Study on anti-hyperlipidemia effect of Linderae Radix via regulating reverse cholesterol transport / 中国中药杂志

This article aims to investigate the ameliorative effect of Linderae Radix ethanol extract on hyperlipidemia rats induced by high-fat diet and to explore its possible mechanism from the perspective of reverse cholesterol transport(RCT). SD rats were divided into normal group, model group, atorvastatin group, Linderae Radix ethanol extract(LREE) of high, medium, low dose groups. Except for the normal group, the other groups were fed with a high-fat diet to establish hyperlipidemia rat models; the normal group and the model group were given pure water, while each administration group was given corresponding drugs by gavage once a day for five weeks. Serum total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol(HDL-c), low density lipoprotein-cholesterol(LDL-c), alanine aminotransferase(ALT), and aspartate aminotransferase(AST) levels were measured by automatic blood biochemistry analyzer; the contents of TC, TG, total bile acid(TBA) in liver and TC and TBA in feces of rats were detected by enzyme colorimetry. HE staining was used to observe the liver tissue lesions; immunohistochemistry was used to detect the expression of ATP-binding cassette G8(ABCG8) in small intestine; Western blot and immunohistochemistry were used to detect the expression of peroxisome proliferator-activated receptor gamma/aerfa(PPARγ/α), liver X receptor-α(LXRα), ATP-binding cassette A1(ABCA1) pathway protein and scavenger receptor class B type Ⅰ(SR-BⅠ) in liver. The results showed that LREE could effectively reduce serum and liver TC, TG levels, serum LDL-c levels and AST activity, and increase HDL-c levels, but did not significant improve ALT activity and liver index; HE staining results showed that LREE could reduce liver lipid deposition and inflammatory cell infiltration. In addition, LREE also increased the contents of fecal TC and TBA, and up-regulated the protein expressions of ABCG8 in small intestine and PPARγ/α, SR-BⅠ, LXRα, and ABCA1 in liver. LREE served as a positive role on hyperlipidemia model rats induced by high-fat diet, which might be related to the regulation of RCT, the promotion of the conversion of cholesterol to the liver and bile acids, and the intestinal excretion of cholesterol and bile acids. RCT regulation might be a potential mechanism of LREE against hyperlipidemia.

Methylophiopogonanone A, an Ophiopogon homoisoflavonoid, alleviates high-fat diet-induced hyperlipidemia: assessment of its potential mechanism

Methylophiopogonanone A (MO-A), a homoisoflavonoid extracted from Ophiopogon japonicus, has been shown to attenuate myocardial apoptosis and improve cerebral ischemia/reperfusion injury. However, the hypolipidemic effects remain unknown. This study was performed to investigate a potential hypolipidemic effect of MO-A in hyperlipidemia rats, as well as its underlying mechanism of action. A rat model of hyperlipidemia was induced by a high-fat diet (HFD). Animals were randomly divided into three groups (n=8/group): normal control group (NC), HFD group, and HFD+MO-A (10 mg·kg-1·d-1) treatment group. The effects of MO-A on serum lipids, body weight, activity of lipoprotein metabolism enzyme, and gene expression of lipid metabolism were evaluated in HFD-induced rats. In HFD-induced rats, pretreatment with MO-A decreased the body weight gain and reduced serum and hepatic lipid levels. In addition, pretreatment with MO-A improved the activities of lipoprotein lipase and hepatic lipase in serum and liver, down-regulated mRNA expression of acetyl CoA carboxylase and sterol regulatory element-binding protein 1c, and up-regulated mRNA expression of low-density lipoprotein receptor and peroxisome proliferator-activated receptor α in the liver. Our results indicated that MO-A showed strong ability to ameliorate the hyperlipidemia in HFD-induced rats. MO-A might be a potential candidate for prevention of overweight and dyslipidemia induced by HFD.

