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Dyslipidemia is the pathological basis of the occurrence and development of atherosclerosis. It is a major independent risk factor for hypertension, coronary heart disease and cerebrovascular disease. Regulating blood lipid level plays an important role in decreasing the incidence of cardio-cerebrovascular disease. Zhibitai capsule, a lipid-regulating Chinese medicine, has the similar effect to statins. We searched animal experiment studies, clinical trials and reviews in China National Knowledge Infrastructure to analyze the application value and advantages of Zhibitai capsule.
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Objective To study the effect of SLCO1B1 521 T>C and APOE gene polymorphisms on the clinical efficacy and safety of atorvastatin in ischemic stroke patients with dyslipidemia. Methods 210 cases of ischemic stroke with dyslipidemia were enrolled from April 2018 to December 2018 to determine SLCO1B1 521 T>C and APOE gene polymorphisms. Patients received atorvastatin 20 mg/d orally. TC, TG, HDL-C, LDL-C levels were measured to evaluate the efficacy 3 months pre-and post- treatment. TBil, ALT, AST, CK levels were assayed with following up adverse reactions to evaluate safety. Results SLCO1B1 521 T>C genotype distribution was TT79.05%, TC19.05%, CC1.90%. E2, E3, E4 allele frequencies of APOE genes were 14.28%, 67.62%, 18.10%. Each genotype conforms to the law of Hardy-Weinberg balance. After three months of medication, there were significant differences in TC, TG, LDL-C, HDL-C changes in patients with different APOE genotypes. No obvious abnormality was found in safety index. The incidence of myalgia in SLCO1B1521 T>C mutant group was significantly higher than that in the wild group (P<0.01). Conclusion Lipid regulation of atorvastatin was affected by APOE gene polymorphism. SLCO1B1521 T>C may be associated with myalgia, the adverse reaction of atorvastatin. The detection of SLCO1B1 and APOE genotyping is helpful for individualized treatment of blood lipids and provides basis for rational use of statins in patients for drug therapy management.
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As pílulas anticoncepcionais são esteroides que visam impedir a gravidez indesejada e regular distúrbios menstruais. Acessíveis em grande variedade no mercado e no SUS, são o método contraceptivo mais aceito pelas mulheres, entretanto trazem diversos efeitos colaterais. O objetivo deste trabalho foi analisar como a pílula anticoncepcional pode alterar as principais vias metabólicas femininas. Trata-se de uma revisão bibliográfica nas bases de dados SciELO, BVS e PubMed, com foco nas correlações entre o uso da pílula anticoncepcional e as alterações metabólicas. Os anticoncepcionais orais atuam na inibição da biossíntese de androgênios e estimulação da SHBG, o que reduz o efeito anabólico proteico. Também promovem o acréscimo dos níveis de LDL-colesterol, colesterol total, PCR-us e dímero D, e alterações na sensibilidade da insulina, no metabolismo do zinco e na hemostasia. Apesar de existirem recomendações que preconizam o uso de outros métodos contraceptivos e estudos que demonstram a satisfação feminina ao trocar os anticoncepcionais orais pelos LARCs, a pílula ainda é a mais utilizada pelas mulheres.(AU)
Contraceptive pills are steroids that prevent unwanted pregnancy and regular menstrual disorders. Accessible in a great variety in market and SUS, they are the contraceptive method most accepted by women, however, they bring several side effects. The objective of this study was analyze how the contraceptive pill can alter the main female metabolic pathways. This is a literature review in the SciELO, BVS and PubMed databases, focusing on the correlations between the use of contraceptive pill and metabolic alterations. Oral contraceptives act to inhibit androgen biosynthesis and stimulate SHBG, which reduces the protein anabolic effect. They also bring about high levels of LDL cholesterol, total cholesterol, CRP, D-dimer, changes in insulin, absence of zinc metabolism and hemostasis. Although there are recommendations that recommend the use of other contraceptive methods and studies that demonstrate the satisfaction of women in exchanging oral contraceptives with LARCs, the pill is still the most used by women.(AU)
