Anti-hyperglycemic and anti-hyperlipidemic effects of a methanolic extract of Debregeasia salicifolia in Alloxan-induced diabetic albino mice

Abstract Diabetes mellitus (DM), an endocrine syndrome characterized by high blood glucose levels due to abrogated insulin activity. The existing treatments for DM have side effects and varying degrees of efficacy. Therefore, it is paramount that novel approaches be developed to enhance the management of DM. Therapeutic plants have been accredited as having comparatively high efficacy with fewer adverse effects. The current study aims to elucidate the phytochemical profile, anti-hyperlipidemic, and anti-diabetic effects of methanolic extract D. salicifolia (leaves) in Alloxan-induced diabetic mice. Alloxan was injected intraperitoneally (150 mg kg-1, b.w), to induced diabetes in mice. The mice were divided into three groups (n=10). Group 1 (normal control) received normal food and purified water, Group II (diabetic control) received regular feed and clean water and group III (diabetic treated) received a methanolic extract of the plant (300 mg kg-1) for 28 days with a typical diet and clean water throughout the experiment. Blood samples were collected to checked serum glucose and concentration of LDL, TC, TG. The extract demonstrated significant antihyperglycemic activity (P 0.05), whereas improvements in mice's body weight and lipid profiles were observed after treatment with the extract. This study establishes that the extract has high efficacy with comparatively less toxicity that can be used for DM management.

Resumo Diabetes mellitus (DM) é uma síndrome endócrina caracterizada por níveis elevados de glicose no sangue devido à atividade anulada da insulina. Os tratamentos existentes para o DM têm efeitos colaterais e vários graus de eficácia. Portanto, é fundamental que novas abordagens sejam desenvolvidas para aprimorar o manejo do DM. As plantas terapêuticas foram acreditadas como tendo eficácia comparativamente alta com menos efeitos adversos. O presente estudo visa elucidar o perfil fitoquímico, efeitos anti-hiperlipidêmicos e antidiabéticos do extrato metanólico de D. salicifolia (folhas) em camundongos diabéticos induzidos por aloxana. Alloxan foi injetado por via intraperitoneal (150 mg kg-1, b.w), para induzir diabetes em camundongos. Os camundongos foram divididos em três grupos (n = 10). Grupo 1 (controle normal) recebeu ração normal e água purificada, Grupo II (controle diabético) recebeu ração regular e água limpa, e o grupo III (tratamento diabético) recebeu extrato metanólico da planta (300 mg kg-1) por 28 dias com uma dieta típica e água limpa durante todo o experimento. Amostras de sangue foram coletadas para verificar a glicose sérica e a concentração de LDL, TC, TG. O extrato demonstrou atividade anti-hiperglicêmica significativa (P 0,05), enquanto melhorias no peso corporal e no perfil lipídico dos camundongos foram observadas após o tratamento com o extrato. Este estudo estabelece que o extrato tem alta eficácia com comparativamente menos toxicidade e pode ser usado para o controle do DM.

Antioxidant, Antidiabetic and Lipid Profiling of Spermadicyton Suaveolens in Streptozotocin (STZ) Induced Diabetic Rats

ABSTRACT Diabetes is a life-threatening disease, and currently available synthetic medicines for treating diabetes are associated with various side effects. Therefore, there is an unmet need to develop herbal remedies against diabetes as an alternative to synthetic medicines. Although local healers use the roots of Spermadicyton suaveolens (SS) to manage diabetes, there is negligible research to validate its antidiabetic properties. The present investigation aims to the assess the antioxidant, antidiabetic, and antihyperlipidemic potential of the ethanolic extract of S. Suaveolen's roots (EESS) on streptozotocin (STZ) induced diabetic rats. The extract was screened for in vitro antioxidant and antidiabetic activity. The in vivo antidiabetic potential of EESS (at 200 and 400 mg/kg) was studied on STZ-induced diabetic rats for 20 days. The EESS displayed significant (p<0.05) antidiabetic and antioxidant properties. The administration of 200 mg/kg and 400 mg/kg EESS in STZ-induced diabetic rats significantly reduced hyperglycemia, and restored antioxidant enzymes and lipid profile-a high density lipoprotein (HDL) increased by the administration of a single dose of streptozotocin. Thus, EESS could be a promising herbal medicine in the treatment of diabetes and hyperlipidemia

Evaluation of antihyperlipidemic activity of gugulipid alone and in combination with different dosage of atorvastatin in triton-induced hyperlipidemic rodent model: Exploring a possible synergistic activity

