Omega 3 fatty acids reduce the triglyceride levels in rats with apical periodontitis

Abstract The aim of this study was to evaluate the influence of the prophylactic and therapeutic supplementation with omega 3 polyunsaturated fatty acids (w-3 PUFAs) on the lipid profile and periapical bone resorption in rats with apical periodontitis. Forty male rats were divided into groups: control rats (C), rats treated with w-3 PUFAs (C+O), rats with pulp exposure-induced apical periodontitis (AP), and rats with AP treated with w-3 PUFAs (AP+O). The administration of w-3 PUFAs was carried out orally once a day for 15 days before pulp exposure and, subsequently, for an additional 30 days after pulp exposure. AP was induced by exposing pulpal tissues to the oral environment. The samples were collected after 30 days. Triglycerides and cholesterol levels were enzymatically measured using the Trinder method. The jaws were collected and submitted for histological analysis. Two-way analysis of variance and Kruskal-Wallis tests were used for statistical analysis, and the significance was set at p<0.05. The triglyceride levels of the AP group were significantly higher than those of the C, C+O and AP+O groups (p<0.05). However, the difference in the cholesterol levels among the groups was not significant (p>0.05). Rats with AP showed larger areas of bone resorption as well as higher inflammatory intensity compared with rats with AP supplemented with w-3 PUFAs. It may be concluded that the presence of multiple AP foci increased the triglyceride levels. In addition, omega 3 supplementation might reduce these levels in rats with AP, as well as the bone resorption areas of periapical tissues.

Resumo O objetivo deste estudo foi avaliar a influência da suplementação profilática e terapêutica com os ácidos graxos ômega-3 no perfil lipídico e na reabsorção óssea, em ratos com periodontite apical. Quarenta ratos machos foram divididos em grupos: ratos controle (C), ratos tratados com ácidos graxos ômega-3 (C+O), ratos com periodontite apical induzida por meio de exposição pulpar (PA), ratos com PA tratados com ácidos graxos ômega-3 (PA+O). A administração do ômega-3 foi realizada oralmente, uma vez ao dia durante 15 antes da exposição pulpar e, subsequentemente, por mais 30 dias depois da exposição pulpar. A PA foi induzida por meio da exposição do tecido pulpar ao ambiente oral. Após 30 dias, os ratos foram mortos e os níveis de triglicérides e colesterol foram mensurados pelo método enzimático de Trinder. As mandíbulas foram coletadas e submetidas à análise histológica. Análise de variância de dois fatores e teste de Kruskal-Wallis foram utilizados para análise estatística, e o nível de significância foi de p < 0,05. Os níveis de triglicérides do grupo PA foram significativamente maiores que dos grupos C, C+O e PA+O (p<0,05). Entretanto, não houve diferença significativa nos níveis de colesterol entre os grupos (p>0,05). Ratos com PA apresentaram maior área de reabsorção óssea bem como maior intensidade no infiltrado inflamatório comparados aos ratos com PA suplementados com ômega-3. Pode-se concluir que a presença de múltiplos focos de PA aumentou os níveis de triglicérides. Além disso, a suplementação com ômega-3 pode reduzir estes níveis em ratos com PA, bem como a área de reabsorção óssea dos tecidos periapicais.

Effectiveness of n-3 fatty acids in the treatment of hypertriglyceridemia in HIV/AIDS patients: a meta-analysis / Efetividade de ácidos graxos n-3 no tratamento da hipertrigliceridemia em pacientes com HIV/AIDS: uma meta-análise

Abstract Hypertriglyceridemia is common in antiretroviral therapy-treated patients and Omega 3 fatty acids are being used as a intervention in reducing serum triglycerides (TG) in these patients. The objective of this study is to evaluate the effectiveness of the use of Omega 3 in the treatment of hypertriglyceridemia in HIV/AIDS patients on antiretroviral therapy. This study is a systematic review with meta-analysis of randomized clinical trials. Electronic databases - PubMed, Cochrane and Lilacs were researched. Fifty one articles were encountered. Nine were added to the meta-analysis. The reduction of triglycerides level was -77.55 mg (IC of -121.85 to -33.25) in Omega 3 groups. The analysis considering trials with more than 1000 mg of EPA/DHA included seven studies and the heterogeneity dropped to 0%.The reduction of combined averages was -101.56mg (IC of -145.76 to -57.37). The analysis considering trials with patients that had more than 200 mg/dL of initial triglycerides included also seven trials and the heterogeneity dropped to 0%. The reduction of combined averages was -114.15 mg (IC of -162.34 to -65.97). EPA/DHA supplementation reduces serum triglycerides levels in patients with HIV/AIDS-associated hypertriglyceridemia in stable use of antiretroviral therapy.

