ABSTRACT
Background: High cholesterol is the sixth-highest risk factor for death in the globe. Herbal medications regularly complement modern medical care, especially by providing safe and well-tolerated therapies for chronic conditions. Aims and Objectives: The present study was undertaken to evaluate and compare cholesterol lowering effects of Terminalia arjuna bark and Bacopa monnieri leaves (Brahmi) extract in human blood samples diagnosed with hyperlipidemia. Materials and Methods: Herbal extract of arjuna (T. arjuna) and Brahmi (B. monnieri) leaves in distilled water (d/w) and cow’s urine (c/u) [A1, A2, B1, B2] was taken and added to the pooled serum samples collected aseptically and a kinetic study was performed with it. Cholesterol standard was obtained from Erba chem Transasia kit (Trinder’s method, endpoint) with standard cutoff value 200 mg/dL. Results: Baseline reading of total cholesterol in all samples was 189 mg/dL. After 2 h, total cholesterol reading in A1 was 159 mg/dL, 157, 155 and 154 mg/dL in A2, B1, B2, respectively. After 4 h, total cholesterol reading in A1 was 149 mg/dL, 148, 146, and 144 mg/dL in A2, B1, B2, respectively. After 6 h, total cholesterol reading in A1 was 109 mg/dL, 104, 112, and 110 mg/dL in A2, B1, B2, respectively. Conclusion: From the findings of the present study, it was found that aqueous extract of Brahmi (B. monnieri) and T. arjuna (Arjuna) were effective in reducing total cholesterol levels. It can be considered as a potential therapeutic alternative in patients with hyperlipidemia, but warrants further clinical studies.
ABSTRACT
Background: High cholesterol is the sixth-highest risk factor for death in the globe. Herbal medications regularly complement modern medical care, especially by providing safe, well-tolerated therapies for chronic conditions. Aims and Objectives: The present study was undertaken to evaluate and compare the cholesterol-lowering effects of Terminalia arjuna bark and Bacopa monnieri leaves (Brahmi) extract in human blood samples diagnosed with hyperlipidemia. Materials and Methods: Herbal extract of arjuna (T. arjuna) and Ashwagandha (Withania somnifera [WS]) in distilled water (d/w) and cow’s urine (c/u) [A1, A2, D1, and D2] was taken and added to the pooled serum samples collected aseptically and a kinetic study was performed with it. Cholesterol standard was obtained from Erba Chem Transasia kit (Trinder’s method, endpoint) with a standard cutoff value of 200 mg/dL. Results: Baseline reading of total cholesterol in all samples was 189 mg/dL. After 2 h, the total cholesterol reading in A1 was 159 mg/dL, 157, 162, and 160 mg/dL in A2, D1, and D2, respectively. After 4 h, the total cholesterol reading in A1 was 149 mg/dL, 148, 151, and 149 mg/dL in A2, D1, and D2, respectively. After 6 h, the total cholesterol reading in A1 was 109 mg/dL, 104, 112, and 110 mg/dL in A2, D1, and D2, respectively. Conclusion: From the findings of the present study, it was found that aqueous extract of Ashwagandha (WS) and Arjuna (T. arjuna) was effective in reducing total cholesterol levels. It can be considered a potential therapeutic alternative in patients with hyperlipidemia but warrants further clinical studies.
ABSTRACT
RESUMEN INTRODUCCIÓN: El ACV es uno de los eventos cardiovasculares más prevalentes en el mundo, en Colombia es la segunda causa de muerte y la primera de discapacidad. Uno de los factores de riesgo más importantes para tener en cuenta es el control del colesterol, la reducción de los niveles de C-LDL, principalmente por medio del tratamiento con estatinas y otros fármacos hipolipemiantes. MATERIALES Y MÉTODOS: En esta revisión narrativa de la literatura se ha recogido la información más relevante sobre el uso y los beneficios de este tratamiento y algunas consideraciones adicionales. CONCLUSIÓN: Los hallazgos de esta revisión demuestran el efecto protector de esta terapia cuando se consiguen reducir los niveles de C-LDL y colesterol, además, las otras terapias como ezetimiba o inhibidores de PSCK9. Por otro lado, los estudios mencionan posibles efectos beneficiosos en el contexto de ACV pero se requieren más ensayos clínicos.