Background: Gugulipid obtained from Commiphora mukul carries a long history of safe and efficacious use in hyperlipidemia as per Ayurvedic literature. Statins like atorvastatin are a highly prescribed hypolipidemic drug but not free from potentially serious adverse effects. Aims and Objectives: The present study was designed to establish antihyperlipidemic activity of gugulipid in triton-induced hyperlipidemic rats in comparison to atorvastatin and simultaneously to explore the combination of gugulipid and atorvastatin for any synergistic activity. Materials and Methods: Male Wistar albino rats (20) were divided equally into vehicle (2% gum acacia) (Group I), gugulipid only 6.75 mg/kgbw (Group II), atorvastatin 7.2 mg/kgbw only (Group III), and gugulipid 6.75 mg/kgbw and atorvastatin in 7.2 mg/kgbw combination (Group IV) in Phase 1 study. In Phase 2, additional three groups were created with five rats in each receiving gugulipid 6.75 mg/kgbw with atorvastatin at 5.4 mg/kgbw, 3.6 mg/kgbw, and 1.8 mg/kgbw dosage, respectively (Groups V–VII). Hyperlipidemia was induced by single intraperitoneal injection (400 mg/kgbw) of triton after 7 days of feeding with respective agents dissolved in vehicle through oral route. Results: Regarding total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL), Gr II was found superior to Gr I but inferior to others (P < 0.01). Gr IV prevented the rise of TC and TG significantly in comparison to Gr V, VI, and VII (P < 0.01) whereas Groups V and VI having non-significant difference in between, both differed significantly (P < 0.01) with Gr VII. Groups IV, V, and VI prevented the rise of serum LDL significantly (P < 0.01) from Group VII. Conclusion: Gugulipid showed significant antihyperlipidemic activity and was found to be optimally efficacious and safe in combination with even reduced dose of atorvastatin.

Synthesis and In Vivo Hypolipidemic Effect of Some N-(Benzoylphenyl)-Carboxamide Derivatives in Triton WR-1339-Induced Hyperlipidemic Rats

A series of N-(benzoylphenyl)-carboxamide derivatives (2a, 2b, 3a, 3b, 4a, 4b, 5a, 5b, 6a and 6b) was prepared with good yields by reacting the corresponding carbonyl chlorides with aminobenzophenones at room temperature. This was followed by evaluating the hypotriglyceridemic and hypocholesterolemic effects of 3b, 5a and 5b. Triton WR-1339 (300 mg/kg) was intraperitoneally administered to overnight-fasted rats to induce hyperlipidemia. Rats were divided into six groups: control, hyperlipidemic, hyperlipidemic plus compounds 3b, 5a and 5b and hyperlipidemic plus bezafibrate. Results showed that after 18 h of treatment at a dose of 15 mg/kg body weight of each of the test compounds, the elevated plasma levels of triglycerides (TG) and total cholesterol (TC) were significantly lowered by compounds 5b and 3b (p < 0.001) and by 5a (p < 0.0001), compared to the hyperlipidemic control group. Compounds 3b and 5a significantly increased levels of high-density lipoprotein cholesterol (HDL-C) by 58 and 71%, respectively. In addition, compounds 3b and 5a caused significant reduction (p < 0.0001) of low-density lipoprotein cholesterol (LDL-C) levels compared to the control group. These results suggest a promising potential for compounds 3b, 5a and 5b as lipid-lowering agents, which may contribute to reducing the risk of atherosclerosis and cardiovascular disease

Therapeutic Effect and Mechanism of Modified Da Chengqitang in Treating Hyperlipidemic Acute Pancreatitis with Damp Heat Accumulation Syndrome / 中国实验方剂学杂志

Objective:To explore the efficacy and mechanism of modified Da Chengqitang in treating hyperlipidemic acute pancreatitis （HLAP） with damp heat accumulation syndrome. Method:A total of 110 patients with HLAP with damp heat accumulation syndrome treated at our hospital were randomly divided into control group and observation group， with 55 cases in each group， both groups were treated with low molecular weight heparin calcium， insulin and alprostadil injection. Control group was given Huazhironggan granules in addition to the basic therapy， while observation group was given modified Da Chengqitang in addition to the basic therapy. After 7 days， the clinical efficacy， traditional Chinese medicine (TCM） syndrome score， gastrointestinal function recovery， acute pancreatitis bedside index （BISAP）， acute physiology and chronic health status Ⅱ （APACHE Ⅱ）， inflammatory factors， such as tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-6 （IL-6） and C-reactive protein （CRP）， oxidative stress， such as malondialdehyde （MDA）， oxidized glutathione （GSSG）， total antioxidant capacity （T-AOC）， total cholesterol （TC）， triglyceride （TG）， high and low density lipoprotein （HDL-C， LDL-C） blood lipid indicators and safety were evaluated. Result:The clinical efficacy of observation group was significantly better than that of control group （<italic>Z</italic>=3.353， <italic>P</italic><0.05）， and the total effective rate of observation group was 94.55%， which was higher than 74.55% of control group （<italic>χ²</italic>=8.419， <italic>P</italic><0.01）. After treatment， the scores of abdominal pain， stool obstruction， chest tightness and fever in observation group were significantly lower than those of control group （<italic>P</italic><0.05）. The gastric tube indwelling exhaust time， defecation time and recovery time of bowel sounds in observation group were significantly lower than those of control group （<italic>P</italic><0.05）. The scores of BISAP and APACHE Ⅱ in two groups were significantly decreased， and the BISAP and APACHE Ⅱ scores of observation group were lower than control group （<italic>P</italic><0.05）. After treatment， the serum levels of TNF-<italic>α</italic>， IL-6 and CRP in observation group were significantly lower than those in control group. The levels of serum MDA， GSSG in two groups were significantly decreased， whereas the T-AOC level was significantly increased； and the level of serum MDA， GSSG observation group was lower than control group， while the T-AOC level was higher than control group （<italic>P</italic><0.05）. After treatment， the levels of TC， TG and LDL-C in two groups were decreased， while the level of HDL-C was increased， the levels of TC， TG and LDL-C in observation group were lower than those in control group， and the HDL-C was higher than that control group （<italic>P</italic><0.05）. Conclusion:modified Da Chengqitang has a definite clinical efficady in treating HLAP with damp heat accumulation syndrome， and can alleviate TCM syndrome and patient symptoms， reduce inflammatory factors， inhibit oxidative stress of the body. It has a good safety， and is worthy of clinical application.