Resumo A hipertrigliceridemia é comum em pacientes tratados com terapia antirretroviral e os ácidos graxos ômega 3 estão sendo usados como uma intervenção na redução triglicérides séricos (TG) nesses pacientes. O objetivo deste estudo é avaliar a eficácia do uso do ômega 3 no tratamento da hipertrigliceridemia em pacientes com HIV/Aids em terapia antirretroviral. Este estudo é uma revisão sistemática com metanálise de ensaios clínicos randomizados. As bases de dados eletrônicas - PubMed, Cochrane e Lilacs foram pesquisadas. Cinquenta e um artigos foram encontrados. Nove incluídos na metanálise. A redução do nível de triglicerídios foi -77.55 mg (IC de -121,85 a - 33,25) no grupo com Omega 3. A análise considerando ensaios com mais de 1000 mg de EPA/DHA incluiu sete estudos e a heterogeneidade caiu para 0%. A redução das médias combinada foi -101.56 mg (IC de -145,76 a -57,37). A análise considerando ensaios com doentes que tinham mais do que 200 mg/dL, de triglicéridos iniciais incluiu também sete ensaios e a heterogeneidade caiu para 0%. A redução das médias combinada foi -114.15 mg (IC de -162,34 a -65,97). A suplementação de EPA/DHA reduz níveis de triglicérides séricos em pacientes com hipertrigliceridemia associada ao HIV/AIDS em uso de terapia antirretroviral estável.

Heparin and insulin in the management of hypertriglyceridemia-associated pancreatitis: case series and literature review

SUMMARY Severe hypertriglyceridemia accounts for up to 7% of all cases of acute pancreatitis. Heparin and insulin activate lipoprotein lipase (LPL), thereby reducing plasma triglyceride levels. However, the safety and efficacy of heparin and insulin in the treatment of hypertriglyceridemia-associated acute pancreatitis have not been well established yet. We successfully used heparin and insulin as first-line therapy in four consecutive patients with acute pancreatitis secondary to hypertriglyceridemia. In a literature search, we revised almost all reports published to date of patients managed successfully with this combination. Heparin and insulin appear to be a safe, effective, and inexpensive first-line therapy for hypertriglyceridemia-associated acute pancreatitis.

Importancia de la interpretación del colesterol total y de los triglicéridos para el diagnóstico de las dislipidemias / Importance of the interpretation of the total cholesterol and triglyceride content for the diagnosis of dyslipidemias

Objetivo: describir la importancia de la interpretación del colesterol total y de los triglicéridos para el diagnóstico de las dislipidemias. Métodos: se evaluaron 2 159 resultados de lipidogramas, realizados en el Laboratorio de Bioquímica, del Instituto de Angiología y Cirugía Vascular entre enero-2008-2009. Se utilizaron las recomendaciones de expertos y las referencias de los diagnosticadores para decidir la positividad o no del resultado. Resultados: se encontró que el colesterol fue positivo en el 32 por ciento de las órdenes según las recomendaciones y el 9,96 por ciento según la referencia. En el mismo orden los triglicéridos fueron positivos en el 43,14 por ciento y en el 38,96 por ciento, respectivamente. Estos hallazgos denotaron que al seguir los criterios de las referencias se deja de diagnosticar una hipercolesterolemia o una hipertrigliceridemia en el 68,88 y 9,68 por ciento respectivamente. Por las recomendacione de expertos se encontró que el orden de frecuencias de las dislipidemias fue: hipertrigliceridemia (42,42 por ciento), hipercolesterolemia (30,33 por ciento) e hiperlipemia combinada (27,25 por ciento). Al constatar la gravedad de las dos primeras se observó que la hipercolesterolemia era: leve (59,89 por ciento), moderada (31,59 por ciento) y grave (8,52 por ciento), mientras que la hipertrigliceridemia era moderada (51,67 por ciento) y grave (48,33 por ciento). Conclusiones: la interpretación correcta de los resultado del estudio lipídico es de gran importancia y representa un aporte social para el diagnóstico de una dislipidemia(AU)

