Factors influencing achievement of low-density lipoprotein cholesterol goals in mexico: the international cholesterol management practice study

ABSTRACT Background The International Cholesterol Management Practice Study is a multinational collaborative effort to describe the effectiveness of the lipid-lowering therapy (LLT) as well as the main barriers to achieve the low-density lipoprotein cholesterol (LDL-C) goals Objective The objective of the study was to investigate factors associated with the achievement of LDL-C goals in Mexico using real-life data Methods This was a cross-sectional observational study from 18 physicians across different health facilities in Mexico, who provided information about their practices between August 2015 and August 2016. We included patients treated for ≥3 months with any LLT in whom LDL-C measurement on stable LLT was available for the previous 12 months Results We included 623 patients with a mean age of 59.3 ± 12.7 years; 55.6% were women. The mean LDL-C value on LLT was 141.8 ± 56.1 mg/dL. At enrollment, 97.4% of patients were receiving statin therapy (11.3% on high-intensity treatment). Only 24.8% of the very-high cardiovascular (CV) risk patients versus 26.4% of the high risk and 52.4% of the moderate risk patients achieved their LDL-C goals. Independent factors associated with non-achievement of LDL-C goal were statin intolerance, overweight and obesity, abdominal obesity, female sex, high CV risk, use of public health-care service, metabolic syndrome, type 2 diabetes, and hypertriglyceridemia. Higher-level of education was associated with a lower risk of not achieving LDL-C goals Conclusions Achievement of LDL-C goals is suboptimal in Mexico, especially in patients with the highest CV risk. The main barriers to achieve the goal are easily detectable. Implementation of LLT should be adapted to the patient’s needs and profile.

Association of the ATP-binding Cassette Transporter A1 Gene Polymorphismo with Lipid Profile and Tye 2 Diabetes Mellitus

Diabetes remains unique among the main non-communicable ailments (NCDs) recognized by the World Health Organization (WHO), apart from the circulatory diseases, tumours, and long-lasting respiratory ailments. The current study aimed to determine the correlation between ABCA1 gene polymorphismo and lipid profile in type 2 diabetes mellitus patients. Serum samples from 100 type 2 diabetes mellitus patients (46 males and 54 females) and 50 standard subjects (26 males and 24 females) were colected from Najaf province/Irak. Fasting blood sugar (FBS), and lipid profiles (total cholesterol (TC), triglycerides (TH), HDL, LDL, and VLDL) were meassured. Plymerase chain reaction (PCR) with the Taq1 enzye was used for the amplification of the ABCA1 gene, which contains 525bp of the AABCA1 gene in the locus V825I. The present study revaled a positive corrrelation between FBS and body mass index (BMI) (r= 0.2390, p= 0.0463), TG (r = 0.1836, p= .01743), and VLDL (r = 0.1836, p = 0.1839). The frequencies of the GG genotype and the G allele were higher in the normal groups compared to the patientes (58% vs. 56% and 70% vs. 67%, respectively); conversely, the frequencies of the AA genotype (18% vs. 22%) and the A allele (30% vs. 33%) were higher in the patients compared to the normal groups. The data also showed a significant relationship between ABCA1 gene polymorphim and both TG and VLDL (P=0.007 for cach). There is relationship between the ABCA1 gene and HDL level. Additiionally, the G allele could be a defensive factor against diabetes mellitus in Iraqi peole (AU)

Lychee (Litchi chinensis Sonn) peel flour: effects on hepatoprotection and dyslipidemia induced by a hypercholesterolemic diet

ABSTRACT Dyslipidemias are associated with the incidence of cardiovascular diseases, obesity, diabetes, hypertension and hepatic steatosis, being the cause of morbidity and mortality. This study investigated the effects of lychee peel flour (PF) on serum levels of total cholesterol (TC), low-density lipoprotein (LDL-c), triacylglycerols (TAG) and various parameters related to obesity, in rats fed a hypercholesterolemic diet. Therefore, 20 male rats were used. In the first 21 days, the animals were fed a hypercholesterolemic diet, except for control group. In the following 21 days, their diets were modified, and they received a standard diet (Control); hypercholesterolemic (Hyper); hypercholesterolemic + 5% PF (PF5) and hypercholesterolemic + 10% PF (PF10). The results revealed that PF intake attenuated weight gain, reduced body mass index, glucose and the levels of TAG, TC, LDL-c, hepatic enzymes and leptin, besides the percentage of hepatic lipids, liver lipid peroxidation and frequency of severe steatosis. Histological studies of the aorta did not show the formation of the atheromatous plaque. These results reinforce its potential to reduce the risk of diseases associated with obesity.

Associação das concentrações séricas de zinco com hipercolesterolemia e resistência à insulina em crianças brasileiras / Association between serum zinc level and hypercholesterolemia and insulin resistance in Brazilian children / Asociación de las concentraciones séricas de zinc con la hipercolesterolemia y resistencia a la insulina en niños brasileñas

O objetivo foi avaliar a associação entre a concentração sérica de zinco e os fatores cardiometabólicos em crianças pré-púberes brasileiras. Trata-se de um estudo transversal com amostra representativa de escolares na faixa etária de 8 e 9 anos, matriculados em escolas urbanas públicas e privadas em Viçosa, Minas Gerais, Brasil. A composição corporal foi avaliada pela técnica de absortometria de raios-x de dupla energia. Foram avaliadas as concentrações séricas de glicose, insulina, colesterol total, lipoproteínas de alta e de baixa densidade de colesterol, triglicerídeos, apolipoproteínas A (Apo A) e B, ácido úrico, leptina, homocisteína, proteína C reativa-ultrassensível e zinco sérico. A pressão arterial foi aferida por equipamento de insuflação automática. A deficiência de zinco foi observada em 1,3% das crianças. As meninas apresentaram o pior perfil cardiometabólico, com maiores prevalências de valores aumentados para gordura androide, triglicerídeos, resistência à insulina, leptina, zinco e Apo A. No 1º terço de concentração sérica de zinco, a prevalência de resistência à insulina foi 96% maior (RP = 1,96; IC95%: 1,04-3,66) e a de hipercolesterolemia foi 23% menor (RP = 0,77; IC95%: 0,61-0,96) em relação à categoria de referência (2º e 3º terços de concentração sérica de zinco agrupado). Apesar da baixa prevalência da deficiência de zinco, a resistência à insulina foi mais prevalente entre crianças localizadas no menor terço da concentração sérica de zinco. Torna-se importante a prevenção das alterações cardiometabólicas na infância, principalmente da resistência à insulina, com ênfase na avaliação sérica do zinco.