ABSTRACT INTRODUCTION: Stroke is one of the most prevalent cardiovascular events in the world, in Colombia it is the second cause of death and first in disability. One of the most important risk factors to consider is cholesterol control, the reduction of LDL-C and cholesterol levels, mainly through treatment with statins and other lipid-lowering drugs. MATERIALS AND METHODS: The most relevant information on the use and benefits of this treatment and some additional considerations have been collected in this narrative review of the literature. CONCLUSION: The results of this narrative review show the protective effect of this therapy when it is possible to reduce LDL-C and cholesterol levels, in addition to other therapies such as ezetimibe or PSCK9 inhibitors. On the other hand, studies mention possible beneficial effects in the context of stroke but more clinical trials are required.
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors , Stroke , Cholesterol, LDL , Hypolipidemic AgentsABSTRACT
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.
ABSTRACT
Abstract The extract of Belamcanda chinensis leaves (BCLE) is a traditional Chinese herbal medicine for the treatment of diabetes-related hyperlipidemia in Hainan province, South China. In this study, the lipid-decreasing effects of BCLE on obese diabetes were investigated on KK-Ay mice. The component F2 ameliorated lipid disorder, as indicated by decreased levels of body weight, liver index, levels of TC, TG and LDL-c in the serum and liver. The enhancement effect of F2 on liver SOD and the inhibitory effect of F2 on MDA demonstrated that F2 exhibited significant antioxidant activity on liver injury. F2 also prevented vacuolar degeneration and reduced pathological tissue injury in liver. In addition, the component F1 decreased the levels of TG, LDL-c and MDA in the liver. These findings suggest that F2 may have therapeutic potential in the prevention and therapy of hyperlipemia and liver disease associated with obesity-related diabetes.
ABSTRACT
Abstract Campomanesia xanthocarpa, a plant belonging to the Myrtaceae family, is popularly known as gabiroba. Leaves of gabiroba has been popularly used to treat various diseases, including inflammatory, renal, and digestive, among others. Additionally, studies have shown an effect to reduce blood cholesterol levels. The aim of this study was to evaluate the antihyperglycemic and hypolipidemic effects of Campomanesia xanthocarpa seed extract in hyperglycemic rats. The results showed that 400 mg/kg of seed extract was able to decrease blood glucose levels and to increase the muscular and hepatic glycogen content as well as to inhibit the sucrase and maltase activity. At doses of 200 mg/kg and 800 mg/kg, the activity of these enzymes was also reduced. In the lipid profile 400 mg/kg produced a decrease in total and LDL cholesterol serum levels; and with 200 mg/kg there was an increase in HDL cholesterol levels. The extract did not present hepatic and renal toxic effects at the different doses tested. The results suggest that the treatment with Campomanesia xanthocarpa seeds extract is useful in reducing glycemia, total cholesterol and LDL levels with potential adjuvant therapeutic in the treatment of diabetes and hypercholesterolemia, however, additional pharmacological and toxicological studies are still required.
Resumo Campomanesia xanthocarpa, planta pertencente à família Mirtaceae, é popularmente conhecida como gabiroba. Folhas da gabiroba são popularmente usadas para tratar de doenças inflamatórias, renais, digestivas entre outras. Além disso, estudos têm mostrado um efeito redutor dos níveis de colesterol. O objetivo deste estudo foi avaliar os efeitos anti-hiperglicêmico e hipolipidêmico do extrato de sementes de Campomanesia xanthocarpa em ratos hiperglicêmicos. Os resultados mostraram que 400 mg/kg do extrato da semente foi capaz de reduzir os níveis de glicose sanguínea e aumentar o conteúdo de glicogênio hepático e muscular, bem como inibir a atividade da maltase e sacarase. Na dose de 200 mg/kg e 800 mg/kg, a atividade das enzimas também foi reduzida. No perfil lipídico, 400 mg/kg produziu uma redução nos níveis séricos de colesterol total e LDL e com 200 mg/kg houve um aumento nos níveis de colesterol HDL. O extrato não apresentou efeitos tóxicos hepáticos e renais nas doses testadas. Os resultados sugerem que o tratamento com o extrato de Campomanesia xanthocarpa é eficaz na redução da glicemia, de colesterol total e LDL com potencial para tratamento adjuvante do diabetes e hipercolesterolemia, no entanto estudos farmacológicos e toxicológicos adicionais são necessários.