Clinical Significance of PLR, NLR, MLR, RPR and CLR in Evaluating Severity of Hyperlipidemic Acute Pancreatitis / 胃肠病学

Background: Peripheral blood test is a routine clinical examination item. Granulocytes and platelets are often used to measure the severity of inflammatory response, and it is worthy to investigate the value of various inflammatory indices ratio for predicting the prognosis of disease. Aims: To compare and analyze the diagnostic efficacy of platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), red blood cell distribution width to platelet ratio (RPR), C-reactive protein to lymphocyte ratio (CLR) and C-reactive protein (CRP) in evaluating the severity of hyperlipidemic acute pancreatitis (HLAP). Methods: The clinical and laboratory data of 104 patients with HLAP from January 2018 to December 2020 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. According to the revised Atlanta classification, HLAP patients were divided into mild HLAP, moderate to severe/severe HLAP. Forty-four healthy subjects during the same period were served as the controls. PLR, NLR, MLR, RPR, CLR and CRP were compared between HLAP group and control group. The ROC curve was used to analyze the diagnostic efficacy of PLR, NLR, MLR, RPR, CLR and CRP for the diagnosis of moderate to severe/severe HLAP. Results: PLR, NLR, MLR, RPR, CLR and CRP were significantly increased in HLAP group than in control group (P<0.05); PLR, NLR, MLR, RPR, CLR and CRP were significantly increased in moderate to severe/severe HLAP group than in mild HLAP group (P<0.05). The cut-off values of PLR, NLR, MLR, RPR, CLR, CRP and combined PLR, NLR, MLR, RPR, CLR were 220.48, 10.95, 0.84, 0.12, 76.66, 87.44 mg/L, 0.37, respectively, the sensitivity for diagnosing moderate to severe/severe HLAP were 0.73, 0.45, 0.47, 0.82, 0.65, 0.65 and 0.88, respectively, the specificity were 0.85, 0.87, 0.90, 0.81, 0.83, 0.83 and 0.85, respectively, AUC were 0.84, 0.65, 0.67, 0.87, 0.77, 0.75 and 0.94, respectively. Conclusions: PLR, NLR, MLR, RPR, CLR and CRP can evaluate the severity of HLAP, and the combined PLR, NLR, MLR, RPR and CLR has higher sensitivity and diagnostic efficacy in the diagnosis of moderate to severe/severe HLAP.

Reactive factors and prognosis analysis of serum lipid level to plasma exchange in patients with hyperlipidemic severe acute pancreatitis / 医学研究生学报