Objective: to describe the importance of right interpretation of the total cholesterol and triglyceride content for the diagnosis of the dyslipidemias. Methods: evaluation of 2 159 results of study of lipid analyses made at the laboratory of biochemistry of the Institute of Angiology and Vascular Surgery from January 2008 to January 2009. The experts' recommendations and diagnosticians' references were used to decide whether the results were positive or not. Results: it was found that the cholesterol indexes were positive in 32 percent of the analyses according to the recommendations and in 9.96 percent according to the references. Similarly, triglycerides indexes were positive in 43.14 percent and 38.96 percent, respectively. These findings indicated that applying the criteria of the diagnosticians' references, hypercholesterolemia or hypertriglyceridemia was not duly diagnosed in 68.88 percent and 9.68 of analyses, respectively. According to the experts' recommendations, the order of frequency of dyslipidemias was hypertriglyceridaemia (42.42 percent), hypercholesterolemia (30.33 percent) and combined hyperlipidemia (27.25 percent). Considering the severity of the two first, it was observed that hypercholesterolemia was mild (59.89 percent), moderate (31.59 percent) and severe (8.52 percent) whereas hypertriglyceridemia was moderate (51.67 percent) and severe (48.33 percent). Conclusions: the correct interpretation of results of the lipid study is highly significant and represents a social contribution to diagnosis of dyslipidemia(AU)

Brazilian Portuguese version of the Patient Competency Rating Scale (PCRS-R-BR): semantic adaptation and validity / Versão em português brasileiro da Patient Competency Rating Scale (PCRS-R-BR): adaptação semântica e validade

This study describes the adaptation of a revised Brazilian version of the Patient Competency Rating Scale (PCRS-R-BR), which focuses on executive, mnemonic, and attention functions. Evidence of content-based and external validity is also reported. The cross-cultural adaptation was conducted in five phases: 1) translations and back translations; 2) item analysis by authors; 3) classification by experts; 4) revisions and reformulations by authors; 5) pilot study with a sample of patients with mild and moderate/severe traumatic brain injury (TBI). Data were analyzed descriptively, and the PCRS-R-BR scores of groups with mild vs. moderate/severe TBI were compared using the Mann-Whitney test. Patients and their relatives were divided into groups and compared using repeated-measures analysis. The results of the PCRS-R-BR questionnaire for relatives and discrepancy scores of patients with moderate/severe TBI revealed significantly more impairment than that found in the group of patients with mild TBI. There were significant differences between item and total scores of both groups of patients and relatives. Results indicated a high level of item content agreement between experts. This study found initial evidence of PCRS-R-BR content-based and external validity when the questionnaire was applied to patients with mild and moderate/severe TBI and their relatives.

O presente artigo teve como objetivo apresentar a adaptação transcultural e evidências de validade externa e de conteúdo da versão brasileira revisada da Patient Competency Rating Scale (PCRS-R-BR), com foco nas funções executivas, mnemônicas e atencionais. A adaptação transcultural incluiu cinco fases: 1) tradução e retrotradução; 2) análise de itens por autores; 3) análise de especialistas; 4) revisões e reformulações dos autores; 5) estudo piloto em pacientes com traumatismo cranioencefálico (TCE) leve e moderado/grave. Os dados foram analisados descritivamente e os pacientes com TCE leve e moderado/grave foram comparados nos escores da PCRS-R-BR pelo teste Mann-Whitney. Os pacientes e familiares foram comparados por grupo através da análise de medidas repetidas. Os pacientes com TCE moderado/grave tiveram maior prejuízo que os pacientes com TCE leve no formulário da PCRS-R-BR dos familiares e no escore de discrepância entre pacientes e familiares. Os resultados indicam bons e altos níveis de concordância entre especialistas frente aos componentes avaliados pelos itens. Esse estudo apresentou evidências iniciais de validade de conteúdo da PCRS-R-BR para pacientes com TCE leve e moderado/severo e seus familiares.