Subject(s)
Animals , Rats , Carbon Dioxide , Myrtaceae , Seeds , Plant Extracts/pharmacology , Hypoglycemic Agents/pharmacologyABSTRACT
Objective: The chemical finger printing-based methods for evaluating TCMs quality can report partial of TCMs quality without linking to effective constituents. In this study, a mathematical model was established for the quality evaluation of total saponins of Panax japonicus (TSPJ), a folk medicine in China and Japan for treating diseases, through coupling the dynamic changes of chemical constitutions with corresponding activities. Methods: High-performance liquid chromatography (HPLC) fingerprints were applied to establish the chromatographic database of TSPJ. The associated hypolipidemic activity database was determined by TG assay using HepG2 cell model. Correlation analyses of two databases were performed by partial least squares (PLS) for calculating regression coefficients, and the interval value of YZL value (the ratio of positive and negative peak-to-peak area coefficient) closely related to hypolipidemic activity was refined by the formula of Norminv function to value the quality of TSPJ. Results: In this study, the chromatographic data of 16 common peaks were obtained from 20 batches of TSPJ. After the estimate by this mathematical evaluation model, seven peaks were positively correlated with hypolipidemic activity, and nine peaks were negatively correlated with hypolipidemic activity. When the YZL value was less than 0.7861, the quality of sample was inferior, while YZL value was more than 6.6992, and the quality of samples was superior. The quality of another ten batches of TSPJ was further assessed to verify this method. Conclusion: These results indicated that the established model could be usefully applied to evaluate the quality of TSPJ in the hypolipidemic activity.
ABSTRACT
The plant, Malva neglecta wallr., is widely consumed for medicinal and nutritional purposes. The current study was carried out to assess the hypoglycemic and antihyperlipidemic potential of aqueous methanolic extract of M. neglecta. Chemical evaluation of the extract was performed by high pressure liquid chromatography. Oral glucose tolerance test (OGTT) was done in diabetic rats pre-exposed to 250, 500 and 750 mg/kg plant extract via the oral route. For hypoglycemic and biochemical study, the same therapy was administered to alloxan induced diabetic rats for 14 days. The standard control group received Glibenclamide (5 mg/kg). Ferulic acid, p-coumaric acid and other phenolic acids were detected and estimated in the extract. Administration of the plant extract significantly reduced blood glucose level in diabetic rats subjected to OGTT. The plant extract lowered the fasting blood glucose and alpha amylase, and prevented the damage to pancreas. It also corrected dyslipidemia in diabetic animals following 14 days therapy. Hence, this experimental study establishes the fact that M. neglecta exhibited significant antidiabetic and antihyperlipidemic activities in alloxan induced diabetic rats.
Subject(s)
Animals , Male , Female , Rats , Plant Extracts/analysis , Malvaceae/classification , Malva/adverse effects , Hyperglycemia/drug therapy , Hyperlipidemias/drug therapy , Hypolipidemic Agents/administration & dosage , Chromatography, High Pressure Liquid/methodsABSTRACT
Ipomoea batatas is a kind of both edible and medicinal plant, which provides a dietary source of vitamins, minerals, carbohydrates, proteins, anthocyanins, essential fatty acids, trace elements and other nutrients, and these active substances play a role in many pharmacological activities such as antitumor, immune regulation, hepatoprotective effect, hypoglycemic, hypolipidemic, anti-aging, intestinal regulation, anti-obesity, anti-radiation, anti-fatigue, etc, and promote health in many aspects. The Dictionary of Traditional Chinese Medicine and Chinese Materia Medica recorded that I. batatas have the characteristics of tonifying deficiency and replenishing qi, strengthening spleen and kidney. In recent years, it has become a research hotspot in multidisciplinary fields for its rich nutritional components and functional characteristics. In this paper, the research progress of biological activity of I. batatas in vivo was reviewed from aspects of basic and clinical researches, which may provide references for its further development, research and comprehensive utilization.
