [ (10.37%) ±1.54%) vs (7.25% ± 1.09%) , (60.85 ± 7.03) umol/L vs (39.11 ± 4.31) umol/L, (112.96 ± 13.58) umol/L vs (238.85 ± 26.05) umol/L]. After treatment, the serum thyroid stimulating hormone (TSH) in the intervention group was significantly lower than that in the non-intervention group [ (2.25±0.26) mU/L vs (8.79±1.60) mU/L] ( P<0.001) . After treatment, the levels of total cholesterol (TC) , triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) in the intervention group were significantly lower than those in the non-intervention group [ (3.52±0.91) mmol/L vs (6.51±1.31) mmol/L L, (1.30±0.31) mmol/L vs (1.44±0.36) mmol/L, (2.29±0.31) mmol/L vs (3.32±0.44) mmol/L] ( P<0.001, P=0.036, P<0.001) . The incidence of obstetric complications such as preeclampsia, fetal growth restriction, premature rupture of membranes, and abnormal amniotic fluid volume in the intervention group were significantly lower than those in the non-intervention group (5.88% vs 17.19%, 1.47% vs 9.38%, 10.29% vs. 23.44%, 2.94% vs 12.50%) ( P=0.041, 0.043, 0.043, 0.038) ; the incidence of miscarriage, premature birth, neonatal asphyxia, cesarean section and other adverse pregnancy outcomes in the intervention group were significantly lower than those in the non-intervention group (1.47% vs 9.38%, 4.69% vs 15.36%, 2.94% vs 10.94%, 57.35% vs 75.00%) ( P=0.043, 0.031, 0.038, 0.033) . Conclusion:Early intervention with levothyroxine in pregnancy complicated with hypothyroidism is beneficial to improve thyroid function, reduce blood lipid level, protect vascular endothelial function, reduce related obstetric complications, and reduce the incidence of adverse pregnancy outcomes for mothers and infants.

Interaction between Abnormal Prepregnancy Body Mass Index and Hyperlipidemia during Pregnancy on the Risk of Gestational Diabetes Mellitus / 中国医学科学院学报

Objective To explore the interaction between abnormal prepregnancy body mass index(pBMI)and high blood lipid level during pregnancy on the risk of gestational diabetes mellitus(GDM). Methods A total of 235 patients with GDM and no blood lipid-related diseases before pregnancy were selected from Hangzhou Women's Hospital during March 2017 to July 2018 as the GDM group.At a ratio of 1∶3,a total of 705 individual age-matched pregnant women with normal glucose metabolism during prenatal examination from the same hospital were selected as the control group.The generalized multifactor dimension reduction(GMDR)method was employed to characterize the possible interaction between pBMI-blood lipid and GDM.The cross-validation consistency,equilibrium test accuracy,and P value were calculated to evaluate the interaction of each model. Results GMDR model analysis showed that the second-order model including pBMI and gestational blood lipid level had the best performance(P=0.001),with the cross-validation consistency of 10/10 and the equilibrium test accuracy of 64.48%,suggesting that there was a potential interaction between pBMI and gestational high blood lipid level.After adjustment of confounding factors,the model demonstrated that overweight/obesity patients with high triglyceride(TG) level had the highest risk of developing GDM(OR=14.349,95%CI=6.449-31.924,P<0.001).Stratified analysis showed that overweight/obesity patients under high TG level group had a higher risk of developing GDM than normal weight individuals(OR=2.243,95%CI=1.173-4.290,P=0.015). Conclusions Abnormal pBMI and high blood lipid level during pregnancy are the risk factors of GDM and have an interaction between each other.Overweight/obese pregnant women with high TG levels are more likely to develop GDM.

Distribution of ApoE polymorphism and its correlation with blood lipid level and type of coronary heart disease in Shaanxi / 西安交通大学学报(医学版)