The objective of the study was to assess the association between serum zinc level and cardiometabolic factors in prepubertal Brazilian children. This was a cross-sectional study in a representative sample of schoolchildren 8 to 9 years of age in public and private urban schools in Viçosa, Minas Gerais State, Brazil. Body composition was assessed with dual-energy x-ray absorptiometry. The study measured serum glucose, insulin, total cholesterol, high and low density lipoprotein cholesterol, triglycerides, apolipoproteins A (Apo A) and B, uric acid, leptin, homocysteine, ultrasenstive C-reactive protein, and serum zinc. Arterial pressure was measured with automatic inflation equipment. Zinc deficiency was observed in 1.3% of the children. Girls showed the worst cardiometabolic profile, with higher prevalence of increased android fat, triglycerides, insulin resistance, leptin, zinc, and Apo A. In the first tertile of serum zinc concentration, prevalence of insulin resistance was 96% higher (PR = 1.96; 95%CI: 1.04-3.66) and hypercholesterolemia was 23% lower (PR = 0.77; 95%CI: 0.61-0.96) than in the reference category (grouped 2nd and 3rd tertiles of serum zinc concentration). Despite the low prevalence of zinc deficiency, insulin resistance was more prevalent in children in the lowest third of serum zinc concentration. It is important to prevent cardiometabolic alterations in childhood, especially insulin resistance, with an emphasis on serum zinc level.

El objetivo fue evaluar la asociación entre la concentración sérica de zinc y los factores cardiometabólicos en niñas pre-púberes brasileñas. Se trata de un estudio transversal con una muestra representativa de escolares en la franja de edad de 8 y 9 años, matriculadas en escuelas urbanas públicas y privadas en Viçosa, Minas Gerais, Brasil. La composición corporal se evaluó por la técnica de absorciometría de rayos-x de doble energía. Se evaluaron las concentraciones séricas de glucosa, insulina, colesterol total, lipoproteínas de alta y de baja densidad de colesterol, triglicéridos, apolipoproteínas A (Apo A) y B, ácido úrico, leptina, homocisteína, proteína C reactiva-ultrasensible y zinc sérico. La presión arterial se midió mediante un equipo de insuflación automática. La deficiencia de zinc se observó en un 1,3% de los niños. Las niñas presentaron el peor perfil cardiometabólico, con mayores prevalencias de valores aumentados para la obesidad androide, triglicéridos, resistencia a la insulina, leptina, zinc y Apo A. En el primer tercio de concentración sérica de zinc, la prevalencia de resistencia a la insulina fue un 96% mayor (RP = 1,96; IC95%: 1,04-3,66) y la de hipercolesterolemia fue un 23% menor (RP = 0,77; IC95%: 0,61-0,96), en relación con la categoría de referencia (2º y 3º tercios de concentración sérica de zinc agrupado). A pesar de la baja prevalencia de la deficiencia de zinc, la resistencia a la insulina fue más prevalente entre niñas localizadas en el menor tercio de la concentración sérica de zinc. Es importante la prevención de las alteraciones cardiometabólicas durante la infancia, principalmente de la resistencia a la insulina, con énfasis en la evaluación sérica del zinc.

Cardiovascular Risk Stratification and Statin Eligibility Based on the Brazilian vs. North American Guidelines on Blood Cholesterol Management / Estratificação de Risco Cardiovascular e Elegibilidade para Estatina com Base na Diretriz Brasileira vs. Norte-Americana para Manejo do Colesterol

Abstract Background: The best way to select individuals for lipid-lowering treatment in the population is controversial. Objective: In healthy individuals in primary prevention: to assess the relationship between cardiovascular risk categorized according to the V Brazilian Guideline on Dyslipidemia and the risk calculated by the pooled cohort equations (PCE); to compare the proportion of individuals eligible for statins, according to different criteria. Methods: In individuals aged 40-75 years consecutively submitted to routine health assessment at one single center, four criteria of eligibility for statin were defined: BR-1, BR-2 (LDL-c above or at least 30 mg/dL above the goal recommended by the Brazilian Guideline, respectively), USA-1 and USA-2 (10-year risk estimated by the PCE ≥ 5.0% or ≥ 7.5%, respectively). Results: The final sample consisted of 13,947 individuals (48 ± 6 years, 71% men). Most individuals at intermediate or high risk based on the V Brazilian Guideline had a low risk calculated by the PCE, and more than 70% of those who were considered at high risk had this categorization because of the presence of aggravating factors. Among women, 24%, 17%, 4% and 2% were eligible for statin use according to the BR-1, BR-2, USA-1 and USA-2 criteria, respectively (p < 0.01). The respective figures for men were 75%, 58%, 31% and 17% (p < 0.01). Eighty-five percent of women and 60% of men who were eligible for statin based on the BR-1 criterion would not be candidates for statin based on the USA-1 criterion. Conclusions: As compared to the North American Guideline, the V Brazilian Guideline considers a substantially higher proportion of the population as eligible for statin use in primary prevention. This results from discrepancies between the risk stratified by the Brazilian Guideline and that calculated by the PCE, particularly because of the risk reclassification based on aggravating factors.

Resumo Fundamento: Existe controvérsia sobre a melhor forma de selecionar indivíduos para tratamento hipolipemiante na população. Objetivos: Em indivíduos saudáveis em prevenção primária: avaliar a relação entre o risco cardiovascular segundo a V Diretriz Brasileira de Dislipidemias e o risco calculado pelas pooled cohort equations (PCE); comparar a proporção de indivíduos elegíveis para estatinas, de acordo com diferentes critérios. Métodos: Em indivíduos de 40 a 75 anos submetidos consecutivamente a avaliação rotineira de saúde em um único centro, quatro critérios de elegibilidade para estatina foram definidos: BR-1, BR-2 (LDL-c acima ou pelo menos 30 mg/dL acima da meta preconizada pela diretriz brasileira, respectivamente), EUA-1 e EUA-2 (risco estimado pelas PCE em 10 anos ≥ 5,0% ou ≥ 7,5%, respectivamente). Resultados: Foram estudados 13.947 indivíduos (48 ± 6 anos, 71% homens). A maioria dos indivíduos de risco intermediário ou alto pela V Diretriz apresentou risco calculado pelas PCE baixo e mais de 70% daqueles considerados de alto risco o foram devido à presença de fator agravante. Foram elegíveis para estatina 24%, 17%, 4% e 2% das mulheres pelos critérios BR-1, BR-2, EUA-1 e EUA-2, respectivamente (p < 0,01). Os respectivos valores para os homens foram 75%, 58%, 31% e 17% (p < 0,01). Oitenta e cinco por cento das mulheres e 60% dos homens elegíveis para estatina pelo critério BR-1 não seriam candidatos pelo critério EUA-1. Conclusões: Comparada à diretriz norte-americana, a V Diretriz Brasileira considera uma proporção substancialmente maior da população como elegível para estatina em prevenção primária. Isso se relaciona com discrepâncias entre o risco estratificado pela diretriz brasileira e o calculado pelas PCE, particularmente devido à reclassificação de risco baseada em fatores agravantes.