ABSTRACT
With the improvement of living standard and enhancement of health consciousness, Salviae Miltiorrhizae Radix et Rhizoma, as a common medicinal material that can be widely used in health food, is focused an increasing number of scholars′ attention at home and abroad. Based on Salviae Miltiorrhizae Radix et Rhizoma health food published by the food website of National Medical Products Administration (NMPA), this paper combs and analyzes their dosage forms, functional components, health-care functions and prescriptions of traditional Chinese medicine (TCM). Meanwhile, the Apriori algorithm module in SPSS Modeler 15.0 is used to explore the formulation rules of Salviae Miltiorrhizae Radix et Rhizoma health food. The results showed that capsules was the most common (about 55.34%), and the infusions and beverages were rare. In the aspect of health-care function, it is mainly used to auxiliary hypolipidemic, auxiliary protective function to chemical liver injury, enhance immunity and dispel chloasma. Among 92 cases of the health food with auxiliary hypolipidemic, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Gynostemmatis Pentaphylli Herba-Puerariae Lobatae Radix. Among 55 cases of the health food with auxiliary protective function to chemical liver injury, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Puerariae Lobatae Radix-Schisandrae Chinensis Fructus. Among 54 cases of the health food with immune-enhancing, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Astragali Radix-Lycii Fructus. Among 46 cases of the health food with dispelling chloasma, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Angelicae Sinensis Radix-grape seeds. The selection of prescription compatibility of Salviae Miltiorrhizae Radix et Rhizoma health food with different health-care functions is basically consistent with the TCM treatment with syndrome differentiation theory and modern medical theory. This article interprets the application of Salviae Miltiorrhizae Radix et Rhizoma health food from the perspective of dosage forms, functional components, health-care functions and compatibility of prescriptions, which can provide a basis and reference for precise and efficient research and development of this kind of health food.
ABSTRACT
Objective: Wild musk melon (Cucumis melo var. agrestis, CMA) is one of the edible plants form Tamil Nadu. Traditionally, this plant was used as diabetic diet (leaves of CMA with Momordica charantia leaves), but there is no scientific report on antidiabetic action of this plant material. Hence, the current research work was designed to evaluate the antihyperglycemic and antihyperlipidemic effect of hydroalcoholic extract of CMA leaves (HALEC) in streptozotocin (STZ)-nicotinamide (NIC)-induced diabetic rats. Methods: Diabetes was induced by administration of STZ (60 mg/kg, i.p.) after 15 min of NIC (120 mg/kg i.p.) administration. The diabetic rats were treated with HALEC (300 and 600 mg/kg, p.o., respectively) for 21 d. Results: After the management with HALEC, blood glucose, HbA1c levels, total cholesterol, LDL cholesterol, triglycerides levels, glycogen phosphorylase and glucose-6-phosphatase levels were significantly diminished in diabetic rats. However, haemoglobin level, HDL cholesterol, liver glycogen, total protein, hexokinase, glucose-6-phosphate dehydrogenase levels were significantly increased in HALEC treated diabetic rats. The histopathological studies of the pancreas in HALEC-treated diabetic rats showed almost normal appearance. L6 cell line study revealed the increased glucose uptake activity of HALEC. High performance thin layer chromatography (HPTLC) analysis confirms the presence of active principles such as rutin, gallic acid and quercetin in HALEC. Conclusion: The results indicated that HALEC possess significant antihyperglycemic and antihyperlipidemic activity in STZ-NIC-induced type II diabetic rats with protective effect. This research work will be useful for the isolation of active principles and development of herbal formulation in phytopharmaceuticals.
ABSTRACT
Introduction. Lipid-lowering drugs, especially statins, have shown great relevance in preventing and treating cardiovascular diseases. Objective. To determine the prescription patterns of lipid-lowering drugs and the variables associated with their use in a Colombian population. Materials and methods. This is a cross-sectional descriptive study. From a drugdispensing database of approximately 4.5 million Colombian health system affiliates, patients of all ages and both sexes treated with lipid-lowering agents (statins, fibrates, ezetimibe) were identified between January and March, 2017. Demographic, pharmacological and co-medication variables were included. Results. In total, 103,624 patients were identified as being treated with lipid-lowering agents. The average age was 67.5 years, and 49.8% were 65 years or older. Women comprised 58.0% of the patients. Statins were the most used (n=96,910; 93.5%), and atorvastatin (n=80,812; 78.0%) and lovastatin (n=12,621; 12.2%) were the most frequent. The mean atorvastatin dose was 30.3 mg/day, and 49.9% of its users received presentations of 40 mg or more. A total of 9,258 (8.9%) patients received fibrates, and only 780 (0.8%) were taking ezetimibe. Of this population, 94.9% were treated with lipid-lowering monotherapy, and 97.3% (n=100,813) had co-medication for their comorbidities, with the most frequent being antihypertensive (89.1%), antiplatelet (57.8%), antidiabetic (31.5%) and antiulcerative agents (34.2%). Conclusions. Atorvastatin is currently the most frequently used lipid-lowering drug in this group of Colombian patients, especially in monotherapy and at doses close to the defined daily dose. Only half received high-intensity doses. New studies are required to verify the efficacy of these therapies.