【Objective】 To explore the distribution of ApoE polymorphism in Shaanxi province and its correlation with lipid level and coronary heart disease type. 【Methods】 ApoE genotypes in the whole blood of 11 533 patients with cardiovascular diseases admitted to The First Affiliated Hospital of Xi’an Jiaotong University from January 2019 to December 2019 were detected by PCR-fluorescent probe method. Then 3 884 patients with coronary heart disease were selected to detect the lipid level and classified for the analysis of ApoE polymorphism. 【Results】 The proportion of E2/E2, E2/E3, E3/E3, E2/E4, E4/E4 and E3/E4 was 0.69%, 11.66%, 70.31%, 1.17%, 0.83% and 15.34%, respectively. E3 genotype was the highest (71.48%), followed by E4 (16.17%), and E2 was the least (12.35%). There was no statistical difference in the distribution of ApoE polymorphism in patients with cardiovascular disease accompanied with or without coronary heart disease. Compared with those of E2, the total cholesterol (TC) and low-density lipoprotein (LDL-C) levels of E3 and E4 increased significantly (P0.008 3). 【Conclusion】 The polymorphism of ApoE in Shaanxi is mainly E3 type, and there is no statistical difference in the distribution of coronary heart disease and other cardiovascular diseases. ApoE gene polymorphism is correlated with blood lipid level and coronary heart disease, but the relationship with different types of coronary heart disease needs to be further determined.

Meta-analysis of Zhibitai Capsules combined with statin in reducing blood lipid levels in patients with coronary heart disease / 中国中药杂志

To systematically review the efficacy and safety of Zhibitai Capsules combined with chemical drugs versus chemical drugs alone in regulating blood lipid of patients of coronary heart disease, so as to provide evidence-based reference for clinical treatment. In this study, PubMed, EMbase, Cochrane Library, China Knowledge Network Database(CNKI), Technology Journal Database(VIP) and WanFang Database(WanFang) were retrieved to find the randomized controlled trials(RCT) about therapeutic efficacy of Zhibitai Capsules combined with statins(experimental group)versus statins alone(control group)in the treatment of regulating blood lipid of patients with coronary heart disease. The retrieval time was restricted to be from the inception to October 2019. The data were extracted from the randomized controlled trials. Meta-analysis was conducted by RevMan 5.3 statistical software after quality evaluation by Cochrane 5.1.0 quality evaluation tool(blood lipid level, inflammation indicators, traditional Chinese medicine syndrome score and adverse reactions). A total of 11 RCT were included, involving 1 538 patients. The results of Meta-analysis showed that in terms of decrease of total cholesterol(MD=-0.15,95%CI[-0.25,-0.05],P=0.004), decrease of triglycerides improvement(MD=-0.16,95%CI[-0.23,-0.10],P<0.000 01), decrease of low-density lipoprotein(MD=-0.08,95%CI[-0.15,-0.01],P=0.03), and increase of high-density lipoprotein(MD=0.06,95%CI[0.03,0.10],P=0.000 2), experimental group was better than control group. At the same time, the incidence of adverse reactions were low in the experimental group(OR=0.40,95%CI[0.18,0.85],P=0.02). As a result, in treatment of coronary heart disease, the therapeutic efficacy of Zhibitai Capsules combined with statins is better than statins alone in lowering total cholesterol level, triglyceride level, low-density lipoprotein level, and increasing high-density lipoprotein level. Patients in the experimental group had a low incidence of adverse events, but the heterogeneity was slightly higher, and the result had a poor stability. However, due to the small sample size of studies included, some experimental designs were not perfect, which reduces the recommendation level and evidence intensity of this system evaluation. Therefore, high-quality multi-center, large-sample, randomized, double-blind randomized controlled trials are needed for providing more reliable basis.

Lipid-lowering effect and mechanism of Danhong Injection on hyperlipidemia rats based on lipid metabolism disorder / 中国中药杂志