Large Accumulation of Collagen and Increased Activation of Mast Cells in Hearts of Mice with Hyperlipidemia / Grande Acúmulo de Colágeno e Aumento da Ativação de Mastócitos nos Corações de Ratos com Hiperlipidemia

Abstract Background: Hyperlipidemia, which is characterized by an elevation of lipids in the bloodstream, is a major risk factor for cardiac disease. Objectives: The present study investigated the role of fibrosis in the progression of hyperlipidemia in the mice heart, and whether mast cell activation was associated with the fibrosis process. Methods: Hyperlipidemia was produced in C57BL / 6 mice by feeding them on a high-fat diet for 8 weeks.To assess tissue fibrosis, picrosirius red staining was performed. Hematoxylin & eosin (H&E) staining was performed to identify the histopathological changes in the hearts. Immunohistochemistry was also accomplished to determine the localization of transforming growth factor (TGF)-β and α-smooth muscle actin (α-SMA). Western blotting was performed to analyze the expression of chymase, tryptase, TGF-β, α-SMA and activity of Wnt/β-catenin pathway. At the end, serum total cholesterol (TC) and triglycerides (TG) levels were measured. All the values were expressed as means ± SD, the statistical significance level adopted was 5%. Results: Hyperlipidemia mice showed significantly increased collagen deposition in the hearts compared with normal mice. In addition, H&E staining showed significant cellular degeneration. Cardiac muscle was arranged in disorder with fracture in mice of the model group. Immunohistochemistry and western blot analysis revealed that expression levels of tryptase, chymase, β-catenin, TGF-β and α-SMA were significantly increased in the hyperlipidemia mice compared with the control group. Conclusions: The results indicated that mast cell activation might induce cardiac fibrosis by tryptase and chymase in hyperlipidemia, which had a close relationship with the increased activity of TGF-β/Wnt/β-catenin pathway.

Resumo Fundamentos: A hiperlipidemia, que se caracteriza por uma elevação dos lipídeos na corrente sanguínea, é um importante fator de risco para a doença cardíaca. Objetivos: O presente estudo investigou o papel da fibrose na progressão da hiperlipidemia no coração do rato e se a ativação dos mastócitos estava associada ao processo de fibrose. Método: A hiperlipidemia foi produzida em ratos C57BL/6 alimentando-os com uma dieta rica em gordura durante 8 semanas. Para avaliar a fibrose tecidual, foi realizada coloração vermelha picro-Sirius. A coloração com hematoxilina e eosina (H & E) foi feita para identificar as alterações histopatológicas nos corações. A imuno-histoquímica também foi levada a cabo para determinar a localização do fator de crescimento transformante (TGF) -β e α-actina do músculo liso (α-SMA). O Western Blot foi realizado para analisar as expressões de quimase, triptase, TGF-β, α-SMA e a atividade da via Wnt / β-catenina. Finalmente, se mediram os níveis séricos de colesterol total (TC) e triglicerídeos (TG). Todos os valores foram expressos como média ± DP, o nível de significância estatística adotado foi de 5%. Resultados: Os ratos hiperlipidêmicos mostraram aumento significativo da deposição de colágeno nos corações em comparação com ratos normais. Além disso, a coloração de H & E mostrou degeneração celular significativa. O músculo cardíaco estava em desordem com ruptura de fibras em ratos do grupo modelo. A análise imuno-histoquímica e o Western Blot revelaram que os níveis de expressão de triptase, quimase, β-catenina, TGF-β e α-SMA estavam significativamente aumentados nos ratos hiperlipidêmicos em comparação com o grupo controle. Conclusões: Os resultados indicaram que a ativação de mastócitos pode induzir fibrose cardíaca por triptase e quimase em hiperlipidemia, a qual teve uma relação estreita com a atividade aumentada da via TGF-β / Wnt / β-catenina.

Genetic & epigenetic approach to human obesity.

Obesity is an important clinical and public health challenge, epitomized by excess adipose tissue accumulation resulting from an imbalance in energy intake and energy expenditure. It is a forerunner for a variety of other diseases such as type-2-diabetes (T2D), cardiovascular diseases, some types of cancer, stroke, hyperlipidaemia and can be fatal leading to premature death. Obesity is highly heritable and arises from the interplay of multiple genes and environmental factors. Recent advancements in Genome-wide association studies (GWAS) have shown important steps towards identifying genetic risks and identification of genetic markers for lifestyle diseases, especially for a metabolic disorder like obesity. According to the 12th update of Human Obesity Gene Map there are 253 quantity trait loci (QTL) for obesity related phenotypes from 61 genome wide scan studies. Contribution of genetic propensity of individual ethnic and racial variations in obesity is an active area of research. Further, understanding its complexity as to how these variations could influence ones susceptibility to become or remain obese will lead us to a greater understanding of how obesity occurs and hopefully, how to prevent and treat this condition. In this review, various strategies adapted for such an analysis based on the recent advances in genome wide and functional variations in human obesity are discussed.