Introducción. Los fármacos hipolipemiantes, especialmente las estatinas, han demostrado gran relevancia para la prevención y el tratamiento de las enfermedades cardiovasculares. Objetivo. Determinar los patrones de prescripción de los fármacos hipolipemiantes y las variables asociadas con su uso en una población de Colombia. Materiales y métodos. Se trata de un estudio descriptivo y transversal. A partir de una base de datos de dispensación de medicamentos de 4,5 millones de afiliados al sistema de salud de Colombia, se identificaron los pacientes de cualquier edad y sexo en tratamiento con hipolipemiantes (estatinas, fibratos, ezetimibe), entre enero y marzo de 2017. Se incluyeron variables demográficas, farmacológicas y de comedicaciones. Resultados. Se identificaron 103.624 pacientes en tratamiento con hipolipemiantes. La edad promedio fue de 67,5 años y el 49,8 % tenía 65 o más años. El 58,0 % eran mujeres. Las estatinas fueron los más utilizados (n=96.910; 93,5 %), siendo la atorvastatina (n=80.812; 78,0 %) y la lovastatina (n=12.621; 12,2 %) las más frecuentes. La dosis promedio de atorvastatina fue de 30,3 mg/día y el 49,9 % de sus usuarios recibía presentaciones de 40 mg o más. Un total de 9.258 (8,9 %) pacientes recibían fibratos y solo 780 (0,8 %) tomaban ezetimibe. El 94,9 % de casos recibió tratamiento en monoterapia hipolipemiante y el 97,3 % (n=100.813) tenía comedicaciones para comorbilidades, siendo las más frecuentes antihipertensivos (89,1 %), antiagregantes plaquetarios (57,8 %), antidiabéticos (31,5 %) y antiulcerosos (34,2 %). Conclusiones. La atorvastatina es actualmente el medicamento hipolipemiante más utilizado en este grupo de pacientes de Colombia, especialmente en monoterapia y a dosis cercanas a las definidas, aunque solo la mitad recibían dosis recibían dosis de alta intensidad. Se requieren nuevos estudios que verifiquen la efectividad de estos tratamientos.
Subject(s)
Dyslipidemias , Hypolipidemic Agents , Drug Prescriptions , Pharmacoepidemiology , Hydroxymethylglutaryl-CoA Reductase Inhibitors , EzetimibeABSTRACT
Background: Hypolipidemic drugs need to be prescribed lifelong for most of the selected patients, once started. Price variation can lead to huge financial strain on the patients, especially when cost associated issues are not considered by the prescribing medical practitioner. This study was conducted to compare the cost, to the patient, of seven most commonly prescribed preparations of different brands of Rosuvastatin ten milligram, in Kolhapur city.Methods: Authors purchased a strip of 10 capsules each of the seven leading brands of Rosuvastatin ten milligrams. The prices of the strip of 10 capsules of each of the seven chosen brands were compared. Finally, the cost of each of these seven brands for one year, was compared directly as well as using percentages. The data was collected, analysed and presented in tabular forms and figures.Results: The data of the cost of seven different brands of a single hypolipidemic drug, Rosuvastatin ten milligram shows that the cost of the costliest among the seven brands of this drug for one year is almost two times that of the cheapest brand, or in other words almost 200 percent that of the cheapest brand.Conclusions: The cost differences between the cheapest and the costliest brands were substantial. The cost of remaining five brands was dispersed in between these two extremes. India, with a major part of the population being highly concerned about the cost of medications, the prescribing medical practitioner must select the preparation wisely . The most costly preparation of Rosuvastatin ten milligram can substantially add to the financial strain on the patient’s yearly expenses. Thus, Pharmaco economic considerations must be a prime concern while making a decision to prescribe medicines, especially in a country like India.