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Humans , Female , Contraceptive Agents/adverse effects , Contraceptive Agents/metabolism , Contraceptive Agents/pharmacokinetics , Databases, Bibliographic , Contraception , Lipid Regulating Agents , Contraceptive EffectivenessABSTRACT
Abri Herba,a kind of plant of Leguminosae family,is widely distributed in Guangdong and Guangxi,with rich resources.With a long medication history in China,its whole-plant, apart from plant seeds have been used as medicine, with the effects in removing dampness and removing jaundice, clearing heat and detoxifying,and clearing the liver and relieving pain. By accessing CNKI, Wanfang date,VIP Web, ScienceDirect,FMRS, Pubmed and multiple domestic and foreign databases,recent literatures on chemical constituents and pharmacological action and clinical trials of Abri Herba were collected and summarized in a review.According to a great quantity of relevant domestic and foreign literatures.Abri herba contains abundant chemical constituents, such as betulinic acid and other triterpenoids, catechin and other flavonoids,abrine and other alkaloids, chrysophanol and other anthraquinones, as well as inorganic elements.Abri Herba has a wide range of pharmacological effects due to rich material basis. Abri Herba, as a folk traditional herb, is used to treat jaundice with damp-heat pathogen, distending pain in the stomach, acute mastitisand gall, steatosis hepatis, hepatitis and internal traumatic injury. It also has many other effects in resisting tumor,oxidation,bacteria,virus and inflammation, relieving pain, promoting wound healing and regulating immunity.At present, there is single herb or traditional Chinese medicine compounds of Abri Herba in clinic, and the latter is the majority. Abri Herba can play a better pesticide effect by combining with traditional Chinese medicine. With a wide range of pharmacological effects,cheap price and easy cultivation. Abri Herba has high economic and social benefits, great potential for development and broad market prospects.Based on domestic and foreign studies on Abri Herba in past 30 years, the recent progress in the studies on chemical constituents,biological activities and clinical applications of this plant was reviewed in this paper, in the expectation of providing reference for further development and comprehensive utilization of Abri Herba medicinal resources.
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Proprotein convertase subtilisin/kexin type 9 (PCSK9) is the highligh of lipid-lowering therapy due to its effect on LDL-C in the cardiovascular field. PCSK9 inhibitor has become the hot spot in biological preparations in these years, but the properties of adverse reaction, high price and injection-methods of biologicals limit its development. Currently, it was reported that many traditional Chinese medicine and natural products had the functions of regulating PCSK9. This paper summarized the regulation and mechanisms of traditional Chinese medicine monomers, active ingredients, compounds and natural products on PCSK9 so as to provide references for the development of small-molecule inhibitors of PCSK9.
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OBJECTIVE To explore the anti-atherosclerotic effect of the extract of traditional Chinese medicine formula Dan-yi-lian(DYL)and the related mechanism.METHODS Atherosclerosis(AS)mod-el was established in ApoE(-/-)mice with a western diet. The mice were orally administered with differ-ent doses of DYL or vehicle daily for 28 d.The anti-atherosclerotic effect was evaluated by measuring the aortic atherosclerotic lesion area and media thickness with ultrasound imaging and histological sec-tions staining method. The effect on blood lipid was investigated by determining TC, TG, LDL, HDL, Apo-A1, Apo-B, etc. The anti-oxidative activity as assessed by determining the level of SOD, CAT, GSH,GSH-Px and MDA.Western blot analysis was used to determine the effect on ICAM-1,VCAM-1, MMP-2 and TNF-α. RESULTS In Dan-yi-lian administered ApoE(-/-)mice,the plaque area and media thickness were significantly reduced. Meanwhile, serum TC, TG, LDL and Apo-B were decreased, in contrast to the increased level of HDL and Apo-A1.On the other hand,SOD,CAT,GSH and GSH-Px were increased, while MDA was reduced in liver homogenate. In addition, the expression of ICAM-1, VCAM-1,MMP-2 and TNF-α was obviously inhibited by Dan-yi-lian.CONCLUSION Dan-yi-lian exhibit-ed potent anti-athero-sclerotic efficacy,in which the lipid-regulating,anti-oxidative and anti-inflammato-ry mechanism might be involved.