The animal model of hyperlipidemia in rats was established to investigate the lipid-lowering effect and mechanism of Danhong Injection on hyperlipidemic rats. SD rats were selected as the research object. The rats in normal group were fed with basic diet, and the rats in other groups were fed with high-fat diet to establish hyperlipidemia model. The successfully modeled rats were randomly divided into model group, Danhong Injection low, medium, high dose(1.0, 2.0, 4.0 mL·kg~(-1)) groups, and simvastatin(2.0 mg·kg~(-1)) group. Danhong Injection groups received intraperitoneal administration, and simvastatin group received intragastrical administration, once a day for 4 weeks. At the first, second, third, and fourth weekends after administration, blood was collected from the orbital vein to detect the levels of total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C), and then the atherosclerosis index(AI) was calculated. After 4 weeks of administration, the animals were sacrificed, and their heart, liver, spleen, lung, kidney and adipose tissue were extracted and weighed respectively to calculate the organ index of each group. The expressions of acyl-coaoxidase 1(Acox1), adenosine 5'-monophosphate(AMP)-activated protein kinase alpha(AMPK-α), bile salt export pump(BSEP), peroxisome proliferator-activated receptor gamma(PPAR-γ), catalase(CAT) and superoxide dismutase(SOD) mRNA in liver tissues were detected by fluorescence quantitative PCR; the content of cholesteryl ester transfer protein(CETP) and lecithin cholesterol acyltransferase(LCAT) in serum was detected by ELISA. The results showed that as compared with the normal group, the levels of serum TC, TG and LDL-C in the model group were significantly increased, and the level of HDL-C was significantly decreased, indicating that the hyperlipidemia rat model was successfully constructed. As compared with the model group, Danhong Injection could decrease the contents of TC, TG, LDL-C and increase the content of HDL-C in hyperlipidemia rats; reduce the body weight of hyperlipidemia rats, and reduce the liver weight, liver index, fat weight and fat index; it had no significant effect on the main organ indexes such as heart, spleen, lung and kidney; but it could increase the expressions of Acox1, AMPK-α, BSEP, PPAR-γ, CAT and SOD mRNA in liver tissues of rats; it could also reduce the level of CETP and increase the level of LCAT in serum; and the regulatory effect of Danhong Injection groups all showed a dose-dependent effect. It can be concluded that Danhong Injection can regulate the blood lipid contents, reduce the blood lipid levels and alleviate the accumulation of body fat in rats with hyperlipidemia. The mechanism may be related to inhibiting lipid metabolism disorder and oxidative stress induced by high-fat diet feeding, and improving the imbalance of lipid transport system.

Effect of ophiopogonin D on serum lipids and intestinal flora in ApoE-/- mice with high-fat diet / 中草药

Objective: To investigate the effect of ophiopogonin D (OP-D) on blood lipids and intestinal flora in ApoE-/- mice fed with high-fat diet (HFD). Methods: A total of 24 male ApoE-/- mice, aged six weeks old, were randomly divided into control group, model group, OP-D group [0.5 mg/(kg∙d)] and simvastatin group [5 mg/(kg∙d)]. Another six male C57BL/6 mice were in blank group. After 12 weeks of HFD, the drugs were given by intragastric administration for 12 weeks. After the end of administration, fresh feces of mice were collected to detect intestinal flora. Serum of mice was separated to detect blood lipid. Liver section staining was prepared to observe the damage. Results: OP-D could reduce the weight gain of mice caused by HFD, inhibit the increase of total cholesterol and triglyceride, improve hepatic steatosis, and regulate intestinal flora imbalance. Conclusion: OP-D may regulate blood lipids and hepatic steatosis by improving intestinal flora imbalance induced by HFD in ApoE-/- mice.

Mechanism of Action of Trichosanthis Fructus-Allii Macrostemonis Bulbus Herb Pairs Against Hyperlipidemia Based on Network Pharmacology / 中国实验方剂学杂志

Objective:Based on the hyperlipidemia rat model and network pharmacology technology, the mechanism of action of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs against hyperlipidemia was analyzed. Method:The levels of blood lipids and inflammatory factors were measured through prophylactic administration of low, medium and high-dose Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs in hyperlipidemia rats. The active ingredients of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs were screened out through Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP) and text mining. The targets of active ingredients screened through the Swiss Target Prediction, Similarity ensemble approach (SEA), DrugBank database. The disease targets were collected through Therapeutic Target Database (TTD), Online Mendelian Inheritance in Man (OMIM), DrugBank, DisGeNET database. The targets of active ingredients and disease target were integrated, and screened through topological parameters to gain the main candidate targets of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs against hyperlipidemia. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and the gene ontology (GO) functional enrichment analysis were conducted through ClueGO and Database for Annotation, Visualization and Integrated Discovery (DAVID), respectively. The traditional Chinese medicine-chemical ingredient-target network model, and the target-pathway network model were constructed through Cytoscape, and their crosstalk target and signal pathway were analyzed. Result:Animal experiments showed that the prophylactic administration of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs significantly reduced the levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) in serum of rats with hyperlipidemia, increased high-density lipoprotein (HDL-C) levels, and inhibited the expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). According to the findings, 27 active ingredients, such as mandenol, diosmetin and α-spinasterol, might be the main active ingredients of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs, 16 crosstalk targets and 10 signal pathways might be the main therapeutic targets and pathways, main targeting apolipoprotein A1 (APOA1), apolipoprotein A2 (APOA2), apolipoprotein C3 (APOC3), lipoprotein lipase (LPL), low-density lipoprotein receptor (LDLR) and other crosstalk targets affected cholesterol metabolism, bile secretion, peroxisome proliferator activated receptor (PPAR) signaling pathway in regulating the lipid level, targeting tumor necrosis factor (TNF), IL-6, interleukin-1β (IL-1β), mitogen-activated protein kinase 1 (MAPK1), C-C motif chemokine 2 (CCL2) and other crosstalk targets affected tumor necrosis factor (TNF) signaling pathway, Toll-like receptor signaling pathway, interleukin-17 (IL-17) signaling pathway, and hypoxia inducible factor (HIF) signaling pathway in regulating the inflammatory factor level. The DAVID database for GO enrichment analysis showed that the hyperlipidemia was treated mainly through biological processes, such as inflammation, lipid localization, storage and lipid metabolism. Conclusion:These findings can predict the mechanism of action of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs against hyperlipidemia, and provide a theoretical basis for the material basis and clinical application of Trichosanthis Fructus-Allii Macrostemonis Bulbus herb pairs.