Hypolipidemic and antioxidant activity of ethanolic extract of Symplocos racemosa Roxb. in hyperlipidemic rats: An evidence of participation of oxidative stress in hyperlipidemia.

Hypolipidemic and antioxidant activity profiles of ethanolic extracts of Symplocos racemosa (EESR) were studied by triton-WR1339 (acute) and high fat diet induced (chronic) hyperlipidemic rat models. In both the models, a significant increase in total cholesterol (TC), triglycerides (TG), very low density lipoproteins (VLDL), low density lipoproteins (LDL) and decrease in high density lipoproteins (HDL) in serum were observed. EESR (200 and 400 mg/kg) and simvastatin (10 mg/kg) administered orally reduced the elevated serum lipids (TC, TG, VLDL, LDL), restored the decreased HDL and improved the atherogenic index. In high fat diet induced hyperlipidemic model, EESR treatment prevented the increased formation of malondialdehyde (MDA) in liver, restored the depleted liver antioxidants, glutathione, superoxide dismutase, catalase significantly. The increased liver cholesterol, HMG-CoA reductase activity and body weight of hyperlipidemic rats were significantly reduced by EESR treatment. The EESR inhibited HMG-CoA reductase, a rate limiting enzyme in cholesterol biosynthesis, thereby causing hypolipidemic effects. EESR treatment also improved histoarchitecture of hepatocytes in hyperlipidemic rats. Experimental findings demonstrated anti-hyperlipidemic and antioxidant activity of EESR, which may be directly or indirectly related to its antioxidant activity. The hypolipidemic activity of EESR may be due to the presence of flavonoids phenolic compounds, phenolic glycosides and steroids.

Development of an Integrated Reporting System for Verifying Hemolysis, Icterus, and Lipemia in Clinical Chemistry Results

BACKGROUND: Hemolysis, icterus, and lipemia (HIL) cause preanalytical interference and vary unpredictably with different analytical equipments and measurement methods. We developed an integrated reporting system for verifying HIL status in order to identify the extent of interference by HIL on clinical chemistry results. METHODS: HIL interference data from 30 chemical analytes were provided by the manufacturers and were used to generate a table of clinically relevant interference values that indicated the extent of bias at specific index values (alert index values). The HIL results generated by the Vista 1500 system (Siemens Healthcare Diagnostics, USA), Advia 2400 system (Siemens Healthcare Diagnostics), and Modular DPE system (Roche Diagnostics, Switzerland) were analyzed and displayed on physicians' personal computers. RESULTS: Analytes 11 and 29 among the 30 chemical analytes were affected by interference due to hemolysis, when measured using the Vista and Modular systems, respectively. The hemolysis alert indices for the Vista and Modular systems were 0.1-25.8% and 0.1-64.7%, respectively. The alert indices for icterus and lipemia were <1.4% and 0.7% in the Vista system and 0.7% and 1.0% in the Modular system, respectively. CONCLUSIONS: The HIL alert index values for chemical analytes varied depending on the chemistry analyzer. This integrated HIL reporting system provides an effective screening tool for verifying specimen quality with regard to HIL and simplifies the laboratory workflow.

Effect of Vanillin on lipid profile in a model of hyperlipidemia, a preliminary study.

To evaluate the effect of vanillin on the lipid profile of high fat diet induced hyperlipidemia in rats, the hyperlipidemia was induced by feeding cholesterol-rich high fat diet for 45 days in wistar rats of either sex. The reduction in the triglycerides and VLDL-C was significant at 200 & 400 mg/kg dose of vanillin compared to atorvastatin group. Reduction in total cholesterol was significant at 200 and 400 mg/kg doses compared to hyperlipidemic control. The results demonstrate that vanillin at a dose of 200 and 400 mg/kg body weight lowers the serum triglyceride, VLDL-C and total cholesterol level significantly in high fat diet induced hyperlipidemic rats. However there was no significant effect on the lipid profile at 100 mg/kg dose. There were no statistically significant changes in the HDL-C and LDL-C levels at any of the given doses.