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Objective To evaluate the anti-lipid metabolic disorder activities of these compounds in vitro, the natural caffeic acid amide derivatives were designed and synthesized. Methods Using caffeic acid as start material, BOP as a condensing agent, and the target compounds were sequentially prepared with fourteen amines, and then the lipid-regulating effect was evaluated using HepG2 cells. Results Fourteen caffeic acid amide compounds CA1-CA14 were synthesized. The structures of the target compounds were identified by spectrum. Pharmacological results showed that fourteen derivatives have potency of lipid-regulating in different levels. In particular, compound CA6 showed significant lipid-regulating effects compared to the lead compounds caffeic acid and Simvastatin. Conclusion Compound CA6, CA7, and CA11 had not been reported in any literatures before. Among them, the novel compounds CA6 and CA11 have showed potential of lipid-regulating activities, and deserved further research.
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Hyperlipidemia is a common clinical disease. In recent years, the incidence of hyperlipidemia increased, and patients gradually increased. Hyperlipidemia easily leads to atherosclerosis, coronary heart disease and other cardiovascular and cerebrovascular diseases, and causes crisis to human health. Clinically, Western medicine treatment has a good effect, but also the existence of side effects and even toxic effects, long-term use of drug resistance and other issues. Chinese materia medica (CMM) under the guidance of traditional Chinese medicine theory, with good efficacy and side effects of small features in the clinical dialectical treatment, plays the characteristics of Chinese medicine, and has obvious advantages. In this paper, CMM monomer, single CMM, compound, and integrated traditional Chinese and Western medicine in the treatment of hyperlipidemia were reviewed, and Chinese medicine lipid-lowering development prospects and problems were analyzed.
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OBJECTIVE:To investigate the effects of NOS1AP rs12742393 A/C gene polymorphism on lipid-regulating re-sponse of rosuvastatin calcium. METHODS:Two hundred and tuirty six patients with coronary heart disease(CHD)were selected from cardiology department of our hospital during Jan. 2014-Jun. 2015,and then given rosuvastatin calcium and other symptomatic treatment for 12 weeks. Polymorphism of NOS1AP rs12742393 A/C was detected by PCR-RFLP. The levels of TG,TC,HDL-C and LDL-C were detected by photoelectric colorimetry before treatment and 4,12 weeks after treatment. The serum relationship of genotype with the level of blood lipid was analyzed. RESULTS:Among 236 CHD patients,there were 131 cases of AA genotype (55.5%),98 cases of AC genotype(41.5%) and 7 cases of CC genotype(3.0%);genotype and allele frequencies met the Har-dy-Weinberg balance(P>0.05). There were 132 patients with normal blood lipid and 104 patients with hypercholesterolemia;there was statistical significance in genotype and allele frequencies (P0.05). 4th and 12th week after treatment,the levels of TG,TC and LDL-C in different genotypes were all de-creased significantly;4th week after treatment,the level of LDL-C in AC+CC genotype was significantly lower than AA genotype, and the change compared to before treatment was significantly more than AA genotype,with statistical significance (P0.05). CONCLUSIONS:NOS1AP rs12742393 A/C gene polymorphism is associated with CHD complicated with hypercholesterolemia;the C allele of NOS1AP rs12742393 may strengthen the response of CHD patients with hy-percholesterolemia to rosuvastatin calcium through influencing the level of LDL-C.
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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.
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Objective To observe the effect ofGuanxin-Shutongcapsule in the treatment of arterial elasticity on patients with hypertension.Methods The hypertension patients who met the inclusion criteria were divided into treatment group (50 cases) and control group (52 cases). The control group was treated with antihypertensive drugs to control blood pressure within the normal range. The treatment group was treated withGuanxin-Shutongcapsule on the basis of the control group. All were given 8 weeks treatment. The main artery elastic parameters were meansured by the carotid-femoral pulse wave velocity (C-FPWV) and cervical-dorsal arterial pulse wave velocity (C-DPWV). The immune turbidimetric method was employed to enhance for the determination of high sensitive C reactive protein (hs-CRP); and radioimmunoassay was used to assess the serum IL-6, TNF-a, triglyceride (TG) and total cholesterol (TC). The blood pressure was monitored during the treatment.Results After the treatment, the level of hs-CRP (2.83 ± 1.35 mg/Lvs. 3.65 ± 1.38 mg/L,t=6.357), TNF-α (0.16 ± 0.08 mg/Lvs. 0.28 ± 0.07 mg/L,t=18.213), C-FPWV (13.85 ± 1.86 m/svs. 15.34 ± 1.78 m/s,t=6.524), C-DPWV (11.98 ± 1.45 m/svs. 12.87 ± 1.48 m/s,t=7.152) in treatment group was significantly lower than those in the control group (P<0.01).ConclusionGuanxin-Shutong capsule by inhibiting systemic inflammation, reducing and reversing atherosclerosis, and improving the arterial elasticity and blood pressure.