Alterações Cardiometabólicas em Ratos Wistar Alimentados com Dieta Hiperlipídica e Hipercolesterolêmica por Seis Semanas / Cardiometabolic Alterations in Wistar Rats on a Six-Week Hyperlipidic, Hypercholesterolemic Diet

Fundamento: Alta ingestão de lipídeos e colesterol compõe a dieta da sociedade moderna e está envolvida com o desenvolvimento de doenças cardiometabólicas. Entretanto, há lacunas na literatura quanto à existência de modelos de dislipidemias em ratos Wistar. Objetivos: Analisar o perfil cardiometabólico de ratos Wistar alimentados com dieta hiperlipídica e hipercolesterolêmica por seis semanas. Métodos: Ratos Wistar jovens foram alimentados com dieta hiperlipídica e hipercolesterolêmica por seis semanas para induzir a hiperlipidemia. Os ratos foram submetidos à cateterização da artéria carótida para determinar a pressão arterial. Após jejum, amostras de sangue foram coletadas por meio do cateter, e as concentrações de colesterol total, colesterol HDL, triglicerídeos e glicose foram determinadas. Amostras do tecido cardíaco foram removidas para análise histológica, a fim de se verificar a hipertrofia ventricular. Resultados: A ingestão da dieta por seis semanas foi eficaz em induzir alterações cardiometabólicas. O perfil dislipidêmico apresentado pelos ratos Wistar foi acompanhado de hiperinsulinemia, hipertensão moderada e hipertrofia ventricular do coração. Não houve alterações na glicemia. Conclusões: A administração de dieta hiperlipídica e hipercolesterolêmica em ratos Wistar jovens por seis semanas induziram alterações cardiometabólicas tornando-se um modelo eficaz para distúrbios dessa natureza

Background: The diet of modern society is composed by large intakes of lipids and cholesterol, involved in the development of cardiometabolic diseases. However, there are gaps in the literature regarding the existence of dyslipidemia models in Wistar rats. Objectives: To analyze the cardiometabolic profile of Wistar rats on a six-week hyperlipidic, hypercholesterolemic diet. Methods: Young Wistar rats were kept on a hyperlipidic, hypercholesterolemic diet for six weeks to induce hyperlipidemia. The rats underwent catheterization of the carotid artery to determine blood pressure. After fasting, blood samples were drawn through the catheter, and concentrations of total cholesterol, HDL cholesterol, triglycerides and glucose were determined. Cardiac tissue samples were taken for a histological analysis to check for ventricular hypertrophy. Results: The six-week diet was effective in inducing cardiometabolic alterations. The dyslipidemic profile presented by the Wistar rats was accompanied by hyperinsulinemia, moderate hypertension and cardiac ventricular hypertrophy. There were no alterations in glycemia. Conclusion: The six-week hyperlipidic, hypercholesterolemic diet in young Wistar rats induced cardiometabolic alterations, becoming an effective model for disorders of this nature

Impact of predictors upon the reduction of lipid parameters in family medicine practice / Impacto de preditores da redução dos parâmetros de lipídios na prática da medicina de família

ABSTRACT CONTEXT AND OBJECTIVE: To evaluate predictors of changes in lipid parameters consisting of LDL-C (low-density lipoprotein cholesterol), TC (total cholesterol) and non-HDL-C (non-high density lipoprotein cholesterol) among primary care patients. DESIGN AND SETTING: Retrospective study conducted on family medicine patients. METHODS: Demographic features and other clinically relevant information were abstracted from medical records. The primary outcome was the difference in LDL-C level from initial testing to the index test. Secondary outcomes were the changes in TC and non-HDL-C levels between two measurements. RESULTS: Three hundred and eleven participants were included in the final secondary analysis. Multiple linear regression revealed that male patients (β = 4.97, P = 0.040), diabetes (β = 9.75, P = 0.003) and higher LDL-C levels at baseline (β = 0.35, P < 0.001) were positively associated with LDL variance, whereas longer time period (β = -0.15, P = 0.045) and familial hypercholesterolemia history (β = -7.56, P = 0.033) were negatively associated. Male patients (β = 8.45, P = 0.002), DM (β = 9.26, P = 0.011), higher TC levels at baseline (β = 0.35, P < 0.001) and taking statins (β = 7.31, P = 0.023) were positively associated with TC variance, whilst longer time period (β = -0.183, P = 0.031) and familial hypercholesterolemia (β = -10.70, P = 0.008) were negatively associated. CONCLUSION: In the present study, patients who were male, on statin treatment, diagnosed with diabetes and had higher baseline lipid values were more likely associated with better lipid outcomes at future testing.

RESUMO CONTEXTO E OBJETIVO: Avaliar preditores de alterações nos parâmetros lipídicos que consistem em LDL-C (colesterol de lipoproteína de baixa densidade), TC (colesterol total) e não HDL-C (não colesterol de lipoproteína de alta densidade) entre os pacientes de cuidados primários. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado em pacientes de medicina familiar. MÉTODOS: Aspectos demográficos e outras informações clinicamente relevantes foram extraídos dos prontuários médicos. O desfecho primário foi a diferença de nível de LDL-C entre os exames iniciais e o exame índice. Os desfechos secundários foram as mudanças dos níveis de TC e não HDL-C entre as duas medidas. RESULTADOS: Trezentos e onze participantes foram incluídos na análise secundária final. Regressão linear múltipla revelou que os pacientes do sexo masculino (β = 4,97, P = 0,040), diabetes (DM) (β = 9,75, P = 0,003) e níveis de LDL mais elevados no início do estudo (β = 0,35, P < 0,001) foram associados positivamente com variância LDL, enquanto longo período de tempo (β = -0,15, P = 0,045) e história hipercolesterolemia familiar (β = -7,56, P = 0,033) foram associados negativamente. Pacientes do sexo masculino (β = 8,45, P = 0,002), com DM (β = 9,26, P = 0,011), níveis elevados de CT na linha de base (β = 0,35, P < 0,001) e tomar estatinas (β = 7,31, P = 0,023) associaram-se positivamente com a variância TC, enquanto longo período de tempo (β = -0,183, P = 0,031), hipercolesterolemia familiar (β = -10,70, P = 0,008) foram associados negativamente. CONCLUSÕES: No presente estudo, os pacientes que eram do sexo masculino, em tratamento com estatinas, com diagnóstico de DM e que tinham valores lipídicos basais mais elevados foram mais provavelmente associados a melhores resultados de lipídios em testes futuros.