Aggravation of Hypertriglyceridemia and Acute Pancreatitis in a Bipolar Patient Treated with Quetiapine

Pancreatitis is a very rare adverse effect of quetiapine treatment, with only 5 cases of quetiapine-associated pancreatitis reported in the English literature to date. Herein, we report one patient who developed severe hypertriglyceridemia (>1000 mg/dL) after quetiapine administration, resulting in acute pancreatitis. An analysis of the underlying pathogenic mechanisms and a review of relevant literature are also presented. Clinicians should be aware of the potentially life-threatening metabolic disturbances and/or pancreatitis associated with quetiapine therapy.

Bezafibrato em lactente portador de lipodistrofia generalizada congênita e hipertrigliceridemia grave / Bezafibrate in an infant with congenital generalized lipodystrophy and severe hypertriglyceridemia

Lipodistrofia congênita generalizada (CGL) com hipertrigliceridemia extrema desde o primeiro ano de vida está associada a piores riscos metabólicos. Foram utilizados dados contidos no prontuário do paciente, bem como revisão bibliográfica para composição do texto. Relatamos o caso de um lactente com fenótipo típico e hipertrigliceridemia de 1.360 mg/dL, que foi tratado com bezafibrato na dose de 30 a 60 mg/dia dos 11 meses aos 5 anos e 6 meses de idade, aferindo um nadir de triglicérides de 55 mg/dL. Evolução clínico-laboratorial antes e após bezafibrato foi feita ao longo de cinco anos e seis meses. O fenótipo apresentado foi classificado clinicamente em CGL tipo 2. Apesar do controle eficiente da hipetrigliceridemia e da ausência de desenvolvimento de diabetes melito, o uso de bezafibrato não impediu o aparecimento de esteatose hepática durante a evolução. A terapia antilipemiante com fibrato se mostrou eficaz em manter níveis normais de triglicerídeos, colesterol e suas frações e não se associou a efeitos colaterais graves durante o período descrito.

Congenital generalized lipodystrophy (CGL) with severe hypertriglyceridemia in a children less than 1 year of age is associated with worse metabolic risk. We used data from patient records, as well as extensive literature research to write the manuscript. We report the case of an infant with typical phenotype of CGL and hypertriglyceridemia of 1,360 mg/dL who was treated with bezafibrate at a dose of 30 to 60 mg/day from age 11 months to 5.5 years old, with a measurement of nadir of triglycerides of 55 mg/dL. Clinical evolution and clinical laboratory tests before and after bezafibrate were carried out over 5 years and 6 months. Phenotype was classified as CGL type 2. Despite the efficient control of hypertriglyceridemia and absence of development of diabetes mellitus, the use of bezafibrate did not prevent the onset of hepatic steatosis during evolution. Hypolipidemic therapy with bezafibrate proved effective in maintaining the levels of triglycerides, cholesterol and its fractions at normal levels, and its use was not correlated with severe side effects during the described period.

Validation of a spectrophotometric method to determine ciprofibrate content in tablets / A validação de um método espectrofotométrico para determinar o conteúdo de ciprofibrato em comprimidos

Ciprofibrate is a drug indicated in cases of hypertriglyceridemia and mixed hyperlipidemia, but no monographs are available in official compendia for the analysis of this substance in tablets. The objective of this work was to develop and validate a spectrophotometric method for routine analysis of ciprofibrate in tablets. In this study, commercial and standard ciprofibrate were used, as well as placebo in absolute ethanol, analyzed by UV spectrophotometer. All tests followed the rules of Resolution RE-899, 2003. The results showed that the developed and validated method offers low cost, easy implementation, precision and accuracy, and may be included in the routine of quality control laboratories.