ABSTRACT
Resumen Introducción: Los estudios de utilización de medicamentos sirven para evaluar la efectividad y seguridad de los fármacos en la práctica real, diferente al contexto del estudio clínico controlado. Los hipolipemiantes actúan sobre el perfil lipídico disminuyendo el riesgo de enfermedades cardiovasculares. Objetivo: Describir el desempeño clínico y seguridad de la utilización de medicamentos hipolipemiantes en la práctica médica real en una cohorte de pacientes con diagnóstico de dislipidemia. Metodología: Estudio observacional de cohorte. Se siguió una cohorte de pacientes con indicación de hipolipemiantes durante 6 meses, en 12 ciudades de Colombia pertenecientes a un registro biomédico de seguimiento de pacientes tratados con medicamentos del portafolio de Abbott. Se midieron variables demográficas y clínicas basales, de seguridad y de desempeño clínico de los medicamentos sobre el perfil lipídico a los 3 y 6 meses. Resultados: Se siguieron 501 pacientes en tratamiento con hipolipemiantes. Las estatinas solas disminuyeron el colesterol de baja densidad de 249 mg/ dL (RIQ=226-268) en la medición basal a 190 (177.6-210) y 170 (108-170) en la segunda y tercera medición, respectivamente. Para estatina + ezetimibe, de 167 mg/dL (RIQ=139-184) a 132 (110-150) y 128.5 (101.5-128.5). El fenofibrato disminuyó los triglicéridos de 275 mg/dL (RIQ=21çj-346) a 201 (172-239) y 150.5 (140-150.5). Conclusiones: la administración de estatinas sola o en combinación disminuyó los niveles de LDL y colesterol total, mientras que el fenofibrato demostró su efectividad al disminuir los triglicéridos. No se reportaron efectos adversos. Hubo una adherencia parcial del médico tratante a la guía de práctica clínica para dislipidemias. MÉD.UIS.2019;32(1):13-20.
Abstract Introduction: Drug use studies are important to evaluate the effectiveness and safety of drugs in daily practice, outside the controlled clinical study. Lipid-lowering drugs act on the lipid profile, decreasing the risk of cardiovascular diseases. Objective: To describe the clinical performance and safety of the use of lipid-lowering drugs in real practice in a group of patients diagnosed with dyslipidemia. Methods: An observational, descriptive cohort study. A cohort of patients with hypolipidemic indication for 6 months was followed in 12 cities of Colombia that belong to the biomedical registry of follow-up of patients treated with medicines from the Abbott portfolio. Baseline demographic and clinical variables, safety and efectivity of the drugs were measured on the lipid profile at 3 and 6 months. Results: 501 patients received lipid-lowering agents. Statins alone decreased the low density (LDL) cholesterol of 249 mg / dL (RIQ = 226-268) at baseline to 190 (177.6-210) and 170 (108-170) at the second and third measurements, respectively. For statin + ezetimibe, from 167 mg / dL (RIQ = 139-184) to 132 (110-150) and 128.5 (101.5-128.5). Fenofibrate decreased triglycerides from 275 mg / dL (RIQ = 219-346) to 201 (172-239) and 150.5 (140-150.5). Conclusions: The administration of statins alone or in combination decreased LDL and total cholesterol levels, while fenofibrate demonstrated its effectiveness in lowering triglycerides. No adverse effects were reported. There was partial adherence of the treating physician to GPC for dyslipidemias. There were no adverse events. MÉD.UIS.2019;32(1):13-20.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hypolipidemic Agents , Medical Records , Cholesterol , Dyslipidemias , PharmacovigilanceABSTRACT
La reducción del colesterol-LDL (C-LDL) es un objetivo primordial en prevención cardiovascular. Estudios recientes demostraron beneficio clínico al administrar inhibidores de la proprotein convertase subtilisin/kexin-9 (iPCSK9) a pacientes que no habían logrado la meta de C-LDL con estatinas de alta intensidad y ezetimibe, sin embargo el uso de estos fármacos está limitado por su costo. El American College of Cardiology, la Sociedad Argentina de Cardiología y la European Society of Cardiology recomiendan una meta de C-LDL menor a 70 mg/dl en prevención secundaria, determinando umbrales de C-LDL de 70, 100 o 140 mg/dl respectivamente, para iniciar el tratamiento con iPCSK9. Con el objetivo de evaluar el esquema hipolipemiante prescripto en internados por síndrome coronario agudo o revascularización coronaria y analizar la proporción de elegibles para ser tratados con iPCSK9 en un escenario real y simulado, realizamos un estudio que incluyó 351 pacientes con enfermedad coronaria, tomados de una base de datos electrónica de un hospital universitario. El 48.4% recibió estatinas de elevada intensidad, 11.4% ezetimibe y 54.7% no logró la meta de C-LDL menor a 70 mg/dl. Utilizando un modelo de simulación en el que todos serían medicados con estatinas de elevada intensidad y ezetimibe, la elegibilidad para prescribir iPCSK9 fue de 31.1%, 12.8% y 9.1% según los umbrales de C-LDL determinados por las tres sociedades científicas. Nuestro estudio demostró una brecha entre las recomendaciones de los consensos para reducir el colesterol y la práctica habitual que debería ser minimizada para optimizar la relación costo/efectividad en prevención secundaria.