Multidisciplinary intervention in obese adolescents: predictors of dropout / Intervenção multidisciplinar em adolescentes obesos: preditores de desistência

Objective To identify biological and psychosocial factors associated with dropout in a multidisciplinary behavioral intervention in obese adolescents.Methods A total of 183 adolescents (15.4±1.6 years), pubertal (Tanner stage 3 or 4) and obese (34.7±4.0kg/m2), were enrolled in a 12-week behavioral intervention, which included clinical consultations (monthly), nutritional and psychological counseling (once a week), and supervised aerobic training (three times/week). The studied variables were weight, height, body mass index, body composition (skinfold), cardiorespiratory fitness (direct gas analysis), blood lipids and self-reported symptoms of eating disorders (bulimia, anorexia and binge eating), anxiety, depression, body image dissatisfaction and quality of life. Statistical analysis included binary logistic regression and independent t-tests.Results Of the adolescents, 73.7% adhered to the program. The greatest chance for dropout was observed among adolescents older than 15 years (odds ratio of 0.40; 95%CI: 0.15-0.98), with more anorexia symptoms (odds ratio of 0.35; 95%CI: 0.14-0.86) and hypercholesterolemia (odds ratio of 0.40; 95%CI: 0.16-0.91) at baseline.Conclusion Older adolescents, with more symptoms of eating disorders and total cholesterol have less chance to adhere to multidisciplinary treatments.

Objetivo Identificar os fatores biológicos e psicossociais associados à desistência de uma intervenção multidisciplinar comportamental em adolescentes obesos.Métodos Foram selecionados para participar das 12 semanas de intervenção 183 adolescentes (15,4±1,6 anos), púberes (Tanner 3 ou 4) e obesos (34,7±4,0 kg/m2). A intervenção incluiu consultas clínicas (mensal), aconselhamento nutricional e psicológico (uma vez/semana), e treinamento aeróbio supervisionado (três vezes/semana). As variáveis estudadas foram peso, altura, índice de massa corporal, composição corporal (dobras cutâneas), aptidão cardiorrespiratória (análise direta de gases), perfil lipídico e sintomas autorrelatados de transtornos alimentares (bulimia, anorexia e compulsão alimentar), ansiedade, depressão, insatisfação com a imagem corporal e qualidade de vida. A análise estatística incluiu regressão logística binária e teste tde Student independente.Resultados Aderiram ao programa 73,7% dos adolescentes. A maior chance de desistência foi observada entre aqueles com mais de 15 anos (odds ratiode 0,40; IC95%: 0,15-0,98), com mais sintomas de anorexia (odds ratio de 0,35; IC95%: 0,14-0,86) e com hipercolesterolemia (odds ratio de 0,40; IC95%: 0,16-0,91) no início do estudo.Conclusão Adolescentes mais velhos, com mais sintomas de transtornos alimentares e de níveis de colesterol total, têm menor chance de aderir a tratamentos multidisciplinares.

Insegurança alimentar em domicílios de indivíduos portadores de hipertensão e/ou diabetes / Food insecurity in households of patients with hypertension and diabetes

Fundamentos: Pessoas que residem em domicílios com insegurança alimentar normalmente consomem uma dieta monótona, pobre em carboidratos complexos e rica em açúcares simples e gorduras. Tal condição associada à obesidade, diabetes mellitus (DM) e hipertensão arterial (HA) compromete a qualidade de vida e contribui para um maior risco de morbimortalidade, principalmente por doenças cardiovasculares. Objetivos: Avaliar fatores de risco cardiovascular (FRCV) em portadores de HA e/ou DM e sua relação com a condição socioeconômica e a situação de insegurança alimentar (IA) nos domicílios. Métodos: Estudo transversal. Avaliados: (In) segurança alimentar domiciliar segundo a Escala brasileira de insegurança alimentar (EBIA): IA leve, moderada e severa; classe econômica e FRCV. Utilizou-se o teste do qui-quadrado, análise logística bivariada, OR com IC de 95% e p≤0,05.Resultados: Estudados 225 indivíduos: 74,0% (n=166) hipertensos (H), 18,0% (n=41) hipertensos diabéticos (HD) e 8,0% (n=18) diabéticos (D); 80,9% eram mulheres, média de idade 60,3±11,19 anos e 64,0% pertencentes à classe econômica D. Residiam em domicílios em IA: 78,0% dos H, 73,0% dos HD e 78,0% dos D. A frequência de FRCV entre os indivíduos em IA foi elevada: 92,0% hipertensão, 80,0% hipercolesterolemia, 79,0% hiperglicemia, 76,0% sobrepeso/obesidade,73,0% obesidade abdominal e 72,0% hipertrigliceridemia. Verificou-se associação positiva entre IA e hipertensão (p=0,034), obesidade abdominal (p=0,009) e hipertrigliceridemia (p=0,001). Conclusões: A condição de insegurança predominante nos domicílios da população estudada representa fator de risco adicional, uma vez que a dificuldade de acesso a uma alimentação saudável em quantidade e qualidade compromete o tratamento e controle desses agravos.

Background: People living in households with food insecurity typically have a monotonous diet, low in complex carbohydrates and rich in simple sugars and fats. Such condition associated with obesity, diabetes mellitus (DM) and hypertension (HA) compromises the quality of life and contributes to an increased risk of morbidity and mortality, especially from cardiovascular diseases. Objectives: To evaluate cardiovascular risk factors (CVRF) in patients with HA and/or diabetes mellitus and its relationship with the socioeconomic status and the situation of food insecurity (IA) in households.Methods: Cross-sectional study. Patients evaluated: (In) household food security according to the Brazilian Scale of food insecurity (EBIA): Mild, moderate and severe FI; economic status and CVRF. We used the chi-square test, bivariate logistic regression, OR with 95% CI and p≤0.05. Results: The study included 225 patients: 74.0% (n=166) hypertensive (M), 18.0% (n=41) diabetic hypertensive (HD) and 8.0% (n=18)diabetic patients (D); 80.9% were women, mean age 60.3±11.19 years and 64.0% belonging to the economy class D. The patients resided in households in FI: 78.0% of H, 73.0% of HD and 78.0% of D. The frequency of CVRF among individuals in FI was high:92.0% hypertension, 80.0% hypercholesterolemia, 79.0% hyperglycemia, 76.0% overweight/obesity, 73.0% abdominal obesity and 72.0% hypertriglyceridemia. There was a positive association between FI and hypertension (p=0.034), abdominal obesity (p=0.009) and hypertriglyceridemia (p=0.001). Conclusions: The predominant unsafe condition in the households of the population studied represents an additional risk factor, since thedifficulty of access to healthy food both in quantitative and quality terms compromises the treatment and control of these diseases.

Daily consumption of banana marginally improves blood glucose and lipid profile in hypercholesterolemic subjects and increases serum adiponectin in type 2 diabetic patients.