ObjectiveHyperlipidemic severe acute pancreatitis, which has a poor prognosis, is a common acute and critical disease. To discuss the reactive factors and prognosis analysis of serum lipid level to plasma exchange in patients with hyperlipidemic severe acute pancreatitis (HL-SAP).MethodsA retrospective study was conducted on the clinical data of 70 HL-SAP patients admitted to the department of critical care medicine in Nanjing drum tower hospital from January 2010 to May 2018. All patients received plasma exchange therapy, and were divided into the high-response group (>60%) and the low-response group (< 60%) according to the decrease of serum triglyceride (TG) level. Single factor analysis was conducted with χ2 or Mann-Whitney U test in the patients' gender, age, body mass index (BMI), Ranson score, clinical acute physiology assessment and chronic health evaluation (APA-CHE), sequential organ failure assessment(SOFA), start time from incidence to plasmapheresis, plasma exchange dosage, blood flow velocity, serum amylase, albumin, red blood cells hematocrit (Hct), blood TG before plasma exchange, total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL). The factors, which include gender, start time from incidence to plasmapheresis, TG, and Hct, have statistical differences in single factor analysis and were incorporated into the Logstic regression analysis for a multifactor analysis.ResultsTG levels ranged from 10.10 to 53.60 mmol/L in 70 patients with an average of (21.45±13.56) mmol/L before plasma exchange while it ranged from 1.97 to 20.00 mmol/L with an average of (6.10±3.58) mmol/L after plasma exchange, and the difference was statistically significant (P<0.05). In this group, the TG decreased by 12.75%~89.43%, which included 46 patients in the high-response group and 24 patients in the low-response group. Compared with the low-response group, the high-response group has statistically significant (P<0.05) in the differences of gender, start time from incidence to plasmapheresis, serum amylase, plasma exchange dosage, red blood cells hematocrit (Hct), blood lipid before exchange, TC, and HDL. Multivariate Logistic regression analysis showed that changes in blood lipid level after plasmapheresis in HL-SAP patients were significantly correlated with gender, start time from incidence to plasmapheresis, red blood cells hematocrit (Hct), blood lipid before plasmapheresis (P<0.05). Compared with the low-response group, it has statistically significant in difference between acute kidney injury and mortality in the high-response group (P<0.05).ConclusionThe reactive factors for the efficacy of plasma exchange in patients with HL-SAP are gender, tart time from incidence to plasmapheresis, red blood cells hematocrit (Hct), and blood lipid before plasmapheresis. The low response group had a higher incidence of acute kidney injury and a poor prognosis.

Anti-Hyperglycemic and Anti-Hyperlipidemic Potentials of Methanol Leaf Extracts of Aframomum melegueta and Piper guineense

Aim: The study investigated the anti-hyperglycemic and anti-hyperlipidemic potentials of methanol extracts of Piper guineense and Aframomum melegueta leaves with a view to utilizing the plants in the treatment and management of cardiovascular disorders. Methodology: Twenty-eight healthy albino rats were randomly divided into seven equal groups: Group I received normal saline (2 ml/kg bwt); Group II received a single dose of alloxan(150 mg/kg bwt) intraperitoneally; Group III received alloxan (150 mg/kg bwt) + glibenclamide (5 mg/kg bwt);Group IV received alloxan (150 mg/kg bwt) +PG (200 mg/kg bwt); Group V received alloxan (150 mg/kg bwt) + PG (400 mg/kg bwt); Group VI received alloxan (150 mg/kg bwt) + AM 200 (mg/kg bwt); Group VII received alloxan (150 mg/kg bwt) + AM (400 mg/kg bwt). The blood glucose level was determined before and after treatment with the extracts. The lipid: (total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were estimated using the Randox diagnostic kits. Results: The results revealed that alloxan was able to induce hyperglycemia at 150 mg/kg bwt and post-treatment with P. guineense and A. melegueta at 200 mg/kg and 400 mg/ kg bwt were able to significantly lower the blood glucose level which was quite apparent in AM treated groups. Also, the extracts at 200 mg/kg and 400 mg/kg were able to bring a significant (p < 0.05) reduction in TC, TG and LDL concentrations when compared to the alloxan treated group with the highest reduction in AM treated groups. Conclusion: These results revealed that the methanol extract of P. guineense and A. melegueta elicited anti-hyperglycemic and anti-hyperlipidemic potentials of the extracts with the highest effect observed in A. melegueta treated rats.

Artichoke edible parts are hepatoprotective as commercial leaf preparation

ABSTRACT Chemical profile analyses of artichoke (Cynara scolymus L., Asteraceae) edible parts (fleshy receptacle, inner bracts) as well as roots are compared with the commercially usable leaf extract using HPLC-DAD-ESI-MS via chlorogenicacid as a marker. Overall polyphenolic constituents demonstrated by means of LC/MS profiling. The nutritional values and inulin contents of different assessed parts were investigated. The present study was designed to determine the effect of artichoke: leaves, bracts, receptacles and roots alcoholic extracts against CCl4-induced acute hepatotoxicity and hyperlipidemia in rats by means of histopathological and biochemical parameters. Serum liver enzymes levels of aspartate amino transferase, alanine amino transferase, alkaline phosphatase and lipid peroxidase content (malondialdehyde MDA) were estimated. Blood glutathione, total cholesterol, triacylglycerides and high density lipid level were estimated in plasma. The ethanol extract of roots, leaves, bracts and receptacles were standardized to (0.82 ± 0.02, 1.6 ± 0.06, 2.02 ± 0.16 and 2.4 ± 0.27 mg chlorogenic acid/100 mg extract), respectively. The receptacle showed the highest content of polyphenols and exhibits the highest antioxidant activity. HPLC analysis of inulin in the receptacles of globe artichoke revealed high content of inulin (41.47 mg/g) dry extract. All artichoke parts contain comparable vitamins and minerals. Artichokes receptacles extract when taken in dose of (500 mg/kg/day) reduce the lesion caused by CCl4 alone more than groups receiving silymarin. Bracts and leaves extract exert nearly the same effect.