Analysis of Effects of Different Doses of Rosuvastatin Calcium on Serum Lipids in Elderly Patients with Coronary Heart Disease and Hyperlipidemia / 现代生物医学进展

Objective:To investigate the effects of different doses of rosuvastatin on lipid levels in elderly patients with CHD complicated with hyperlipidemia.Methods:120 elderly patients with coronary heart disease admitted in our hospital were retrospectively chosen.By lipid examination,they were all hyperlipidemia.According to the dose of rosuvastatin,they were divided into three groups,and 40 cases in each group.They were given 5 mg,10 mg and 20 mg treatment,respectively.After 2 months,the changes of blood lipid level and the clinical effective rate were compared before and after the treatment.Results:①The blood lipid levels HDL-C [(1.17 ± 0.62) mmol / L] was significantly higher than the other two groups.LDL-C [(3.67 ± 0.83) mmol / L],TC [(4.36 ± 0.96) mmol / L] and TG [(1.68 ± 0.94) mmol / L] were significantly lower than those of the other two groups (P ＜0.05).②The effective rate of treatment in the 20mg group (97.5％) was significantly higher than that in the 5mg group (87.5％) and the 10mg group(85.0％).Conclusions:Rosuvastatin can treat coronary heart disease complicated with hyperlipidemia in elderly patients.The dosage of 20 mg can improve the blood lipid level of the patients,is an effective and convenient method,and with high therapeutic efficiency.

Effect of atorvastatin calcium on carotid plaque in patients with cerebral infarction / 中国生化药物杂志

Objective To observe the clinical effect of atorvastatin calcium on carotid plaque in patients with cerebral infarction.Methods112 cases of arteriosclerosis in patients with cerebral infarction were randomLy selected from January 2015 to 2016 year in January in our hospital, according to digital method, divided into the observation group (n=56) and control group (n=56), the control group were treated with cinepazide treatment lasted 6 months, the observation group in the control group based on the use of atorvastatin calcium 20mg/d.For 6 months, clinical curative effect and compared two groups of patients with blood lipid levels and blood rheology indexes.ResultsThe total efficiency of the observation group was 89.28% higher than that of the control group (50/56) 69.65% (39/56);to compare the clinical efficacy of the two groups, the difference was statistically significant (P<0.05);the two groups of patients after treatment, blood rheology and blood lipid levels were significantly improved (P<0.05);and the observation group blood lipid levels and blood rheology the improvement is better than the control group (P<0.05).Conclusionatorvastatin can improve the metabolism of blood lipid, promote the circulation of cerebral blood flow, and has the function of resisting carotid atherosclerosis.