In this study, we explored the effects of consumption of banana in thirty hypercholesterolemic and fifteen type 2 diabetic subjects. They were given a daily dose of 250 or 500 grams of banana for breakfast for 12 weeks. Fasting serum lipid, glucose and insulin levels were measured initially as well as every 4 weeks. Daily consumption of banana significantly lowered fasting blood glucose (from 99±7.7 to 92±6.9 and 102±7.3 to 92±5.7 mg∙dL-1 (p<0.05) after consuming banana 250 or 500 g/day for 4 wk, respectively) and LDL-cholesterol/HDL-cholesterol ratio (from 2.7±0.98 to 2.4±0.85 and 2.8±0.95 to 2.5±0.79, p<0.005) in hypercholesterolemic volunteers. Analysis of blood glycemic response after eating banana showed significantly lower 2 h-postprandial glucose level compared to baseline in hypercholesterolemic volunteers given a dose of 250 g/day. The changes of blood glucose and lipid profile in diabetic patients were not statistically significant, but for plasma levels of adiponectin, there were significantly increased (from 37.5±9.36 to 48.8±7.38 ng∙ml-1, p<0.05) compared to baseline. Although it remains to be confirmed with larger group of volunteers, this pilot study has demonstrated that daily consumption of banana (@ 250 g/day) is harmless both in diabetic and hypercholesterolemic volunteers and marginally beneficial to the later.

Effect of Pitavastatin on Vascular Reactivity in Hypercholesterolemic Rabbits / O Efeito da Pitavastatina na Reatividade Vascular em Coelhos Hipercolesterolêmicos

Background: Pitavastatin is the newest statin available in Brazil and likely the one with fewer side effects. Thus, pitavastatin was evaluated in hypercholesterolemic rabbits in relation to its action on vascular reactivity. Objective: To assess the lowest dose of pitavastatin necessary to reduce plasma lipids, cholesterol and tissue lipid peroxidation, as well as endothelial function in hypercholesterolemic rabbits. Methods: Thirty rabbits divided into six groups (n = 5): G1 - standard chow diet; G2 - hypercholesterolemic diet for 30 days; G3 - hypercholesterolemic diet and after the 16th day, diet supplemented with pitavastatin (0.1 mg); G4 - hypercholesterolemic diet supplemented with pitavastatin (0.25 mg); G5 - hypercholesterolemic diet supplemented with pitavastatin (0.5 mg); G6 - hypercholesterolemic diet supplemented with pitavastatin (1.0 mg). After 30 days, total cholesterol, HDL, triglycerides, glucose, creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT) were measured and LDL was calculated. In-depth anesthesia was performed with sodium thiopental and aortic segments were removed to study endothelial function, cholesterol and tissue lipid peroxidation. The significance level for statistical tests was 5%. Results: Total cholesterol and LDL were significantly elevated in relation to G1. HDL was significantly reduced in G4, G5 and G6 when compared to G2. Triglycerides, CK, AST, ALT, cholesterol and tissue lipid peroxidation showed no statistical difference between G2 and G3-G6. Significantly endothelial dysfunction reversion was observed in G5 and G6 when compared to G2. Conclusion: Pitavastatin starting at a 0.5 mg dose was effective in reverting endothelial dysfunction in hypercholesterolemic rabbits. .

Fundamento: A pitavastatina é a mais nova estatina disponível no Brasil e com prováveis menores efeitos colaterais. Assim, a pitavastatina foi avaliada em coelhos hipercolesterolêmicos em relação à ação na reatividade vascular. Objetivo: Investigar a menor dose de pitavastatina na redução dos lípides plasmáticos, colesterol e peroxidação lipídica tecidual e função endotelial em coelhos hipercolesterolêmicos. Métodos: Trinta coelhos divididos em seis grupos (n=5): G1 - dieta ração padrão; G2 - dieta hipercolesterolêmica por 30 dias; G3 - dieta hipercolesterolêmica e a partir do 16º dia suplementada com pitavastatina (0,1 mg); G4 - dieta hipercolesterolêmica e suplementada com pitavastatina (0.25 mg); G5 - dieta hipercolesterolêmica e suplementada com pitavastatina (0,5 mg); G6 - dieta hipercolesterolêmica e suplementada com pitavastatina (1,0 mg). Após 30 dias foram dosados o colesterol total, HDL, triglicérides, glicose, creatinoquinase, aspartato aminotransferase, alanina aminotransferase e o LDL calculado. Aprofundada a anestesia com tiopental sódico e retirado segmentos de aorta para estudo da função endotelial, colesterol e peroxidação lipídica tecidual. O nível de significância adotado para os testes estatísticos foi 5%. Resultados: Colesterol total e LDL elevados significativamente em relação ao G1. HDL reduzida significativamente em G4, G5 e G6 em relação ao G2. Triglicérides, creatinoquinase, aspartato aminotransferase, alanina aminotransferase, colesterol e peroxidação lipídica tecidual sem diferença estatística entre G3-G6 e G2. Disfunção endotelial revertida significativamente em G5 e G6 em relação ao G2. Conclusão: A pitavastatina, a partir da ...

Evaluation of Sexual Dimorphism in the Efficacy and Safety of Simvastatin/Atorvastatin Therapy in a Southern Brazilian Cohort / Papel do Dimorfismo Sexual na Eficácia e Segurança da Terapia com Sinvastatina ou Atorvastatina em uma Coorte no Sul do Brasil

Background: Dyslipidemia is the primary risk factor for cardiovascular disease, and statins have been effective in controlling lipid levels. Sex differences in the pharmacokinetics and pharmacodynamics of statins contribute to interindividual variations in drug efficacy and toxicity. Objective: To evaluate the presence of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin treatment. Methods: Lipid levels of 495 patients (331 women and 164 men) were measured at baseline and after 6 ± 3 months of simvastatin/atorvastatin treatment to assess the efficacy and safety profiles of both drugs. Results: Women had higher baseline levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) compared with men (p < 0.0001). After treatment, women exhibited a greater decrease in plasma TC and LDL-C levels compared with men. After adjustment for covariates, baseline levels of TC and LDL-C influenced more than 30% of the efficacy of lipid-lowering therapy (p < 0.001), regardless of sex. Myalgia [with or without changes in creatine phosphokinase (CPK) levels] occurred more frequently in women (25.9%; p = 0.002), whereas an increase in CPK and/or abnormal liver function was more frequent in in men (17.9%; p = 0.017). Conclusions: Our results show that baseline TC and LDL-C levels are the main predictors of simvastatin/atorvastatin therapy efficacy, regardless of sex. In addition, they suggest the presence of sexual dimorphism in the safety of simvastatin/atorvastatin. The effect of sex differences on receptors, transporter proteins, and gene expression pathways needs to be better evaluated and characterized to confirm these observations. .