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OBJECTIVE:To provide reference for drug procurement and supply and rational use of lipid-regulating agents. METHODS:The epidemiological investigation was carried out among 159 506 cases from 74 hospitals in Beijing,Chengdu, Guangzhou,Hangzhou,Shanghai and Tianjin in 2013. The utilization of lipid-regulating agents was analyzed statistically in re-spects of purchase value,DDDs,DDC,actual average daily dose and sort ratio. RESULTS:The prevalence rate of hyperlipidemia was relatively high,accounting for 29.56% and showing a tendency of regional distribution and young age in all regions. The pa-tients with hypertension,diabetes and coronary heart disease had a higher incidence to suffer from hyperlipidemia. The use of atorv-astatin was in the first place,but it also had a higher DDC;while rosuvastatin hasd the advantage over aorvastatin in drug market. Simvastatin had a lower DDC and was more suitable for the patients with low income. The doses of lipid-regulating agents in other regions were lower than DDD except for those in Beijing and Tianjin. CONCLUSIONS:Statins dominate the lipid-regulating agents market. But new lipid-regulating agents and drug combination provide a new choice for clinical treatment.
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BACKGROUND/OBJECTIVES: We investigated the effects of a combination of grape pomace (Vitis labrusca, Campbell Early) and Omija fruit (Schizandra chinensis, Baillon) ethanol extracts on lipid metabolism and antioxidant defense system in diet-induced obese mice. MATERIALS/METHODS: Forty male C57BL/6J mice were divided into four groups and fed high-fat diet (control group, CON) or high-fat diet added 0.5% grape pomace extract (GPE), 0.05% Omija fruit extract (OFE) or 0.5% GPE plus 0.05% OFE (GPE+OFE) for 12 weeks. RESULTS: In contrast to the GPE- or OFE-supplemented groups, the GPE+OFE group showed significantly lower body weight and white adipose tissue weights than the CON group. Moreover, GPE+OFE supplementation significantly decreased plasma total cholesterol and increased the plasma HDL-cholesterol/total-cholesterol ratio (HTR) compared to the control diet. The hepatic triglyceride level was significantly lower in the GPE+OFE and GPE groups by increasing beta-oxidation and decreasing lipogenic enzyme compared to the CON group. Furthermore, GPE+OFE supplementation significantly increased antioxidant enzyme activities with a simultaneous decrease in liver H2O2 content compared to the control diet. CONCLUSIONS: Together our results suggest that supplementation with the GPE+OFE mixture may be more effective in improving adiposity, lipid metabolism and oxidative stress in high-fat diet-fed mice than those with GPE and OFE alone.
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Animals , Humans , Male , Mice , Adipose Tissue, White , Adiposity , Body Weight , Cholesterol , Diet , Diet, High-Fat , Ethanol , Fruit , Lipid Metabolism , Liver , Mice, Obese , Oxidative Stress , Plasma , Triglycerides , Vitis , Weights and MeasuresABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is a clinical syndrome which is characterized by diffuse fatty degeneration of hepatocytes without excessive use of alcohol, and it is one of the most common causes of abnormal liver function and chronic liver disease. Although the etiology and pathogenesis of NAFLD have not been well defined, the pathological basis of NAFLD is fatty degeneration of hepatocytes. On the one hand, the lipid-regulating drugs can reduce blood lipids to decrease liver fat deposition; on the other hand, they can promote lipid accumulation in the liver to increase liver injury. So there is still controversy that if the lipid-regulating drugs can be used for treating NAFLD. In this paper, the application and progression of four lipid-regulating drugs, statins, fibrates, probucol, and ezetimibe, in NAFLD are briefly described.