LDL-cholesterol (LDL-C) lowering is a primary objective in cardiovascular prevention. Recent studies demonstrated clinical benefit when proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i) were added to the treatment in patients who had not achieved the LDL-C goal despite being treated with high intensity statins and ezetimibe, however the use of these drugs is limited by their cost. The American College of Cardiology, the Argentine Society of Cardiology and the European Society of Cardiology recommend an LDL-C goal less than 70 mg/dl in secondary prevention, determining thresholds of LDL-C to start treatment with PCSK9i of 70, 100 or 140 mg/dl respectively. In order to evaluate the lipid-lowering regimen prescribed in patients hospitalized for acute coronary syndrome or coronary revascularization and analyze the proportion of eligible to be treated with PCSK9i in a real and simulated scenario, we conducted a study that included 351 patients with coronary disease collected from an electronic database of a university hospital. The 48.4% received high intensity statins, 11.4% ezetimibe and 54.7% did not achieve the LDL-C goal of less than 70 mg/dL. Using a simulation model in which all would be treated with high intensity statins and ezetimibe, the eligibility to prescribe PCSK9i was 31.1%, 12.8% and 9.1% according to the C- LDL thresholds determined by the three scientific societies. Our study demonstrated a gap between the consensus recommendations for LDL-C lowering and the current practice that should be minimized to optimize the cost/effectiveness ratio in secondary prevention.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Proprotein Convertase 9/antagonists & inhibitors , Hypercholesterolemia/drug therapy , Anticholesteremic Agents/therapeutic use , Argentina , Societies, Scientific , Time Factors , Sex Factors , Cross-Sectional Studies , Age Factors , Treatment Outcome , Practice Guidelines as Topic , Statistics, Nonparametric , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Ezetimibe/therapeutic useABSTRACT
Objective To investigate the difference of hypoglycemic and hypolipidemic effects of Coptis deltoidea (Coptis chinensis) and its processed products on T2DM rats. Methods Type 2 diabetes mellitus induced by high sugar, high fat diet and low dose of streptozotocin. C. deltoidea were processed with yellow wine, ginger, and evodia rutaecarpa, respectively. The effects of C. deltoidea on fasting blood glucose (FBG), fasting insulin (FINS), glycosylated serum protein (GSP), pancreatic pathology, serum triglyceride (TG), total cholesterol (TC) and lipoprotein (HDL-C or LDL-C) and key protein and gene expression of SCAP\SREBP-1c pathway in liver of model rats were investigated. Result C. deltoidea and its processed products reduced the FBG and GSP in T2DM rats. The wine products significantly reduced FBG and GSP in model rats (P < 0.01). The hypoglycemic range was better than raw and ginger products. At hypolipidemic aspect, C. deltoidea and its processed products decreased the content of TG, TC, and LDL-C (P < 0.05, 0.01), increased the content of HDL-C in serum (P < 0.05, 0.01), and down-regulated the protein and gene expression of SCAP/SREBP-1c in liver, the insulin target organ. However, wine and evodia products were better than crude drug or ginger products. Conclusion C. deltoidea processed by yellow wine, ginger and evodia rutaecarpa is traditional method to improve the disadvantages of C. deltoidea with bitter cold nature and not easy to take for a long time. However, different processing methods have different effects. Clinical medication should be combied withTCM syndrome differentiation and simple hypoglycemic effect of wine product is appropriate; while wine and evodia products were better in hypoglycemic and lipid regulation aspects.