O ciprofibrato é um fármaco indicado em casos de hipertrigliceridemia e hiperlipidemia mista, mas não há monografias em compêndios oficiais para a análise desta substância em comprimidos. O objetivo deste trabalho é desenvolver e validar um método espectrofotométrico para análise de rotina de ciprofibrato em comprimidos. Neste estudo foram empregados ciprofibrato comercial, padrão e placebo em etanol absoluto, analisadas por espectrofotometria UV. Todos os testes seguiram as regras da Resolução RE- 899, 2003. Os resultados mostraram que o método desenvolvido e validado apresenta baixo custo, fácil implementação, precisão e exatidão e pode ser incluído em rotina de laboratórios de controle de qualidade.

Fenofibrate-induced rhabdomyolysis in a patient with chronic kidney disease: an unusual presenting feature of hypothyroidism / Rabdomiólise induzida por fenofibrato em paciente com doença renal crônica: uma apresentação clínica incomum do hipotireoidismo

Clinical and most often moderate skeletal muscle involvement is a frequent problem in adults with hypothyroidism, and includes a number of different manifestations. Severe involvement with rhabdomyolysis, however, is very rare, and only a few cases have been reported to date, most of them with an additional factor of muscle injury. We described a patient with stage 3 chronic kidney disease who presented with rhabdomyolysis while taking fenofibrate, and was found to have hypothyroidism. We also highlighted the importance of excluding the diagnosis of thyroid dysfunction before treatment with lipid-lowering agents.

Manifestações musculoesqueléticas variadas e de moderada intensidade são comuns em adultos com hipotireoidismo. No entanto, o envolvimento muscular grave, caracterizado por rabdomiólise, é incomum. Até o momento, poucos casos foram descritos na literatura, e a maior parte deles em associação com um fator adicional de dano muscular. Descrevemos um paciente com doença renal crônica (estádio 3) que se apresentou com rabdomiólise durante o tratamento com fenofibrato e cuja investigação adicional evidenciou hipotireoidismo primário. Enfatizamos, ainda, a importância da exclusão de disfunção tireoidiana antes de iniciar terapia com agentes hipolipemiantes.

[Possible hypoglycemic effect of aloe vera L. high molecular weight fractions on type 2 diabetic patients]

Aloe vera L. high molecular weight fractions [AHM] containing less than 10 ppm of barbaloin and polysaccharide [MW: 1.000KD] with glycoprotein, verectin [MW 29KD], were prepared by patented hyper-dry system in combination of freeze-dry technique with micro wave and far infrared radiation. AHM produced significant decrease in blood glucose level sustained for 6 weeks of the start of the study. Significant decrease in triglycerides was only observed 4 weeks after treatment and continued thereafter. No deterious effects on kidney and liver functions were apparent. Treatment of diabetic patients with AHM may relief vascular complications probably via activation of immunosystem

Xantomas eruptivos: A propósito de dos casos familiares / Eruptive xanthomas: Two familial clinical cases

Se presentan dos pacientes de sexo masculino, familiares de primer grado, tabaquistas y etilistas severos, sin antecedentes patológicos conocidos. Ambos presentan en forma eruptiva la aparición de xantomas y uno de ellos una pancreatitis necrohemorrágica atribuida a su hipertrigliceridemia, complicación muy grave de este trastorno. Si bien los xantomas eruptivos no son muy frecuentes de observar, deben hacernos sospechar en una dislipidemia severa, confirmándola con una examen de laboratorio que pondrá de manifiesto una elevación significativa de los triglicéridos y frecuentemente alteración de los niveles de glucosa en sangre. Además, el estudio histopatológico de las lesiones mostrará macrófagos cargados de lípidos, de aspecto espumoso e infiltrado polimorfonuclear y mononuclear en dermis.

We report a case of two male patients, first-grade relatives, who are heavy drinkers and smokers but apparently have no pathological records. Both show eruptive xanthomas and one of them presents acute necrotic and hemorrhagic pancreatitis due to hypertriglyceridemia, a serious complication of this disorder. Despite the fact that eruptive xanthomas are not frequently observed, they should make us suspect an instance of severe dyslipidemia. In order to verify it, a laboratory test will show a dramatic raise of serum triglyceride levels and usual changes in the blood glucose levels. Moreover, a histopathologic study of the lesion will reveal macrophages full of lipids (foam cells) with polymorphonuclear and mononuclear infiltrate.