The impact of sleeve gastrectomy on recurrent obese hyperlipidemic pancreatitis / 中华肝胆外科杂志

Objective To study the impact of weight loss surgery after 3 months of stable condition through intervention on patients with obese hyperlipidemic acute pancreatitis (HLAP).Methods Ten patients with obese HLAP who underwent laparoscopic sleeve gastrectomy (LSG) at the General Surgery Department of our hospital were followed-up at 1,3,6,12,24 months after surgery.Their weight,BMI,EWL,and blood parameters (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) were compared.The impact on postoperative obese HLAP was assessed.Results The weight,BMI,EWL and blood index (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) of the patients gradually decreased.The decrease was significantly different from that before surgery (P＜0.05),which became stable at 12 months and with no recurrence at 24 months after surgery.Conclusions LSG reduced body weight and improved metabolic status of the patients.It stopped the occurrence of obese HLAP.LSG can be used as an effective intervention for patients with obese HLAP.

Metabolites profiling and hypolipidemic/hypocholesterolemic effects of persimmon (Diosyros kaki Thumb.) by different processing procedures: in vitro and in vivo studies / 한국영양학회지

PURPOSE: Our previous study demonstrated that persimmon (Diospyros kaki Thumb.) at different stages of ripening provided different protective effects against high-fat/cholesterol diet (HFD)-induced dyslipidemia in rats. In this study, we compared the metabolites profile and gene expressions related to triglyceride (TG)/cholesterol metabolism in vitro and in vivo after treating with persimmon water extracts (PWE) or tannin-enriched persimmon concentrate (TEP). METHODS: Primary and secondary metabolites in test materials were determined by GC-TOF/MS, UHPLC-LTQ-ESI-IT-MS/MS, and UPLC-Q-TOF-MS. The expression of genes related to TG and cholesterol metabolism were determined by RT-PCR both in HepG2 cells stimulated by oleic acid/palmitic acid and in liver tissues obtained from Wistar rats fed with HFD and PWE at 0, 150, 300, and 600 mg/d (experiment I) or TEP at 0, 7, 14, and 28 mg/d (experiment II) by oral gavage for 9 weeks. RESULTS: PLS-DA analysis and heatmap analysis demonstrated significantly differential profiling of metabolites of PWE and TEP according to processing of persimmon powder. In vitro, TEP showed similar hypolipidemic effects as PWE, but significantly enhanced hypocholesterolemic effects compared to PWE in sterol regulatory element-binding protein 2 (SREBP2), HMG-CoA reductase (HMGCR), proprotein convertase subtilisin/kexin type 9 (PCSK9), cholesterol 7α-hydroxylase (CYP7A1), and low density lipoprotein receptor (LDLR) gene expression. Consistently, TEP and PWE showed similar hypolipidemic capacity in vivo, but significantly enhanced hypocholesterolemic capacity in terms of SREBP2, HMGCR, and bile salt export pump (BSEP) gene expression. CONCLUSION: These results suggest that column extraction after hot water extraction may be a good strategy to enhance tannins and long-chain fatty acid amides, which might cause stimulation of hypocholesterolemic actions through downregulation of cholesterol biosynthesis gene expression and upregulation of LDL receptor gene expression.

Assessment of anti-diabetic potential of aqueous and ethanol extracts of Strophanthus hispidus stem bark in Wistar rats / 中国药理学与毒理学杂志

OBJECTIVE Diabetes mellitus is a chronic disease, for which there is no known cure except in a very specific situation. The available orthodox drugs used for its management are having disadvantages. This study investigated the anti-diabetic potential of aqueous and ethanol extracts of Strophanthus hispidus(SH)stem bark in Wistar rats.METHODS Glucose concentrations,serum α-amylase and lipid profile parameters of normal and diabetic rats were monitored for 12 weeks.Diabetes mellitus was induced by intraperitoneal injection of streptozotocin (55 mg·kg-1). 30 Male rats were randomly selected into six groups of five rats per group. Two groups served as normal and diabetic controls, respectively, and received distilled water for 12 weeks. Another two groups (normal rats) were treated orally with the aid of a gavage,250 mg·kg-1of aqueous and ethanol extracts of SH respectively for 12 weeks whereas the other two groups(diabetic rats)received the respective dose of aqueous and ethanol extracts for the same period. RESULTS The results revealed significant (P<0.05) progressive decrease in the fasting blood glucose concentration on the 2nd-12thweeks in normal rats, whereas the diabetic treated rats,showed reduction(P<0.05)in the fasting blood glucose concentration on the 4th-12thweeks.Total cholesterol,LDL and TG levels were lowered significantly(P<0.05)by the extracts in normal and diabetic treated rats, whereas HDL levels (17.6±0.50) mg·dL-1(aqueous) and (21.4±1.28) mg·dL-1(ethanol) were elevated in diabetic treated rats.The activity of serum α-amylase was also elevated by the extract in diabetic treated rats. CONCLUSION These findings indicated that SH showed hypoglycemic, anti-hyperlipidemic and anti-diabetic activities. These findings may be connected with the presence and amount of phytochemicals in the plant.