Avaliação do efeito da sobrecarga lipídica na reatividade microvascular em mulheres obesas / Evaluation of the effect of lipid overload in microvascular reactivity in obese women

As mudanças nos hábitos alimentares têm causado efeitos impressionantes na saúde pública, diretamente relacionados ao aumento da ingestão de refeições ricas em gorduras, principalmente gorduras saturadas. A principal consequência desse consumo é o estado prolongado e excessivo da lipemia pós-prandial (LPP), considerada um dos fatores relacionados às anormalidades metabólicas e aos danos vasculares. O objetivo do estudo foiavaliar o efeito da sobrecarga lipídica na reatividade microvascular em mulheres obesas. Das 41 participantes deste estudo, 21 apresentavam o diagnóstico de obesidade, com IMC de 32,4±1,6 kg/m2 (média ±SD) e idade 31,6±5 anos e 20 mulheres saudáveis, com IMC de 21,9±1,7 kg/m2 e idade 27,2±5,5 anos. Após a avaliação clínica e laboratorial, as participantes tiveram a microcirculação examinada por dois métodos: a dinâmica do leito periungueal, para avaliação da densidade capilar funcional (DCF), velocidade de deslocamento das hemácias no basal (VDH) e após uma isquemia de 1 min (VDHmax) e tempo de reperfusão (TVDHmax). A segunda técnica foi a do dorso do dedo para avaliação da DCF no repouso, durante a hiperemia reativa e após oclusão venosa. Foi feita a coleta de sangue para avaliação do colesterol total (CT), triglicerídeos (TG), HDL-c e ácidos graxos livres (AGL), glicose, insulina e viscosidade plasmática em 30 e 50 rotações por minuto (rpm). Também foram medidas a pressão arterial sistólica (PAS), diastólica (PAD) e frequência cardíaca (FC). Após essas análises no repouso, todas as participantes receberam uma refeição rica em lipídios, e após 30, 60, 120 e 180 minutos da ingestão da refeição, os exames de videocapilaroscopia e a coleta de sangue foram novamente realizados.As participantes com obesidade apresentaram, após a sobrecarga lipídica, valores significativamente menores do que no jejum para: DCF basal do dorso do dedo (p=0,02); DCF durante hiperemia reativa (p=0,02), DCF pós-oclusão venosa (p=0,02), HDL-c (p<0,0001)...

Changes in eating habits have caused striking effects on public health, directly related to increased intake of food rich in fat, mainly saturated fat. The main consequence of this consumption is the excessive and prolonged state of postprandial lipemia (PPL), considered one an important factor related to metabolic abnormalities and vascular damage. The aim of this study was to assess effects of fat overload on microvascular reactivity in obese women. Of the 41 study participants, 21 had the diagnosis of obesity, with BMI of 32.4 ± 1.6 kg/m2 (mean ± SD) and age of 31.6 ± 5 years and 20 healthy women with BMI of 21.9 ± 1.7 kg/m2and age 27.2 ± 5.5 years. After clinical and laboratorial assessment, participants had the microcirculation examined by two methods: dynamic, using the nailfold bed to assess functional capillary density (FCD), red blood cell velocity in in control conditions (RBCV) and peak (RBCVmax) and time (TRBCVmax) to reach it after 1 min arterial occlusion. The second technique was the finger dorsum to assess FCD at rest and during the reactive hyperemia response and after venous occlusion. Blood sampling was performed to determine total cholesterol (TC), triglycerides (TG), HDL- c and free fatty acids (FFA), glucose, insulin and plasma viscosity at 30 and 50 rotations per minute (rpm). Systolic (SBP) and diastolic (DBP) blood pressures and heart rate (HR) were also measured. After these measurements at rest, all participants received a meal rich in lipids, and after 30, 60, 120 and 180 min after ingestion, videocapillaroscopy exams and blood samples were taken again. Results - Obese participants, after fat overload, presented significantly lower values than at rest at finger dorsum of FCD (p = 0.02), FCD during reactive hyperemia (p = 0.02) and post- venous occlusion (p = 0.02), HDL-C (p <0.0001), LDL-C (p <0.0001) and FFA (p <0.0001) and high values for: RBCV at rest (p<0 ,0001), RBCVmax (p = 0.003), TRBCVmax (p = 0.004), glucose (p <0.0001)...