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Estima-se que 170 milhões de pessoas no mundo estejam infectadas com o vírus da hepatite C (VHC), o que está altamente relacionado à ocorrência de hepatite crônica e carcinoma hepatocelular. A prevalência de esteatose hepática em doentes com hepatite C crônica é muito maior do que na população geral variando entre 40 a 75%. A associação entre a infecção pelo VHC e esteatose hepática é multifatorial. Duas formas de esteatose hepática são encontradas em pacientes com hepatite C crônica: esteatose metabólica (fatores de risco) e citopática relacionada ao genótipo 3a. Os lipídios são essenciais para o ciclo de replicação do VHC, eles podem exercer seu efeito em diferentes níveis como: grupos prostéticos em proteínas virais e/ou cofatores celulares na replicação de VHC, componentes especializados na estrutura do VHC onde ocorre a replicação ou como constituinte das partículas lipovirais. Trabalhos experimentais realizados anteriormente por nosso grupo relataram que a administração do composto natural Yo Jyo Hen Shi Ko (YHK) promove a inibição do desenvolvimento da esteatose, redução dos marcadores de estresse oxidativo, menor escore de inflamação, melhora nas concentrações de aminotransferases e diminuição da gordura visceral em um modelo animal de esteato-hepatite não alcoólica. A terapia padrão da hepatite C consiste em uma combinação de interferon peguilado alfa (PEG-IFN-alfa) que estimula o sistema imunológico do hospedeiro para combater a infecção e o composto antiviral ribavirina. Atualmente foram aprovados pelas agências de saúde os inibidores de protease Boceprevir, Telaprevir, Daclatasvir e Simeprevir. No entanto, sua eficiência varia entre os genótipos e as constantes mutações do vírus podem levar a resistência. A falta de uma vacina ou uma terapia definitiva faz com que diversos compostos com diferentes mecanismos de ação sejam testados como possíveis alternativas de tratamento. Tendo em vista a capacidade do YHK de reduzir a esteatose e a importância...
Worldwide is estimated that nearly 170 million people are infected with hepatitis C virus (HCV), highly correlated with the occurrence of chronic hepatitis and hepatocellular carcinoma. Hepatitis C patients present higher prevalence of steatosis when compared with the general population, ranging between 40% and 75%. There are two forms of steatosis in HCV infected patients: metabolic steatosis (risk factors) and cytopathic associated with genotype 3. Lipids are essential for the HCV replication cycle. It acts on different functions: as prosthetic groups into viral proteins and / or cellular cofactors in the HCV replication, as specific HCV components or as a constituent of lipovirals particles. Our group previously reported that the administration of the natural compound Yo Jyo Hen Shi Ko (YHK) inhibits steatosis development, decreases markers of oxidative stress and inflammation, improves aminotransferases concentration and decreases the visceral fat. Standard therapy for hepatitis C is a combination of pegylated interferon alpha (PEG-IFN-alfa), stimulating the host immune system to fight infection and the antiviral compound named ribavirin. Nowadays, Telaprevir, Boceprevir, Sofosbovir and Simeprevir are approved as new anti-HCV drugs; they act as protease inhibitors. Its efficiency, however, varies between genotypes, and the constant mutations of the virus can lead to resistance. The lack of vaccines, or a definitive therapy, stimulates the research of new compounds and alternative treatments. In this study, we evaluated the effect of YHK in HCV replication cycle due to the effect of YHK and the importance of lipid metabolism for HCV. For this purpose we used cell culture techniques allowing the study of different stages of HCV replication cycle: entry (HCVpp), replication - replicons JFH1 NS3-5B and Con1, also replication and infection-JC1-Fluc. We also used active compounds of its ingredients: Panax pseudo ginseng - Notoginsenoside R1...
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Antiviral Agents , Cell Culture Techniques , Drugs, Chinese Herbal , Hepacivirus , Hepatitis C , Lipid Regulating Agents , Virus ReplicationABSTRACT
Objective: To design and synthetise the natural products caffeic acid ester derivatives, and to study the lipid metabolic disturbance regulation activity of the derivatives. Methods: Applying caffeic acid as material, the target compounds were prepared by two routes and evaluated for antihyperlipidemic effects in HepG2 cells. Results: Ten caffeic acid ester derivatives were synthesized, and compound C5 has not yet been reported. The structures of the target compounds were identified by spectrum. Pharmacological results showed that eight derivatives had potency of lipid-regulating in different levels. In particular, compounds C3 and C5 showed significant lipid-regulating effects compared to the lead compound caffeic acid and positive drug Simvastatin. Conclusion: Compound C5 is a new caffeic acid ester derivative. The primary structure-activity relationships are discussed in this article.