Comparison of clinical efficacy between early low and high enteral nutrition (EN) administration in the early treatment of hyperlipidemic severe acute pancreatitis / 肠外与肠内营养

Objective: This study aimed to compare the effects of high versus low calorie early enteral nutrition (EEN) administration on the complications and prognosis of hyperlipidemic acute pancreatitis (HLAP) patients. Methods: In this study, HLAP patients were randomly divided into high calorie EEN group and low calorie EEN group. The nutritional support was carried out within 48h at patients' admission. The serum lipid levels, inflammatory parameters, the incidence of EN intolerance, hospitalization duration, ICU duration, the incidence of organ failure and infected pancreatic necrosis as well as mortality rate were recorded and compared between two groups. Results: 48 patients with diagnosis of HLAP were included in this study from January 2014 to June 2017. In the first two days, the serum lipid levels of patients in low-calorie group decreased gradually. The serum lipid levels of the two groups were 2. 3 (1. 7-3. 4) mmol/L versus 5. 2 (2. 9-6. 1) mmol/L (P = 0. 05) respectively on third day after EN administration. There was no significant difference in the incidence of MODS and mortality rate between the two groups while the ICU duration of low-calorie group was significantly shorter than that in high-calorie group. The incidence of IPN in low-calorie group showed an elevated trend but there was no statistical significance. Conclusion: For HLAP patients, low calorie-high protein nutrition supply could benefit the patients to gain lean body weight due to the positive nitrogen balance, and to consume body fat due to the deficiency of calories. It is an effective nutrition support strategy for the patients' recovery.

Clinical Study on Effects of Enteral Immunonutrition in Patients with Hyperlipidemic Acute Pancreatitis / 医学研究杂志

Objective To discuss the clinical effects of enteral immunonutrition on patients with hyperlipidemic acute pancreatitis and its influence on levels of immunologic function and nutrition indicators.Methods 2015,100 patients with hyperlipidemic acute pancreatitis Selected from department of general surgery between January 2012 and December were randomly divided into observation group and control group,and each group had 50 cases.All patients were treated with conventional treatment,monitored for vital signs,fasting water,gastrointestinal decompression,anti-infection,acid suppression therapy and suppression of trypsin activity,balance of water electrolyte and acid-basewere included.After bowel function in patients with recovery,two groups were given enteral nutrition support,observation group were received enteral immunonutrition therapy.At the same time,we added the immune enhancement components.After treatment for 10 days,we compare two groups of patients with therapeutic effect,for APACHE-Ⅱ score,nutrition indicators (ALB,PAB),immune index(TLC,IgA,IgG,IgM) changes.Results After two groups of patients were given different enteral nutrient solution,the clinical total effective rate of observation group was obviously higher than that of control group(P ＜ 0.05).After treatment for 10 days,the indicators were obviously improved.The APACHE-Ⅱ score of the observation group were significantly fallinger than that of the control group (t =3.311,P ＜0.05).The ALB and PAB levels of the observation group were significantly higher than those of the control group (t =2.217,6.622,P ＜ 0.05).At the same time,the TLC,IgA,IgG,IgM of the observation group were improved significantly better than the control group (t =3.600,4.867,3.270,3.911,P ＜ 0.05).Conclusion Enteral immunonutrition can improve the nutrition indicators and immunological function of patients with hyperlipidemic acute pancreatitis,thus improve prognosis and promoting recovery of the patient.

Effects of S-allylcysteine on Nitric Oxide Production and Antioxidant Enzyme Activities in Hyperlipidemic Model Rats / 医药导报