An Update on Accumulating Exercise and Postprandial Lipaemia: Translating Theory Into Practice / 예방의학회지

Over the last two decades, significant research attention has been given to the acute effect of a single bout of exercise on postprandial lipaemia. A large body of evidence supports the notion that an acute bout of aerobic exercise can reduce postprandial triacylglycerol (TAG) concentrations. However, this effect is short-lived emphasising the important role of regular physical activity for lowering TAG concentrations through an active lifestyle. In 1995, the concept of accumulating physical activity was introduced in expert recommendations with the advice that activity can be performed in several short bouts throughout the day with a minimum duration of 10 minutes per activity bout. Although the concept of accumulation has been widely publicised, there is still limited scientific evidence to support it but several studies have investigated the effects of accumulated activity on health-related outcomes to support the recommendations in physical activity guidelines. One area, which is the focus of this review, is the effect of accumulating exercise on postprandial lipaemia. We propose that accumulating exercise will provide additional physical activity options for lowering postprandial TAG concentrations relevant to individuals with limited time or exercise capacity to engage in more structured forms of exercise, or longer bouts of physical activity. The benefits of accumulated physical activity might translate to a reduced risk of cardiovascular disease in the long-term.

Alleviation of metabolic abnormalities induced by excessive fructose administration in Wistar rats by Spirulina maxima.

Background & objectives: Diabetes mellitus is a metabolic disorder characterized by hyperglycaemia. Several natural products have been isolated and identified to restore the complications of diabetes. Spirulina maxima is naturally occurring fresh water cyanobacterium, enriched with proteins and essential nutrients. The aim of the study was to determine whether S. maxima could serve as a therapeutic agent to correct metabolic abnormalities induced by excessive fructose administration in Wistar rats. Methods: Oral administration of 10 per cent fructose solution to Wistar rats (n=5 in each group) for 30 days resulted in hyperglycaemia and hyperlipidaemia. Aqueous suspension of S. maxima (5 or 10%) was also administered orally once daily for 30 days. The therapeutic potential of the preparation with reference to metformin (500 mg/kg) was assessed by monitoring various biochemical parameters at 10 day intervals during the course of therapy and at the end of 30 days S. maxima administration. Results: Significant (P<0.001) reductions in blood glucose, lipid profile (triglycerides, cholesterol and LDL, VLDL) and liver function markers (SGPT and SGOT) were recorded along with elevated level of HDL-C at the end of 30 days therapy of 5 or 10 per cent S. maxima aquous extract. Co-administration of S. maxima extract (5 or 10% aqueous) with 10 per cent fructose solution offered a significant protection against fructose induced metabolic abnormalities in Wistar rats. Interpretation & Conclusions: The present findings showed that S. maxima exhibited anti-hyperglycaemic, anti-hyperlipidaemic and hepatoprotective activity in rats fed with fructose. Further studies are needed to understand the mechanisms.

Lindane-induced biochemical perturbations in rat serum and attenuation by omega-3 and Nigella sativa seed oil.

Lindane (-hexachlorocyclohexane, -HCH), a highly persistent organochlorine insecticide is neurotoxic at acute doses and has been reported to induce oxidative stress in cells and tissues. In this study, we investigated the antioxidant property of Nigella sativa seed oil (N.O) and omega-3 polyunsaturated fatty acids (3) against -HCH-induced oxidative hepatic and renal damage in male rats serum. Rats were orally given sublethal dose of -HCH (12 mg/kg, 24 h prior to decapitation), while N.O (0.3 ml/kg) and 3 (20 mg/kg) were given every 48 h for 20 days single or together, or also combined with -HCH. -HCH caused a significant increase in the levels of serum total lipids, cholesterol, and triglycerides by 49, 61 and 30% respectively, while HDL-cholesterol decreased by 45% compared to control group. Pretreatment with 3 and N.O prior -HCH administration re-established the altered biochemical features and alleviated the harmful effects of g-HCH on lipid profile. The concentration of serum total protein and albumin was significantly decreased by 35 and 45% respectively in rats treated with -HCH compared to control. -HCH also caused hepatic and renal damage, as observed from the elevated serum levels of urea, creatinine, total bilirubin and uric acid contents and aminotransferases (AST and ALT), phosphatases (ACP and ALP) and lactate dehydrogenase (LDH) activities. Co-administration of 3 and N.O reversed the hazardous effects induced by -HCH on the liver and kidney and also protected acetylcholinesterase from the inhibitory action of -HCH as well as suppressed the lipid peroxidation. Thus, the results show that 3 and N.O might prevent oxidative stress and attenuate the changes in the biochemical parameters induced by -HCH in male rats.