Patrones de prescripción de antilipémicos en un grupo de pacientes colombianos / Prescription patterns for antilipidemic drugs in a group of Colombian patients

OBJETIVOS: Determinar los patrones de prescripción de medicamentos antilipémicos en un grupo de afiliados al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Estudio descriptivo observacional con 41 580 dislipidémicos de ambos sexos, mayores de 20 años, con tratamiento, al menos, de abril a junio de 2006 y residentes en 19 ciudades colombianas. Se diseñó una base de datos de registros sobre consumo de medicamentos, capturados por la empresa que distribuye los fármacos a los pacientes. RESULTADOS: Edad promedio de 58,4 ± 13,5 años; 58,9 por ciento de los participantes son mujeres. Del total de pacientes, 95,6 por ciento recibían monoterapia y 4,4 por ciento dos o más antilipémicos. El orden de prescripción de los medicamentos fue: estatinas (70,9 por ciento), fibratos (27,5 por ciento), resinas fijadoras de colesterol (0,9 por ciento) y otros (0,7 por ciento), todos a dosis bajas. Las combinaciones más empleadas fueron lovastatina + gemfibrozilo (n = 1 568), colestiramina + gemfibrozilo (n = 92), coles tiramina + lovastatina (n = 78). La comedicación más prescrita fue: antihipertensivos (60,9 por ciento), antiinflamatorios (56,5 por ciento), antiulcerosos (22,9 por ciento), antidiabéticos (20,6 por ciento), ASA (3,8 por ciento). Existe subempleo de antianginosos y ASA y sobreempleo de antiinflamatorios y antiulcerosos. CONCLUSIONES: La dislipidemia es un factor de riesgo primario para desarrollar enfermedad coronaria y accidentes cerebrovasculares, causas frecuentes de morbilidad y mortalidad en Colombia y el mundo. Todos los antilipémicos se emplean en dosis menores a las recomendadas. Se plantea la necesidad de diseñar estrategias educativas para corregir algunos hábitos de prescripción y explorar resultados clínicos de formulaciones estudiadas.

OBJECTIVES: To determine patterns in antilipidemic drug prescriptions among a group of patients covered by the General Social Security System (Sistema General de Seguridad Social) in Colombia. METHODS: A descriptive, observational study was conducted of 41 580 hyperlipidemics of both sexes, who were over 20 years of age, undergoing treatment from at least April to June 2006, and were residents of one of 19 cities in Colombia. A database was created to track prescription data collected by the pharmaceutical company that dispenses medications to the patients. RESULTS: The mean age was 58.4 ± 13.5 years; 58.9 percent of the participants were women. Of the total number of patients, 95.6 percent were receiving monotherapy, while 4.4 percent were receiving two or more antilipidemics. Prescriptions were ranked as follows: statins (70.9 percent), fibrates (27.5 percent), bile acid sequestrant resins (0.9 percent), and others (0.7 percent), all at low dosage levels. The most common therapy combinations were lovastatin + gemfibrozil (n = 1 568), cholestyramine + gemfibrozil (n = 92), and cholestyramine + lovastatin (n = 78). Comedications most frequently prescribed were: antihypertensive (60.9 percent), antiinflammatory (56.5 percent), antiulcer (22.9 percent), and antidiabetes drugs (20.6 percent), and acetylsalicylic acid (ASA, 3.8 percent). Antianginals and ASA were being underused, while antiinflamatories and antiulcer drugs were being overused. CONCLUSIONS: Dyslipidemia is a primary risk factor for developing coronary heart disease and stroke, frequent causes of morbidity and mortality in Colombia and the world. All of the antilipidemics are being used at lower-than-recommended dosage levels. Clearly there is a need for creating educational strategies to address these prescribing habits and for exploring clinical results of the pharmaceuticals studied.