Objective To investigate the effects of S-allylcysteine ( SAC ) , on nitric oxide ( NO ) production and antioxidant enzyme activities in hyperlipidemic rats. Methods Male Wistar rats were randomly divided into seven groups. Five groups including normal control group ( normal diet) , model control group ( high-fat diet, HFD) and SAC low,medium,high treated group (high-fat diet +25,50,100 mg·kg-1 SAC) were sacrificed after 4 weeks dosing,while the other two groups including L-arginine group (normal diet+ 20 mg·kg-1 L-arginine) and SAC+L-arginine group (50 mg·kg-1 SAC+20 mg·kg-1 L-arginine) were sacrificed at 4 h after dosing. The serum, livers and kidneys were collected. The levels of NO, the activities of nitric oxide synthase ( NOS ) , antioxidant enzymes in vivo and L-arginine contents in serum were determined. Results Comparing with model control group, the activities of total NOS in serum and liver were significantly reduced in SAC-treated groups (P<0. 05). The level of L-arginine in SAC-treated groups was (8. 25 ± 1. 15), (7. 76 ± 1. 24) and (7. 22 ± 1. 64)μg·mL-1 , respectively. Compared with model control group, the level of L-arginine were significantly reduced in SAC-treated groups (P<0. 05). Comparing with L-arginine group, the activities of total NOS (T-NOS) and iNOS were reduced in SAC+L-arginine group. SAC treatment (100 mg·kg-1) significantly increased the activities of superoxide dismutase (SOD) (P<0. 01) and the level of glutathione (GSH) (P<0.01), and decreased the level of malondialdehyde (MDA) in serum and liver of hyperlipidemic rats. Conclusion These data suggest that SAC inhibits the NO production by reducing iNOS activity, arginine concentration and exhibited antioxidant activity, which may play a pharmacologically important role in protection from oxidative injury and pathogenesis of atherosclerosis.

Effects of Plasma Exchange Combined with Intensive Insulin Glycemic Control on Related Indexes of Patients with Hyperlipidemic Pancreatitis / 中国药房

OBJECTIVE:To investigate the effects of plasma exchange (PE) combined with intensive insulin glycemic control on related indexes of patients with HLP.METHODS:A total of 120 HLP patients were randomly divided into control group (60 cases) and observation group (60 cases).Based on routine treatment,2 groups were given PE treatment for 3 times+Low molecular weight heparin calcium for injection 5 000 U subcutaneously+Methylprednisolone sodium succinate for injection 40 mg intravenously+Calcium gluconate injection 2 g intravenously.Based on it,Insulin injection was pumped to random blood glucose ＜12 mmol/L with a micro-infusion pump in control group when random blood glucose concentration was equal to or more than 12 mmol/ L.When random blood glucose of patients in observation group were higher than 8.3 mmol/L,Insulin injection was pumped with a micro-infusion pump for a week and random blood glucose concentration was maintained at 6.1-8.3 mmol/L.Plasma levels of triglyceride,PCT,WBC count,APACHE Ⅱ score,Balthazar CT score,length of hospitalization stay in ICU and the occurrence of ADR were observed in 2 groups before and after treatment.RESULTS:After treatment,plasma levels of triglyceride,amylase and PCT,WBC count,APACHE Ⅱ score and Balthazar CT score in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P＜0.05).Length of hospitalization stay in ICU observation group was significantly shorter than control group,with statistical significance(P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups(P＞0.05).CONCLUSIONS:PE combined with intensive insulin glycemic control can effectively reduce the level of plasma triglyceride,relieve inflammatory reaction and improve prognosis without increasing the occurrence of ADR.

Effects of Licorice on Pharmacokinetics of Lovastatin in Hyperlipidemic Rats / 中国医科大学学报

Objective To study the effect of licorice on the pharmacokinetics of lovastatin in hyperlipidemic rat model.Methods Eighteen rats were randomly divided into control group (n =6) and test group (n =12).Rats in the test group were administered high fat diet to construct hyperlipidemic rat model.The 12 hyperlipidemic rats were then randomly divided into two groups:lovastatin group (n =6) and lovastatin combined with hcorice group (n =6).The rats in both groups were administered lovastatin capsule (20 mg/kg,0.5％ CMC-Na solution) after receiving licorice (for lovastatin combined with licorice group) or saline (for lovastatin group) for 7 days.Blood samples were collected at different time points before and after the administration of lovastatin capsule.The plasma concentrations of lovastatin and lovastatin acid (an active metabolite of lovastatin) were determined by LC-MS/MS method.Pharmacokinetics parameters were calculated using DAS 2.0 software,and the two groups were compared using SPSS 18.0 software.Results Long-term administration of licorice resulted in a significant increase in the plasma level of lovastatin acid in the hyperlipidemic rat,and the corresponding mean Cmax was approximately 80％ higher than that of the lovastatin group (P ＜ 0.05),while AUC0-t and AUC0-t increased by 115％ and 109％,respectively (P =0.005 and P =0.027).Cmax and AUC of lovastatin also increased,but there was no statistical significance (P ＞ 0.05).Conclusion Licorice can inhibit the metabolism of lovastatin in hyperhpidemic rats and increase its exposure in vivo.