Fundamento: A dislipidemia é o principal fator de risco para doenças cardiovasculares e as estatinas são efetivas no controle do perfil lipídico. Diferenças sexuais na farmacocinética e farmacodinâmica contribuem para a variação interindividual na eficácia e toxicidade de fármacos. Objetivo: Avaliar a existência de dimorfismo sexual na eficácia e segurança do tratamento com sinvastatina/atorvastatina. Métodos: 495 sujeitos (331 mulheres e 164 homens) tiveram seus níveis lipídicos mensurados antes e após 6±3 meses de tratamento com sinvastatina/atorvastatina para avaliação dos perfis de eficácia e segurança. Resultados: As mulheres apresentaram maiores níveis basais de colesterol total, LDL-C e HDL-C quando comparadas aos homens (p < 0,0001). Após o tratamento, mulheres tiveram uma maior redução dos níveis de colesterol total e de LDL-C que homens. Após ajuste para covariáveis, foi observado que os níveis basais de colesterol total e de LDL-C são responsáveis por cerca de 30% da eficácia (p < 0,001), independentemente do sexo. Mialgia (com ou sem alteração de creatina fosfoquinase - CPK) ocorreu mais frequentemente em mulheres (25,9%) (p = 0,002), enquanto o aumento isolado de CPK e alterações de função hepática foram mais frequentemente observados em homens (17,9%) (p = 0,017). Conclusões: Nossos resultados demonstram que os níveis basais de colesterol total e LDL-C são os maiores preditores da eficácia do tratamento, independente do sexo. Adicionalmente, sugerimos que existe dimorfismo sexual na segurança do tratamento com sinvastatina/atorvastatina. O efeito das diferenças sexuais em receptores, proteínas transportadoras e rotas de expressão gênica devem ser avaliados ...

¿Pueden ocho semanas de ejercicio físico combinado normalizar marcadores metabólicos de sujetos hiperglicémicos y dislipidémicos? / Eight weeks of combined high intensity intermittent exercise normalized altered metabolic parameters in women

Background: Short term physical training programs may improve insulin resistance and hyperglycemia. Aim: To assess the effects of eight weeks of combined exercise program on serum lipids and glycemic level in women with hyperglycemia and hypercholesterolemia. Patients and Methods: Ten healthy women, nine women with hyperglycemia, ten with hypercholesterolemia and nine with hyperglycemia/hypercholesterolemia were studied. Participants were subjected to eight weeks into a program of combined physical exercise (high intensity interval + resistance training). Results: Fasting glycemia decreased by 12 and 14% in hyperglycemic and hyperglycemic/hypercholesterolemic participants, respectively. Serum insulin decreased in all groups in a range from 27 to 37%. HOMA IR for insulin resistance decreased similarly. A significant decrease in TC and TG was observed only in those altered baseline subjects. Conclusions: Eight weeks of combined physical exercise had a favorable effect on insulin resistance in this group of women.

Relationship between platelet indices and lipidemias: a cross-sectional study at Karachi

To compare platelet indices among patients with low and high levels of cholesterolemia and triglyceridemia. This cross-sectional study was conducted from January 2011to May 2012 at the departments of pathology, PNS Rahat and Baqai medical and dental university, Karachi. A total of 867 subjects presenting for estimation of fasting triglycerides and total cholesterol were selected after excluding patients receiving anti-platelet or lipid medication, pregnancy, acute in factious disorders. They were interviewed, examined and sampled for measurement of total cholesterol, triglycerides and platelet indices including total platelet count, mean platelet volume [MPV], platelet distribution width [PDW] and platecrit [PCT]. The results of platelet count and mean platelet volume were found to be significantly different among subjects with normal cholesterolemia [<5.2mmol/L], borderline raised cholesterol group [5.2-6.3 mmol/L] and hypercholesterolemia [>6.3 mmol/L]; however, post-hoc comparison did not show any significant difference between all groups. Using age as a variable and segregating total cholesterol results into 7 groups, starting from very low cholesterol values [<4.0 mmol/L] to highest [>6.5 mmol/L], in a univariate general linear model, higher mean platelet volume were observed at the extremes of cholesterolemia groups [p=0.039]. A similar trend was observed for platelet count after adjusting for age, where low levels of platelet levels were associated with hypocholesterolemia and hypercholesterolemia [p=0.021]. Higher MPV and low total platelet counts were associated with the observed extremes of cholesterol range. No significant differences were observed for platelet indices across various groups formulated based upon fasting triglycerides

Hypocholesterolemia in Patients with an Amebic Liver Abscess

BACKGROUND/AIMS: Many parasites induce changes in the lipid profiles of the host. Cholesterol increases the virulence of Entamoeba histolytica in animal models and in vitro culture. This study aimed to determine, in patients with an amebic liver abscess, the correlation between cholesterol and other features, such as the size and number of abscesses, standard hematological and serum chemistry profiles, liver tests, and duration of hospital stay. METHODS: A total of 108 patients with an amebic liver abscess and 140 clinically healthy volunteers were investigated. Cholesterol and triglycerides were measured in the sera. The data from medical observations and laboratory tests were obtained from the clinical records. RESULTS: A total of 93% of patients with an amebic liver abscess showed hypocholesterolemia not related to any of the studied parameters. Liver function tests correlated with the size of the abscess. The most severe cases of amebic liver disease or death were found in patients whose cholesterol levels continued to decrease despite receiving antiamebic treatment and hospital care. CONCLUSIONS: Our results show that the hypocholesterolemia observed in patients with an amebic liver abscess is not related to any of the clinical and laboratory features analyzed. This is the first study relating hypocholesterolemia to severity of hepatic amebiasis.

High plasma concentrations of asymmetric dimethylarginine inhibit ischemic cardioprotection in hypercholesterolemic rats

A low concentration of nitric oxide associated with a high concentration of asymmetric dimethylarginine (ADMA) can explain the lack of ischemic cardioprotection observed in the presence of hypercholesterolemia. The objective of the present study was to evaluate the effect of hypercholesterolemia on ischemic pre- and postconditioning and its correlation with plasma concentrations of ADMA. Male Wistar rats (6-8 weeks old) fed a 2% cholesterol diet (n = 21) for 8 weeks were compared to controls (n = 25) and were subjected to experimental myocardial infarction and reperfusion, with ischemic pre- and postconditioning. Total cholesterol and ADMA were measured in plasma before the experimental infarct and the infarct area was quantified. Weight, total cholesterol and plasma ADMA (means ± SE; 1.20 ± 0.06, 1.27 ± 0.08 and 1.20 ± 0.08 vs 0.97 ± 0.04, 0.93 ± 0.05 and 0.97 ± 0.04 µM) were higher in animals on the hypercholesterolemic diet than in controls, respectively. Cardioprotection did not reduce infarct size in the hypercholesterolemic animals (pre: 13.55% and post: 8% compared to 7.95% observed in the group subjected only to ischemia and reperfusion), whereas infarct size was reduced in the animals on a normocholesterolemic diet (pre: 8.25% and post: 6.10% compared to 12.31%). Hypercholesterolemia elevated ADMA and eliminated the cardioprotective effects of ischemic pre- and postconditioning in rats.