Efficacy of different doses of levothyroxinein treatment of subclinical hypothyroidism in elderly patients and the effect on blood lipid level / 药物评价研究

Objective To investigate the clinical effect of different doses of levothyroxine in treatment of subclinical hypothyroidism and its effect on blood lipid level.Methods 98 cases of subclinical hypothyroidism elderly patients accepted in our hospital from March 2013 to May 2016 were divided into group A and B with 49 patients in each.The two groups were treated with different doses of levothyroxine treatment for 6 months.Then the clinical efficacy,thyroid function,blood lipid levels and adverse reactions of two groups were compared.Results The cure rate and total effective rate of group A were 59.18％ and 87.76％ respectively.The cure rate and total effective rate of group B were 61.22％ and 91.84％ respectively.There was no significant differencebetween two groups.After treatment,thethyroid function and blood lipid levels of two groups were better than before treatment.After 4 weeks of treatment,the thyroid function and blood lipid level in group B were better than those in group A (P ＜0.05).There was no significant difference in thyroid function and blood lipid between the two groups after 12 weeks of treatment.The incidence of total adverse reactions in group A was 4.08％,which was significantly lower than that in group B (16.33％),the difference was statistically significant (P ＜ 0.05).Conclusion Different doses of levothyroxine in the treatment ofsubclinical hypothyroidism were similar,and the thyroid function and blood lipids levels were improved after treatment,but the adverse reaction rate of low dose group was less.

Efficacy of different doses of levothyroxinein treatment of subclinical hypothyroidism in elderly patients and the effect on blood lipid level / 药物评价研究

Objective To investigate the clinical effect of different doses of levothyroxine in treatment of subclinical hypothyroidism and its effect on blood lipid level.Methods 98 cases of subclinical hypothyroidism elderly patients accepted in our hospital from March 2013 to May 2016 were divided into group A and B with 49 patients in each.The two groups were treated with different doses of levothyroxine treatment for 6 months.Then the clinical efficacy,thyroid function,blood lipid levels and adverse reactions of two groups were compared.Results The cure rate and total effective rate of group A were 59.18％ and 87.76％ respectively.The cure rate and total effective rate of group B were 61.22％ and 91.84％ respectively.There was no significant differencebetween two groups.After treatment,thethyroid function and blood lipid levels of two groups were better than before treatment.After 4 weeks of treatment,the thyroid function and blood lipid level in group B were better than those in group A (P ＜0.05).There was no significant difference in thyroid function and blood lipid between the two groups after 12 weeks of treatment.The incidence of total adverse reactions in group A was 4.08％,which was significantly lower than that in group B (16.33％),the difference was statistically significant (P ＜ 0.05).Conclusion Different doses of levothyroxine in the treatment ofsubclinical hypothyroidism were similar,and the thyroid function and blood lipids levels were improved after treatment,but the adverse reaction rate of low dose group was less.

Effects of MTP Gene Polymorphism on the Lipid-regulating Effect of Simvastatin in the Treatment of T2DM Complicating with Lipid Metabolism Disorder / 中国药房

OBJECTIVE:To investigate the effects of MTP gene polymorphism on the lipid-regulating effect of simvastatin in the treatment of T2DM complicating with lipid metabolism disorder. METHODS:120 T2DM inpatients with hypercholesterolemia were selected from our hospital during Jun. to Dec. 2015 and given Metformin hydrochloride sustained-release tablets,Enalapril ma-leate tablets and Simvastatin tablets. PCR-RFLP was used to detect MTP G493T genotype. The levels of TG,TC,LDL-C and HDL-C were detected by AU 400 automatic biochemistry analyzer before treatment and the 4th week after treatment. The effects of different genotype on the change of blood lipid level was analyzed. RESULTS:Among 120 patients,the patients with MTP G493T GG,GT,TT genotypes accounted for 61.67%,26.67% and 11.67%,respectively,meeting Hardy-Weinberg balance(P>0.05). Before treatment,there was no statistical significance in TC,TG,LDL-C and HDL-C among different genotypes(P>0.05). After 4 weeks of treatment,the decrease of TC and LDL-C in TT genotype patients were lower than that in GG and GT genotype,with statistical significance(P>0.05). There was no significant difference in the decrease of TC and LDL-C between GT and GG geno-type,the decrease of TG and HDL-C(P>0.05). There was no significant difference in the incidence of ADR among different geno-types(P>0.05). CONCLUSIONS:After simvastatin treatment,the improvement of TC and LDL-C in patients with TT genotype is poor. MTP G493T gene polymorphism may be associated with the lipid-regulating effect of simvastatin in the treatment of T2DM patients with lipid metabolism disorder.

The effect of walnut (Juglans regia L.) intake on improvement of blood lipid levels and vascular health: A meta-analysis / 한국영양학회지

PURPOSE: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). RESULTS: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). CONCLUSION: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.