Study on changes of C-reactive protein and D-dimer in hyperlipidemic and biliogenic acute pancreatitis patients / 重庆医学

Objective To investigate the changes of C-reactive protein(CRP)and D-dimer in the patients with hyperlipidemic acute pancreatitis(HLAP)and biliogenic acute pancreatitis(BAP).Methods One hundred fifty-five inpatients with acute pancreati-tis in our hospital from Jan.2012 to Dec.2014 were divided into the HLAP group and BAP group by etiology.Also the patients were divided into mild acute pancreatitis(MAP)subgroup and moderately severe acute pancreatitis(MSAP)subgroup by disease se-verity.Blood routine,liver and kidney function,glucose(Glu),calcium,blood lipids,CRP and D-dimer were measured.Results Platelet,Glu and blood lipid indicators in the HLAP group were significantly higher than those in the BAP group.But alanine amin-otransferase(ALT),r-glutamyl transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),calci-um(Ca)and creatinine(Cr)in the HLAP group were significantly lower than those in the BAP group(P <0.05).CRP in the HLAP group was significantly higher than that in the BAP group with statistical difference(P <0.01).CRP had statistical difference be-tween the HLAP group and BAP group in the MAP and MSAP subgroups (P <0.01).CRP and D-dimer had statistical difference between in the MAP and MSAP subgroups of the HLAP group(P <0.05).Increased CRP and D-dimer in the HLAP group were the risk factors for MSAP occurrence(OR =1.121,3.716,P =0.025,0.001 ).In the BAP group,only increased D-dimer was the risk factor for MSAP occurrence(OR=2.717,P =0.002).Conclusion CRP and D-dimer in HLAP and BAP are increased with dis-ease severity aggravation,moreover CRP increase is more obvious in HLAP patients.

HPLC-DAD-MS/MS profiling of phenolics from Securigera securidaca flowers and its anti-hyperglycemic and anti-hyperlipidemic activities

Abstract Securigera securidaca (L.) Degen & Döefl., Fabaceae, has been widely used in the Iranian, Indian and Egyptian folk medicine as antidiabetic and anti-hyperlipidemic remedy. Phenolic profiling of the ethanolic extract (90%) of the flowers of S. securidaca was performed via HPLC-DAD-MS/MS analysis in the positive and negative ion modes. The total polyphenols and flavonoids in the flowers were determined colorimetrically, and the quantification of their components was carried out using HPLC-UV. Total phenolics and flavonoids estimated as gallic acid and rutin equivalents were 82.39 ± 2.79 mg/g and 48.82 ± 1.95 mg/g of the dried powdered flowers, respectively. HPLC-DAD-MS/MS analysis of the extract allowed the identification of 39 flavonoids and eight phenolic acids. Quantitative analysis of some flavonoids and phenolics (mg/100 g powdered flowers) revealed the presence of isoquercetrin (3340 ± 2.1), hesperidin (32.09 ± 2.28), naringin (197.3 ± 30.16), luteolin (10.247 ± 0.594), chlorogenic acid (84.22 ± 2.08), catechin (3.94 ± 0.57) and protocatechuic acid (34.4 ± 0.15), in the extract. Moreover, the acute toxicity, hypoglycemic and hypolipidemic effects of the extract were investigated using alloxan induced diabetes in rats in a dose of 100, 200, and 400 mg/kg bwt. The ethanolic extract was safe up to a dose of 2000 mg/kg. All tested doses of the flower extract showed marked decrease in blood glucose level by 31.78%, 66.41% and 63.8% at 100, 200 and 400 mg/kg bwt, respectively, at p < 0.05. Regarding the anti-hyperlipidemic effect, a dose of 400 mg/kg of the flower extract showed the highest reduction in serum triacylglycerides and total cholesterol levels (68.46% and 51.50%, respectively at p < 0.05). The current study proved the folk use of the flowers of S. securidaca as anti-diabetic and anti-hyperlipidemic agent which could be attributed to its high phenolic content.

Effect on Blood Lipid and Hepatoprotective Efficacy of Hemp Seed Oil in Hyperlipidemic Rats / 中国药师

Objective:To observe the effect of hemp seed oil on the blood lipid and its hepatoprotective efficacy in hyperlipidemic rats. Methods:High fat diet was used to make the hyperlipidemia model in SD rats,and the rats were randomly divided into 6 groups:the normal control group,high fat model group,high dose group(1. 5 g·kg-1 ),medium dose group(1. 0 g·kg-1 ),low dose group (0. 5 g·kg-1 )and Xuezhikang group(0. 5 g·kg-1 ). After 35-day treatment,serum TC,TG,HDL-C,LDL-C,SOD,MDA,ALT, AST and liver SOD were detected. Results:Compared with the model group,hemp seed oil at different dosages could significantly de-crease the contents of serum TC,TG,ALT and the atherogenic index(AI)( P<0. 05 or P<0. 01),and significantly increase the SOD activity in serum and liver(P<0. 01). The contents of serum MDA and AST in the medium and high dose groups were signifi-cantly decreased(P<0. 01),and the content of LDL-C in serum and the content of MDA in liver in the high dose group were signifi-cantly reduced(P<0. 01). Conclusion:Hemp seed oil shows promising blood lipid reducing ability and liver protective effect in hy-perlipidemic rats,and the mechanism may be related with liver lipid metabolism improvement and antioxidant function enhancement.