Papel de inibidores da síntese e absorção do colesterol na modulação de biomarcadores de inflamação e adesão celular in vivo e in vitro / Role of inhibitors of the cholesterol synthesis and absorption on modulation of inflammation and cell adhesion biomarkers in vivo and in vitro

O processo inflamatório tem um papel fundamental na gênese e desenvolvimento da aterosclerose, sendo que a disfunção endotelial é considerada um dos estágios iniciais da aterogênese. Por meio da inibição da enzima hidroxi-metil-glutaril coA redutase (HMGCR), as estatinas reduzem a biossíntese do colesterol e a formação de isoprenóides, produtos intermediários da síntese do colesterol que são importantes na modificação pós-transcricional de GTPases pequenas que estão envolvidas na disfunção endotelial e inflamação vascular. A ezetimiba é um inibidor da absorção do colesterol através da inibição da proteína NPC1L1. Com a finalidade de esclarecer os mecanismos moleculares da inibição da síntese e da absorção do colesterol sobre a modulação de biomarcadores inflamatórios e de adesão celular foram utilizados modelos in vitro com células endoteliais (HUVEC) e monócitos (células THP-1), e in vivo com células mononucleares do sangue periférico (CMSP) de indivíduos hipercolesterolêmicos (HC). O efeito das estatinas, atorvastatina e sinvastatina, e da ezetimiba na expressão de RNAm e proteínas de moléculas de adesão endoteliais e moduladores do processo inflamatório, como citocinas e óxido nítrico (NO), foi estudado em células HUVEC. O efeito desses fármacos sobre a expressão de moléculas de adesão monocitárias foi estudado em células THP-1. O efeito da terapia hipolipemiante sobre essas moléculas foi também estudada em CMSP de HC tratados com ezetimiba (10 mg/dia/4 semanas), sinvastatina (10 mg/dia/8 semanas) e sinvastatina combinada com ezetimiba (10 mg de cada/dia/4 semanas). A expressão de RNAm foi avaliada por RT-qPCR. A expressão de moléculas de adesão na superfície de células THP-1 e HUVEC foi estudada por citometria de fluxo. A quantificação de citocinas secretadas no sobrenadante de células HUVEC e no plasma dos HC foi analisada pela tecnologia Milliplex. A quantificação do perfil lipífico, Proteína C reativa ultra-sensível (PCRus) e NO foi realizada por métodos laboratoriais convencionais. O papel do NO na modulação dos marcadores inflamatórios pelas estatinas foi também estudada, usando modelo de células HUVEC com NOS3 silenciado por interferência de RNAm e também por meio do uso do inibidor da síntese do óxido nítrico, L-NAME. Também foi avaliado o efeito de hipolipemiantes na expressão dos microRNAs (miRs) 221, miR-222 e miR-1303 em células HUVEC por meio do stem-loop RT-qPCR. O tratamento com atorvastatina e sinvastatina reduziu a expressão de RNAm e proteínas das moléculas de adesão LSelectina, PSGL-1 e VLA-4, em células THP-1 pré-tratadas com TNFα por 12 h. A ezetimiba reduziu a expressão de L-Selectina apenas no nível transcricional. Em células HUVEC, as estatinas diminuíram a expressão de RNAm de IL1B e SELP, entretanto aumentaram a de VCAM1. A ezetimiba reduziu a expressão de RNAm do IL1B. Entretanto as expressões de SELE, MMP9, IL6 e MMP9 não foram afetadas pelos tratamentos. A expressão das proteínas ICAM-1 e P-Selectina, na superfície de células HUVEC, foi diminuída pelo tratamento com as estatinas, mas não pela ezetimiba. Da mesma forma, a secreção das citocinas IL-6 e MCP-1 foram reduzidas pelas estatinas, entretanto a secreção de IL-8 não foi modificada por nenhum dos tratamentos. A expressão de NOS3 e a liberação de NO em células HUVEC foi aumentada pelas estatinas, porém não foi estimulada pela ezetimiba. Entretanto, os efeitos antiinflamatórios exercidos pelas estatinas foram independentes dessa via devido a que estes efeitos foram mantidos em células HUVEC com NOS3 silenciado por interferência de RNAm. Apesar de que o efeito sobre ICAM-1 e MCP-1 foi atenuado quando as células foram simultaneamente tratadas com L-NAME, os efeitos das estatinas parecem ser independentes da liberação de NO. As estatinas e a ezetimiba reduziram a expressão do miR-221, em células HUVEC. A expressão do miR-222 foi reduzida só pelo tratamento com atorvastatina. A expressão do miR-1303 não foi modulada pelos tratamentos hipolipemiantes. Em pacientes HC, a terapia de associação da sinvastatina e ezetimiba demonstrou melhorar o perfil lipídico de forma mais efetiva que ambas monoterapias. Da mesma forma, o tratamento combinado resultou em maior beneficio pela redução da expressão de RNAm em CMSP e da concentração plasmática das proteínas IL-1 ß, MCP-1, IL-8 e TNFα. A expressão de ICAM1 foi diminuída apenas no nível transcricional, entretanto a expressão de RNAm mas não da proteína do TNFα foi também reduzida pela sinvastatina em monoterapia. Não houve modulação de RNAm ou proteínas de outros marcadores estudados no modelo in vivo. Por outro lado, os efeitos anti-inflamatórios observados nos indivíduos HC foram independentes da modulação de PCRus e NO que não foram modificados pelos tratamentos hipolipemiantes. Neste estudo, foram confirmados os propostos efeitos pleiotrópicos das estatinas em modelos células de monócito e endotélio vascular in vitro e em pacientes HC. Por outro lado, apesar de ser menos potente que as estatinas foi mostrado que a inibição da absorção do colesterol tem também um efeito anti-inflamatório. A redução adicional do colesterol causado pela combinação das terapias hipolipemiantes outorga um maior beneficio cardiovascular em pacientes hipercolesterolêmicos