ABSTRACT
Objective: To explore the high-efficiency green environmental extraction method of total flavones from Microcos paniculata (MPTF), and investigate its lipid-lowering activity. Methods: The ionic liquid was used to assist the ultrasonic extraction of MPTF, and the extraction process was investigated by single factor experiment and orthogonal test. Wistar rats were randomly divided into normal control group and positive control group (Resuvastatin Calcium Tablets 5.2 mg/kg) by high fat diet, high-fat model group and MPTF low, medium and high dose groups (ig dose MPTF 300, 600, 900 mg/kg), with 10 rats in each group. The total cholesterol (TC), glycerol lipid (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) levels were determinated. Results: The optimum process conditions for ultrasonic-assisted extraction of MPTF by ionic liquid were as follow: ionic liquid was [BMIM]Cl at concentration of 0.30 mol/L; ratio of material to liquid was 1:40, extraction solvent was 60% ethanol aqueous solution with extraction time of 30 min at 50 ℃. The verification test results showed that the extraction rate of total flavonoids obtained from the extraction process was high and the process was stable. The results of lipid-lowering test showed that the levels of TC, TG and LDL-C were decreased in all doses of MPTF groups, and the level of HDL-C was increased (P < 0.05). With the increase of MPTF dose, the indicators showed obvious trends in a dese-dependent manner. Conclusion: The ionic liquid combined with ultrasonic- assisted extraction of MPTF is stable and feasible, which provides reference for ionic liquid synergistic ultrasound-assisted extraction of poorly soluble active ingredients in Chinese materia medica. MPTF extract has better lipid-lowering effect.
ABSTRACT
Objective To investigate the effects of Maiqi-Jiangtang pill on the glycolipid level in type 2 diabetic ob/ob mice.Methods The 8-week old male ob/ob mice were randomly divided into Maiqi-Jiangtang pill high- (8 g/kg), medium- (4 g/kg), low- (2 g/kg) dose groups. All the mice orally adiministered with the drugs once a day for 10 weeks. The same week age normal C57BL/6J control mice and ob/ob model group mice were orally administered with the equal volume solvent. The body weight per week were recorded. The fasting blood-glucose (FBG) was measured by glycemic instrument. The content of TG, TC, HDL-C, LDL-C in serum, and TG and TC content in liver were determined by biochemical method. The liver index was calculated.Results Compared with ob/ob model group, there was no significant change in body weight of mice administered with Maiqi-Jiangtang pill for 10 weeks. Compared with the model group, the low-, medium- dose Maiqi-Jiangtang pill could significantly decrease the FBG (7.43 ± 1.71 mmol/L,7.84 ± 1.09 mmol/L vs.8.95 ± 0.96mmol/L), the high- dose Maiqi-Jiangtang pill could significantly reduce the TG (0.93 ± 0.16 mmol/L vs.1.18 ± 0.26 mmol/L) and LDL-C (2.10 ± 0.51 mmol/L vs.2.56 ± 0.44 mmol/L) content in serum of ob/ob mice (P<0.05), increase the HDL-C/LDL-C ratio (2.40 ± 0.39vs.1.96 ± 0.24) in serum (P<0.01), decrease the liver weight (3.52 ± 0.26 gvs. 3.98 ± 0.35 g) and the liver index (0.063 ± 0.004vs. 0.071 ± 0.006) (P<0.05). Compared with the model group, the low dose Maiqi-Jiangtang pill could also significantly decrease the TG level (0.63 ± 0.25 mmol/gvs. 1.05 ± 0.67 mmol/g) in liver and significantly increase the HDL-C/LDL-C ratio (2.30 ± 0.44vs. 1.96 ± 0.24) in serum (P<0.05).Conclusions The Maiqi-Jiangtang pill can reduce lipid in serum and liver of ob/ob mice while it can decrease the blood glucose, which need to further study its mechanism.
ABSTRACT
Aim To explore the hypolipidemic mechanism of the total phenylpropanoid glycoside from Ligustrum robustum (Roxb. ) Blume (LRTPG) on hyperlipidemic hamsters using label-free quantitative proteomic technique. Methods The total protein was extracted from livers of model group and the group treated with LRTPG for label-free quantitative proteomics research. Results The proteomic data showed that a total of 2231 proteins were identified. And 549 proteins were found to be differentially expressed between model group and group treated with LRTPG. Among the 549 proteins, 93 proteins were up-regulated and 59 proteins were down-regulated, and 397 proteins had quantitative values only in model group or drug-administered group. Further, gene ontology (GO) analysis indicated that those differentially expressed proteins were primarily involved in an array of biological processes including metabolism, transport, oxidation-reduction, phosphorylation, signal transduction and lipid metabolism. KEGG pathway analysis revealed that these proteins were involved in several signal pathways including oxidative phosphorylation, non-alcoholic fatty liver dis-ease, PI3K-Akt, cAMP, and cGMP-PKG pathway. And some of these proteins were much related to the lipid metabolism, such as CD36, PK, HSS, GCK, ApoA I, Acly and FABP5. Conclusion The hypolipidemic effect of LRTPG may be related to CD36, PK, HSS, GCK, ApoA I, Acly and FABP5.