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FUNDAMENTO: A atividade do óxido nítrico sintase endotelial (eNOS) pode ser modulada pelo colesterol da lipoproteína de alta densidade (HDL-C), estatinas ou polimorfismos, como o T-786C de eNOS. OBJETIVO: Este estudo teve como objetivo avaliar se o polimorfismo T-786C está associado a alterações nos efeitos da atorvastatina no perfil lipídico, nas concentrações de metabólitos de óxido nítrico (NO) e da proteína C reativa de alta sensibilidade (PCR-as). MÉTODOS: Trinta voluntários do sexo masculino, assintomáticos, com idade entre 18-56 anos foram genotipados e classificados de acordo com a ausência (TT, n = 15) ou presença (CC, n = 15) do polimorfismo. Eles foram selecionados aleatoriamente para a utilização de placebo e atorvastatina (10 mg/dia por 14 dias). Após cada tratamento foram medidos lípides, lipoproteínas, frações HDL2 e HDL3, atividade da proteína de transferência de colesteril éster (CETP), metabólitos de NO e PCR-as. RESULTADOS: As comparações entre genótipos após a administração de placebo mostraram aumento da atividade da CETP polimorfismo-dependente (TT, 12 ± 7; CC, 22 ± 12, p < 0,05). As análises da interação entre os tratamentos indicaram que a atorvastatina tem efeito sobre colesterol, LDL, nitrito e razões lípides/proteínas (HDL2 e HDL3) (p < 0,001) em ambos os genótipos. É interessante notar as interações genótipo/droga sobre a CETP (p < 0,07) e a lipoproteína (a) [Lp(a)] (p < 0,056), levando a uma diminuição limítrofe da CETP, embora sem afetar a Lp(a). A PRC-as não mostrou alterações. CONCLUSÃO: Os resultados sugerem que o tratamento com estatinas pode ser relevante para a prevenção primária da aterosclerose em pacientes com o polimorfismo T-786C do eNOS, considerando os efeitos no metabolismo lipídico.
BACKGROUND: Endothelial nitric oxide synthase (eNOS) activity may be modulated by high-density lipoprotein cholesterol (HDL-C), statins or polymorphisms, such as the T-786C of eNOS. OBJECTIVE: This study aimed at evaluating if the T-786C polymorphism is associated with changes of atorvastatin effects on the lipid profile, on the concentrations of metabolites of nitric oxide (NO) and of high sensitivity C-reactive protein (hsCRP). METHODS: Thirty male volunteers, asymptomatic, aged between 18 and 56 years were genotyped and classified according to absence (TT, n = 15) or presence (CC, n = 15) of the polymorphism. They were randomly selected for the use of placebo or atorvastatin (10 mg/day/14 days). After each treatment lipids, lipoproteins, HDL2 and HDL3 composition, cholesteryl ester transfer protein (CETP) activity, metabolites of NO and hsCRP were evaluated. RESULTS: The comparisons between genotypes after placebo showed an increase in CETP activity in a polymorphism-dependent way (TT, 12±7; CC, 22±12; p < 0.05). The interaction analyses between treatments indicated that atorvastatin has an effect on cholesterol, LDL, nitrite and lipid-protein ratios (HDL2 and HDL3) (p < 0.001) in both genotypes. Interestingly, we observed genotype/drug interactions on CETP (p < 0.07) and lipoprotein (a) (Lp(a)) (p < 0.056), leading to a borderline decrease in CETP, but with no effect on Lp(a). HsCRP showed no alteration. CONCLUSION: These results suggest that statin treatment may be relevant for primary prevention of atherosclerosis in patients with the T-786C polymorphism of eNOS, considering the effects on lipid metabolism.