[Effects of combination of vitamin E and nicotinic acid on serum lipids and apoproteins of hypertriglyceridemic hemodialyzed patients]

Oxidative stress and lipid abnormalities are two major risk factors for development of atherosclerosis among hemodialyzed patients. Administrating of Lipidnormalising agents, solely or in combination together, can not correct all lipid abnormalities in hemodialyzed patients. The present study, therefore, was desinged to evaluate the effects of combination therapy of vitamin E and tolerable doses of nicotinic acid on serum lipids and apoproteins in hypertriglyceridemic hemodialyzed patients. The study was a double-blind randomized clinical trial. Thirty-nine hemodialyzed patients with fasting triglyceride range between 230 and 500 mg/dl were randomly assigned into three groups, receiving combination of vitamin E [600mg/d] and nicotinic acid [500mg/d], nicotinic acid alone [500mg/d], and placebo, respectively. All patients received their supplements for 13 weeks. The blood samples were collected after a 12 to 14-hour duration of fasting at the beginning of the study, followed by other samplings performed at the end of sixth and thirteenth weeks, respectively, and serum lipids and apoproteins were measured. accordingly. During the study, the mean serum triglyceride level was significantly reduced in the group receiving combination therapy of vitamin E and nicotinic acid, compared to the placebo group. Compared to that of placebo group, mean serum HDL-C levels were significantly increased two groups of combination therapy, and nicotinic acid alone, although LDL-C/HDL-C ratios were significantly decreased. There was no significant difference in the means of total cholesterol of serum, LDL-C, apoAI, apoB100 and Lp[a] between three groups. It is concluded that combination therapy of vitamin E and nicotinic acid in hypertriglyceridemic hemodialyzed patients can result in improvement in almost every lipid abnormalities, but except high levels of Lp[a]

Acute hypoglycemic, hypocholesterolemic and hypotriglyceridemic effects of continuous intravenous infusion of a lyophilised aqueous extract of Ajuga iva l. Schreber whole plant in streptozotocin-induced diabetic rats

The hypoglycemic and hypolipidemic effect of continuous intravenous infusion of a lyophilised aqueous extract of the whole plant Ajuga iva [L.] Schreber [Labiatae] [Al-extract] was investigated in anesthetized normal and streptozotocin [STZ]-induced diabetic rats. The Al-extract was administered to a group of rats by continuous intravenous infusion for 4 h at a dose of 4.2 microg/min/l00g body weight; another group was infused with taurine, the reference compound, at the same dose. In normal rats, Al-extract infusion had no effect on plasma glucose or triglycerides, but plasma cholesterol levels were significantly decreased [22%; P<0.05]. However, taurine infusion produced significant hypoglycemic, hypocholesterolemic and hypotriglyceridemic effects [all changes, P<0.05]. In STZ-diabetic rats, Al-extract infusion reduced plasma levels of glucose by 24% [P<0.05], cholesterol by 35% [P<0.01] and triglycerides by 13% [P<0.05]. Infusion with taurine produced a greater fall in plasma glucose [72%, P<0.01], cholesterol [54%; P < 0.001] and triglyceride [24%; P < 0.001] levels. Our results indicate that intravenously administered Al-extract exerts hypoglycemic and hypolipidemic effects in diabetic rats by mechanism [s] which appear to be similar to that of taurine, which involve insulin sensitization or an insulin-like effect. The identity and the exact mechanism [s] of action of the active component [s] of the Al-extract are not known. Ajuga iva appears to be a useful plant in the therapy of diabetes, a condition in which hyperglycemia and dyslipidemia coexist quite often

Bezafibrate for the treatment of hypertriglyceridemia in HIV1-infected patients on highly active antiretroviral therapy