Hypolipidemic activity of Hibiscus rosa sinensis root in rats.

The hypolipidemic activity of Hibiscus rosa sinensis (family Malvaceae) root extract was studied on triton and cholesterol-rich high fat diet (HFD) induced models of hyperlipidemia in rats. In triton WR-1339-induced hyperlipidemia, feeding with root extract (500 mg/kg body wt/day p.o.) exerted lipid-lowering effect, as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL) and triglycerides (TG) and reactivation of post-heparin lipolytic activity (PHLA) of plasma. The other model was fed with cholesterol-rich HFD and root extract (500 mg/kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma PHLA and hepatic total lipoprotein lipase activity. The hypolipidemic activity of Hibiscus rosa sinensis root was compared with a standard drug guggulipid (200 mg/kg body wt/day p.o.), a known lipid- lowering agent in both models. Histopathological findings in rat liver supported the protective role of H. rosa sinensis root extract in preventing cholesterol-rich HFD-induced hepatic steatosis.

Effect of a cholesterol-rich diet on the metabolism of the free and esterified cholesterol components of a nanoemulsion that resembles LDL in rabbits

We have shown that the free cholesterol (FC) and the cholesteryl ester (CE) moieties of a nanoemulsion with lipidic structure resembling low-density lipoproteins show distinct metabolic fate in subjects and that this may be related to the presence of dyslipidemia and atherosclerosis. The question was raised whether induction of hyperlipidemia and atherosclerosis in rabbits would affect the metabolic behavior of the two cholesterol forms. Male New Zealand rabbits aged 4-5 months were allocated to a control group (N = 17) fed regular chow and to a 1 percent cholesterol-fed group (N = 13) during a 2-month period. Subsequently, the nanoemulsion labeled with ³H-FC and 14C-CE was injected intravenously for the determination of plasma kinetics and tissue uptake of the radioactive labels. In controls, FC and CE had similar plasma kinetics (fractional clearance rate, FCR = 0.234 ± 0.056 and 0.170 ± 0.038 h-1, respectively; P = 0.065). In cholesterol-fed rabbits, the clearance of both labels was delayed and, as a remarkable feature, FC-FCR (0.089 ± 0.033 h-1) was considerably greater than CE-FCR (0.046 ± 0.010 h-1; P = 0.026). In the liver, the major nanoemulsion uptake site, uptake of the labels was similar in control animals (FC = 0.2256 ± 0.1475 and CE = 0.2135 ± 0.1580 percent/g) but in cholesterol-fed animals FC uptake (0.0890 ± 0.0319 percent/g) was greater than CE uptake (0.0595 ± 0.0207 percent/g; P < 0.05). Therefore, whereas in controls, FC and CE have similar metabolism, the induction of dyslipidemia and atherosclerosis resulted in dissociation of the two forms of cholesterol.

Hypolipidemic activity of Eclipta prostrata (L.) L. leaf extract in atherogenic diet induced hyperlipidemic rats.

In atherogenic diet induced hyperlipidemic model, the rats receiving treatment with the aqueous extract of the leaves of E. prostrata showed significant reduction in total cholesterol, triglyceride, total protein and elevation in high density lipoprotein cholesterol.The aqueous extract of E. prostrata was found to possess significant hypolipidemic activity. The results also suggest that E. prostrata leaf extract at 100 and 200 mg/kg b.wt. concentrations is an excellent lipid-lowering agent.

Perfil lipídico de pacientes com alto risco para eventos cardiovasculares na prática clínica diária / Lipid profile of patients with increased risk for cardiovascular events in daily clinical practice

Embora existam recomendações especificas envolvendo o tratamento das dislipidemias em pacientes com alto risco, estas recomendações dificilmente são seguidas adequadamente. O objetivo deste estudo é investigar fatores de risco em pacientes com alto risco cardiovascular acompanhados ambulatorialmente no Brasil e Venezuela. Os prontuários de 412 pacientes foram selecionados em 4 instituições. Os pacientes foram divididos conforme a utilização de hipolipemiantes. Pacientes sem hipolipemiantes apresentavam níveis mais elevados de colesterol total (p< 0,001), LDL colesterol (p< 0,001) e HDL colesterol (p< 0,001), além de menores níveis de triglicérides (p< 0,001). O uso de hipolipemiantes foi associado à diminuição dos níveis de colesterol total (251,0 ± 40,0 para 196,0 ± 46,0), LDL colesterol (168,0 ± 36,0 para 116,0 ± 39,0), HDL colesterol (51,0 ± 46,0 para 46,0 ± 12,0) e triglicérides (181,0 ± 120,0 para 160,0 ± 79,0). Concluímos que apenas um pequeno percentual de pacientes, mesmo em uso de estatinas, apresenta níveis de colesterol compatível com os atualmente recomendados. Desta forma, embora as recomendações para tratamento das dislipidemias sejam bem conhecidas, um pequeno percentual de pacientes atinge os valores desejados de colesterol. É necessário um melhor controle dos níveis lipídicos dos pacientes, tanto através da utilização de doses maiores de estatinas como da utilização da associação de hipolipemiantes.