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Adolescent , Adult , Humans , Male , Middle Aged , Young Adult , Heptanoic Acids/pharmacology , Lipid Metabolism/drug effects , Lipids/blood , Nitric Oxide Synthase Type III/genetics , Polymorphism, Genetic/genetics , Pyrroles/pharmacology , Analysis of Variance , C-Reactive Protein/analysis , Cholesterol Ester Transfer Proteins/blood , Heptanoic Acids/blood , Nitric Oxide Synthase Type III/blood , Nitric Oxide Synthase Type III/drug effects , Nitric Oxide/blood , Pyrroles/blood , Single-Blind Method , Statistics, Nonparametric , Treatment OutcomeABSTRACT
Objective To observe the incidence and awareness of dyslipidemia in newly diagnosed elderly type 2 diabetic patients,and to determine the efficacy and safety of simvastatin and Xuezhikang in the treatment of dyslipidemia.Methods Totally 255 newly diagnosed type 2 diabetic patients aged 60 to 75 years in CDCPS research were included and the incidence of dyslipidemia were retrospectively analyzed.Patients were divided into 3 groups:the group 1 was given simvastatin (20 mg/d); the group 2 was given Xuezhikang (0.6～ 1.2 g/d); the group 3 was given no lipid-lowering drugs.All the three groups were given lifestyle intervention and blood pressure and blood sugar control.All patients were followed up monthly and TG,TC,LDL-C,BUN,ALT and creatinine were examined at 7th,14th,and 20th months.Results The incidence of dyslipidemia and the rate of awareness in the study cohort was 62％ and 55.7％.Hypertriglyceridemia was the most common type of dyslipidemia (29％).Among 88 patients with dyslipidemia,25 (28.4％) patients had been treated with lipid-lowering drugs before our study,in whom,8(32％) patients had normal serum lipid levels and only 3 (12％)patients reached to the control standards.20 months after the treatment,the decrement scales of TG,TC and LDL-C were 1.8％,10.5 ％ and 20 ％ respectively in group 1;5.5 ％,15.0％ and 15.7％ respectively in group 2;2.7％,8.7％ and 4.5％ respectively in group 3.The long-term lifestyle intervention and blood pressure and blood sugar control reduced serum lipid to some degree.In the patients with dyslipidemia,lipid-lowering drugs had a better effect on serum lipid reduction than did the lifestyle intervention (P=0.0047,0.0433).There was no significant difference between simvastatin and Xuezhikang.The function changes of liver and kidney had no difference before and after drug intervention (P＞0.05).Conclusions Serum lipid should be monitored and early medicine intervention should be taken in newly diagnosed elderly type 2 diabetic patients.Medicine intervention has a better effect on serum lipid reduction than lifestyle intervention,and there are no significant differences in efficacy and safety between simvastatin and Xuezhikang.
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Niacin, a broad-spectrum lipid-regulating agent, can significantly lower plasma triglyceride and raise the high density lipoprotein-cholesterol.Extended-release niacin added to statins monotherapy could further modify the lipid profile and reduce residual cardiovascular risk.This combination therapy provides a safe, effective and economical treatment for clinicians and may be superior to other drugs combined with statins.
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OBJECTIVE:To evaluate the lipid-regulatory efficacy and safety of rosuvastatin (10 mg?d-1) for Chinese population. METHODS: The pertinent literature comparing the serum blood lipid level before and after treatment with rosuvastatin (10 mg?d-1) between 2001 and 2008 were collected by retrieving Wanfang database,CNKI,Weipu electronic periodicals;and the data were given a meta-analysis using RevMan 4.2 software,meanwhile the safety of rosuvastatin was evaluated. RESULTS: A total of 346 patients were enrolled in 5 trials. After treatment with rosuvastatin (10 mg?d-1),the low density lipoproteincholesterol(LDL-C) was lowered by 1.71 mmol?L-1 on average;the total cholesterol (TC) was lowered by 1.98 mmol?L-1 on average;high density lipoprotein cholesterol(HDL-C) was increased by 0.17 mmol?L-1 on average;and the level of triglyeride was lowered by 0.79 mmol?L-1 on average. A total of 54 adverse events were reported,and the adverse drug reactions manifested chiefly as upper respiratory infection,mild notalgia,debilitation and gastrointestinal upset. No severe side effects were reported. CONCLUSION: It has been confirmed by domestic clinical trials that rosuvastatin(10 mg?d-1) is safe and effective for Chinese population.