The use of highly active antiretroviral therapy (HAART) in HIV-infected patients has been associated with the development of risk factors for cardiovascular diseases (CD) including dyslipidemia and insulin resistance, hypertriglyceridemia being the most frequent metabolic disturbance in these patients. Fibrates are indicated when hypertriglyceridemia is accentuated and persists for over six months. We evaluated the efficacy and safety of bezafibrate for the treatment of hypertriglyceridemia in HIV-infected individuals on HAART. All patients received 400mg/day of bezafibrate and were evaluated three times: Mo (pre-treatment), M1 (one month after treatment), and M2 (six months after treatment). Fifteen adult individuals, eight males and seven females with mean age = 41.2 ± 7.97 years and triglyceride serum levels > 400mg/dL were included in the study. Smoking, alcohol ingestion and sedentarism rates were 50 percent, 6.66 percent and 60 percent, respectively. Family history of CD, hypertension and diabetes mellitus was reported in 33.3 percent, 40 percent and 46.7 percent of the cases, respectively, while dyslipidemia was reported by only 13.3 percent. More than half of the patients were using a protease inhibitor plus a nucleotide analog transcriptase inhibitor. Eutrophy and tendency toward overweight were observed at all three study time points. There were significant reductions in triglyceride serum levels from Mo to M1 and from Mo to M2. No significant changes were observed in the serum levels of creatine phosphokinase, hepatic enzymes, CD4+, CD8+ and viral load. Therefore, bezafibrate seems to be safe and effective for the reduction of hypertriglyceridemia in HIV-infected patients on HAART.

Associação de medicamentos: estatinas e fibratos / Combination of drugs: statins and fibrates

Monoterapia para o tratamento das dislipidemias é frequentemente insuficiente para o alcance das metas recomendadas pelas diretrizes. Entretanto, nos últimos anos, o uso de terapia combinada tem se apresentado como uma nova opção em muitos casos. Uma revisão de 36 estudos envolvendo a combinação de estatinas com fibratos apresentou 29 casos de rabdomiólise e uma prevalência geral de miopatia de 0,12 por cento. A combinação de estatinas com o genfibrozil parece causar mais rabdomiólise que com os fibratos de nova geração (especialmente quando comparado com fenofibrato ou bezafibrato). Idade avançada, diabetes, mulheres, medicações concomitantes, disfunção renal, consumo excessivo de álcool, exercícios, traumatismos e cirurgias estão também associados com maior risco de efeitos adversos.

Long-term treatment of N-3 PUFAS on plasma lipoprotein levels and fatty acid composition of total serum and erythrocyte lipids in hypertriglyceridemic patients.

The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have high consumption of fish and seafood has called the attention in the role of eicosapentaenoic (EPA = 20:5n-3) and docosahexaenoic (DHA = 22: 6n-3) acids, the major n-3 polyunsaturated fatty acids (PUFAs) in fish oils, in reducing cardiovascular risk. N-3 PUFAs may reduce serum lipids by promoting fatty acid oxidation and decrease VLDL producing from the liver, depress tissue arachidonate synthesis and alter the composition and tissue PUFAs. Plasma lipoprotein and fatty acid composition of total serum and erythrocyte lipids in 9 hypertriglyceridemic patients consisting of 4 males and 5 females aged 39-72 yr who attended the Nutrition Clinic, Ramathibodi Hospital were investigated. The study period consisted of 4 wks of dietary advice only followed by 48 wks of dietary advice with a daily intake of 6 g of fish oil capsules (FOC). Six grams of FOC provided 1080 mg of 2:5n-3 and 720 mg of 22:6n-3. Their plasma triglyceride (TG) levels at wk 0, 12, 24, 36, 48 were 356.7, 230.1, 209.7, 192.9, 22 7.4 mg/dL and M-particle (equivalent to very low density lipoprotein, VLDL) were 484.4, 354.8, 383.1, 349.7, 453.2 mg/dL respectively that decreased significantly, whereas their plasma low density lipoprotein cholesterol (LDL-C) levels at the same periods were 139.4, 164.9, 171.0, 157.1, 158.3 mg/dL that increased significantly. Serum and erythrocyte 20:5n-3 and 22:6n-3 in these subjects were significantly higher than those at wk 0 throughout the study. These findings indicate the bioavailability of 20: 5n-3 and 22:6n-3 in TG lowering effect of FOC. Fatty acids from fish oil have a remarkable effect on the synthesis and clearance of TG-rich lipoproteins, especially VLDL and chylomicrons. Though daily treatment with 6 g of FOC has a striking effect in increasing plasma LDL-C levels.