The inflammatory process has a key role in the genesis and development of atherosclerosis and the endothelial disfunction is considered as a first step in atherogenesis. By inhibiting the hydroxyl-methyl-glutaryl coA reductase (HMGCR)m statins reduce the cholesterol synthesis and isoprenoid generation, which are intermediary products of cholesterol synthesis with important role in posttranscriptional modifications of small GTPases that are involved in endothelial disfunction and vascular inflammation. The ezetimibe is an inhibitor of cholesterol absorption by inhibiting the NPC1L1 protein. To clarify the molecular mechanisms of the inhibition of cholesterol synthesis and absorption modulating inflammatory and cell adhesion biomarkers we used in vitro models of endothelial cells (HUVEC) and monocytes (THP-1), and an in vivo model of peripheral blood mononuclear cells (PBMC) from hypercholesterolemic (HC) patients. The effect of the statins, atorvastatin and simvastatin, and the ezetimibe on mRNA and protein expression of endothelial adhesion molecules and modulators of the inflammatory process, as citokynes and nitric oxide (NO), was analyzed in HUVEC. The effect of these drugs on the expression of monocyte adhesion molecules was also studied in THP-1. The influence of hypolipemiant therapy on the adhesion molecules was also analyzed in PBMC from HC treated with ezetimibe (10 mg/day/4-weeks), simvastatin (10 mg/day/8-weeks) and simvastatin combined with ezetimibe (10 mg each/day/4-weeks). The mRNA expression was evaluated by RT-qPCR. The expression of adhesion molecules on the surface of THP-1 and HUVEC cells was analyzed flow cytometry. The citokynes in the supernatants of HUVEC were quantified using the milliplex technology. The Lipid profile, high-sensivity PCR (hsPCR) and NO were determined by conventional laboratory methods. The role of the NO on the statin-modulation of inflammatory markers was also studied using a model with silenced NOS3 by interference of mRNA and by the use of the inhibitor of NO synthesis, L-NAME. The effect of hypolipemiants on the expression of microRNAs (miRs) 221, miR-222 and miR-1303 was also evaluated in HUVEC using the stem-loom RT-qPCR. Atorvastatin and simvastatin reduced the mRNA and protein expression of the adhesion molecules L-Selectin, PSGL-1 and VLA-4 in THP-1 cells pre-treated with TNFα for 12 h. The ezetimibe reduced the L-Selectin expression only at transcriptional level. In HUVEC, statins diminished IL1B and SELP mRNA expression, whereas VCAM1 was increased. The ezetimibe reduced the IL1B mRNA expression. However, SELE, MMP9, IL6 and MMP9 mRNA expressions were not affected by the treatments. The protein expression of ICAM-1 and P-Selectin on the surface of HUVEC was reduced by statins, but not by the ezetimibe. Similarly, IL-6 and MCP-1 secretion were reduced by statins, whereas IL-8 secretion was not modified by the treatments. The NO release and NOS3 expression in HUVEC was increased by the statins, however it was not stimulated by ezetimibe. Moreover, the anti-inflammatory statin effects were independent of this pathway due to statin effects were maintained in HUVEC with silenced NOS3. Although the statin effect on ICAM-1 and MCP-1 were attenuated by L-NAME co treatment, the statin effects seem to be independent of NO release. Statins and ezetimibe reduced miR221 in HUVEC. miR-222 expression was reduced only by atorvastatin. miR-1303 was not affected by the treatments. In HC patients, the improvement of the lipid profile simvastatin combined with ezetimibe was more efficient than both monotherapies. Similarly, the association therapy was better in reducing the mRNA expression in PBMC and plasma concentration of IL-1ß, MCP-1, IL-8 and TNFα. ICAM1 expression was reduced only at transcriptional level, whereas mRNA but not protein expression of TNFα was also reduced by the simvastatin monotherapy. There was no modulation mRNA or protein expression of other studied markers in the in vivo model. Additionally, the anti-inflammatory effects observed in the HC were independent of PCRus or NO modulation, which were not altered by the hypolipemiant treatments. In this study, the proposed plitropic effects of statins were confirmed in monocytes and endothelial cells in vitro and in HC patients. Moreover, although it was less potent than statins, an anti-inflammatory effect was also observed for the inhibition of cholesterol absorption. An additional reduction of the cholesterol caused by combined hypolipemiant therapies gives a greater cardiovascular beneffict in hypercholesterolemic patients

Evaluación del screening de perfil lipídico propuesto por la Academia Americana de Pediatría / Usefulness of the American Academy of Pediatrics lipid screening

Objective: To determine if the screening adopted by the American Academy of Pediatrics to search for alterations in lipid profile is useful in the population of Centro Asistencial Norte of Antofagasta. Patients and Method: 61 patients 2 to 14 years of age were screened using the AAP lipid profile (family history of cardiovascular disease, hypercholesterolemia of parents, presence of overweight, arterial hypertension, tobacco addiction, consumption of fats) to evaluate its relationship to laboratory results (total cholesterol, HDL, LDL and triglycerides). Ain analytical study of cross section was used, utilizing /-test and the Fisher's Test were used with alpha = 0.05. Results: A difference in parent hypercholesterolemia (p = 0.013) with sensitivity of 31 percent and specificity of 63 percent was found, with a risk of 6 times higher for dyslipidemia in children with hypercholeste-rolemia in parents (RO with CI of 95 percent of 6.75 (1.18-68.51)). Conclusion: In this sample, utilizing the AAP screening, only the history of hypercholesterolemia in parents was valuable to determine if the patients had a higher risk of presenting dyslipidemia.

Objetivo: Determinar si los criterios de screening adoptados por la American Academy of Pediatrics para pesquisar alteraciones de perfil lipídico son útiles en población consultante del Centro Asistencial Norte de Antofagasta. Pacientes y Método: 61 pacientes entre 2 y 14 años fueron sometidos a screening de perfil lipídico (historia familiar de enfermedad cardiovascular, hipercolesterolemia parental, sobrepeso, hipertensión arterial, tabaquismo, consumo elevado de grasas) para analizar si se relacionaban con los resultados obtenidos del laboratorio. El diagnóstico se realizó considerando los valores de colesterol total, HDL, LDL y triglicéridos. El diseño correspondió a un estudio analítico de corte transversal. Para analizar los grupos se utilizó el /-test y la prueba de Fisher con alfa = 0,05. Resultados: Sólo hubo diferencia significativa en el antecedente de hipercolesterolemia parental (p = 0,013) con sensibilidad del 31 por ciento y especificidad de 63 por ciento, observándose un riesgo de 6 veces más posibilidades de tener dislipidemia en los hijos de padres con hipercolesterolemia (OR con intervalo de confianza al 95 por ciento de 6,75 (1,18 - 68,51). Conclusión: En la muestra, según los criterios de screening, sólo el antecedente de hipercolesterolemia de los padres resultó valioso para determinar si los pacientes tenían más riesgo de presentar dislipidemia.

Antihypercholesterolaemic influence of dietary tender cluster beans (Cyamopsis tetragonoloba) in cholesterol fed rats.

Background & objectives: Cluster beans (Cyamopsis tetragonoloba) are rich source of soluble fibre content and are known for their cholesterol lowering effect. The beneficial anti-hypercholesterolaemic effect of whole dietary cluster beans as a source of dietary fibre was evaluated in high cholesterol diet induced hypercholesterolaemia in experimental rats. Methods: Male Wistar rats (90-95 g) divided in six groups of 10 rats each were used. Freeze dried tender cluster beans were included at 12.5 and 25 per cent levels in the diet of animals maintained for 8 wk either on high (0.5%) cholesterol diet or basal control diet. Results: Significant anti-hypercholesterolaemic effect was seen in cluster bean fed animals, the decrease in serum cholesterol being particularly in the LDL associated fraction. There was also a beneficial increase in HDL associated cholesterol fraction. Hepatic lipid profile showed a significant decrease in both cholesterol and triglycerides as a result of feeding tender cluster beans along with high cholesterol diet. Interpretation & Conclusions: The present experimental results showed the beneficial hypocholesterolaemic and hypolipidimic influences dietary tender cluster beans in atherogenic situation. Studies in human need to be done to confirm the results.