effect of garlic on cyclosporine-a-induced hyperlipidemia in male rats

Cyclosporin A [CsA] is a potent immunosuppressive drug. However, it has adverse effects that include elevation of plasma low-density lipoprotein [LDL]. This study was designed to determine the effect of garlic on CsA-induced hyperlipidemia in male rats. Baseline serum blood samples from forty 10-month-old, male Wistar rats were obtained. They received intraperitoneal [IP] injection of CsA [25 mg/kg] for 28 days. Blood samples were again obtained after the 28-day treatment. Sixteen of 40 rats showed increased serum LDL levels. These 16 were divided into 2 groups of 8 rats each. In the first [experimental] group, 8 rats received garlic [tablets, 400 mg/d], CsA [25 mg/kg IP], and regular diet for 28 days. In the second [control] group, 8 rats received the same regimen without the garlic tablets. At the end of the experiment, blood samples were taken from animals in both groups, and LDL levels were assessed. The mean baseline LDL level in animals in the control group was 17.75 +/- 4.1 mg/dL. This increased to 21.5 +/- 1.6 mg/dL after 28 days of CsA administration. After 28 more days, the mean LDL level increased to 25.4 +/- 4.9 mg/dL [P=.004]. In animals in the experimental group, the baseline LDL level was 23.8 +/- 3.7 mg/dL, which increased to 31.3 +/- 1.6 mg/dL after the first 28 days [P<.001]. After the second 28 days, it decreased to 26.0 +/- 4.8 mg/dL [P=.06], and among 4 animals, the LDL level decreased more than 49%. In a Wistar rat model, animals given cyclosporin A subsequently treated with garlic demonstrated reduced LDL levels compared with controls. This treatment may be useful in patients receiving organ transplantation

Receiver operating characteristics curve analysis of body fat & body mass index in dyslipidaemic Asian Indians.

BACKGROUND & OBJECTIVES: Optimal limit of body mass index (BMI) for Asian Indians remains to be defined. In this study, we describe the anthropometric and lipid profiles and determine the appropriate cut-offs of BMI for defining obesity in dyslipidaemic patients. METHODS: Correlations were carried out between lipid profile and anthropometric variables in 217 dyslipidaemic Asian Indians and the data were compared to those of 123 healthy historical controls. Receiver operating characteristics (ROC) curve analysis was carried out to determine the appropriate cut-offs of BMI for defining obesity taking the percentage of body fat (% BF) as the standard. RESULTS: Dyslipidaemic patients had high waist-hip ratio (W-HR) and percentage of BF. The prevalence of obesity as measured by percentage of BF was significantly (P < 0.05) higher as compared to obesity defined by the BMI cut-off. W-HR was the most important independent predictor (odds ratio: 2.8; 95% CI: 1.02-7.83) of atherogenic dyslipidaemia on multivariate logistic regression analysis. On ROC curve analysis the suggested appropriate cut-offs of BMI were; males 24.0 kg/m2 (sensitivity, 74.7%, and specificity, 79.7%), and females 23.0 kg/m2 (sensitivity, 85.7% and specificity, 62.5%). According to the suggested lower limits of BMI, an additional 15 per cent dyslipidaemic patients will be diagnosed as obese. INTERPRETATION & CONCLUSION: The observations in dyslipidaemic Asian Indians suggest high prevalence rates of generalized and abdominal obesity, and that high values of W-HR alone predisposes to atherogenic dyslipidaemia. Further, obesity may be optimally defined by a lower cut-off of BMI. The revised criteria for the BMI-based diagnosis of obesity will lead to a more rational management of dyslipidaemia in Asian Indians.