Relación de riesgo entre dislipidemia y COVID-19 / Risk relationship between dyslipemia and COVID-19

La presencia de dislipidemia en pacientes con la COVID-19 parece agravar el curso clínico de la enfermedad. En esta revisión bibliográfica se describen los principales mecanismos que las vinculan y sus implicaciones en el tratamiento de los pacientes afectados. Para realizar este trabajo se efectuó una búsqueda bibliográfica en bases de datos, tales como Google académico, SciELO, Annual Reviews y PMC. Los descriptores analizados fueron COVID-19, SARS-CoV-2, dislipidemia, LDL-colesterol, HDL-colesterol, triglicéridos, hipercolesterolemia y lipoproteínas VLDL. Se revisaron preferentemente artículos de revistas arbitradas por pares y disponibles a texto completo, publicados en inglés y español. A pesar de las controversias, la dislipidemia es un factor de riesgo de pronóstico desfavorable en afectados con la COVID-19 y el tratamiento para los pacientes con esa condición desfavorable mejora dicho pronóstico.

The presence of dyslipemia in patients with COVID-19 seems to increase the clinical course of the disease. In this literature review the main mechanisms that link them and their implications in the treatment of the affected patients are described. To carry out this work a literature search was made in databases, such as academic Google, SciELO, Annual Reviews and PMC. The analyzed describers were COVID-19, SARS-CoV-2, dyslipemia, LDL-cholesterol, HDL-cholesterol, triglycerides, hypercholesterolemia and VLDL lipoproteins. Articles of magazines arbitrated by pairs and available to complete text, published in English and Spanish were preferably revised. In spite of the controversies, dyslipemia is a risk factor of unfavorable prognosis in patients affected with COVID-19 and the treatment for the patients with that unfavourable condition improve this prognosis.

Alteration in Serum Lipid Profile Pattern in Oral Squamous Cell Carcinoma and Potentially Malignant Disorders

ABSTRACT Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients. Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively. Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

Cardioprotective effect of lipstatin derivative orlistat on normotensive rats submitted to cardiac ischemia and reperfusion

Abstract Purpose: To evaluate in vivo animal model of cardiac ischemia/reperfusion the cardioprotective activity of pancreatic lipase inhibitor of the orlistat. Methods: Adult male Wistar rats were anesthetized, placed on mechanical ventilation and underwent surgery to induce cardiac I/R by obstructing left descending coronary artery followed by reperfusion to evaluation of ventricular arrhythmias (VA), atrioventricular block (AVB) and lethality (LET) with pancreatic lipase inhibitor orlistat (ORL). At the end of reperfusion, blood samples were collected for determination of triglycerides (TG), very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB (CK-MB). Results: Treatment with ORL has been able to decrease the incidence of VA, AVB and LET. Besides that, treatment with ORL reduced serum concentrations of CK and LDL, but did not alter the levels of serum concentration of TG, VLDL and HDL. Conclusion: The reduction of ventricular arrhythmias, atrioventricular block, and lethality and serum levels of creatine kinase produced by treatment with orlistat in animal model of cardiac isquemia/reperfusion injury suggest that ORL could be used as an efficient cardioprotective therapeutic strategy to attenuate myocardial damage related to acute myocardial infarction.

Comparative effects of metformin and pioglitazone on lipid profile of rabbits

This is the initial part of study in which the effects of two oral hypoglycemic drugs metformin and pioglitazone were studied on lipid profile of rabbits. White rabbits of both sexes were equally divided in to three groups each comprising of seven animals. Control group was given distilled water 2m1/kg, animals of group II were given metformin in the dose of 22mg/kg and animals of group III received pioglitazone in the dose of 0.5mg/kg. Serum concentration of cholesterol, very low-density lipoprotein [VLDL], triglycerides [TGs], low density lipoprotein [LDL] and high density lipoprotein [HDL] were measured after 8 week of oral dosing. Results shows that after 8 weeks animals received metformin did not reveal any significant change in lipid profile, but animals received pioglitazone showed significant [P<0.05] decrease in lipid profile, the decrease in cholesterol, LDL, VLDL and triglycerides is favorable however decrease in HDL is troublesome and warrant further investigations

Senile cataract; serum lipids a modifiable risk factor

To estimate the serum lipid profile of patients having different types of senile cataract and compare them with that of the controls. Observational case control study. Tertiary care centre in the city of Lahore, Pakistan. Six months. We selected fifty patients with senile cataract and fifty control individuals from tertiary care hospital of Lahore. History, ophthalmic and systemic examinations were done. Fasting serum samples were taken for estimation of lipid profile from all the subjects. In the patient group, female to male ratio was 1.63:1. 78% patients had Nuclear cataract, 16% had cortical and 6% had posterior sub capsular type of senile cataract. Serum Triglycerides, Cholesterol, LDL, HDL and VLDL of patients were compared with controls. The p-value of cholesterol, LDL and HDL was non-significant. The p-value of triglycerides and VLDL was significant. Serum Triglycerides and VLDL are modifiable risk factors in the development of senile cataract in Pakistani patients. Serum Triglycerides is the only lipid, which has shown consistent results related to cataract development in different parts of the world. Other lipids show variable results in different countries

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.

Comparison of fasting blood sugar and serum lipid profile changes after treatment with atypical antipsychotics olanzapine and risperidone

<p><b>INTRODUCTION</b>This study aimed to compare the effects of the two most commonly prescribed atypical antipsychotics, olanzapine and risperidone, on fasting blood sugar and serum lipid profile of the recipients.</p><p><b>METHODS</b>A randomised, comparative, open clinical study was conducted on 60 schizophrenic patients. The patients were divided into two groups, one receiving olanzapine and the other receiving risperidone. The patients were assessed for changes in fasting blood sugar and serum lipid profile (triglycerides [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], very-low-density lipoprotein [VLDL] and total cholesterol) eight weeks after starting treatment. The number of patients positive for fasting blood sugar and lipid profile criteria of metabolic syndrome was calculated by applying the modified National Cholesterol Education Programme Adult Treatment Panel III guidelines (NCEP ATP III) criteria at eight weeks.</p><p><b>RESULTS</b>Patients treated with olanzapine showed a highly significant increase in the observed parameters, whereas those treated with risperidone showed a significant increase in fasting blood sugar, HDL and LDL levels, and a highly significant increase in other parameters. Intergroup comparison was insignificant except for TG, VLDL and total cholesterol levels. More men as compared to women fulfilled the NCEP ATP III criteria for metabolic syndrome in both groups.</p><p><b>CONCLUSION</b>Olanzapine has a higher propensity to cause derangement of some parameters of lipid profile than risperidone. These parameters include TG, VLDL and total cholesterol levels.</p>

High-density lipoprotein prevents SAA-induced production of TNF-α in THP-1 monocytic cells and peripheral blood mononuclear cells

In this study, we evaluated whether human serum and lipoproteins, especially high-density lipoprotein (HDL), affected serum amyloid A (SAA)-induced cytokine release. We verified the effects of SAA on THP-1 cells in serum-free medium compared to medium containing human serum or lipoprotein-deficient serum. SAA-induced tumour necrosis factor-alpha (TNF-α) production was higher in the medium containing lipoprotein-deficient serum than in the medium containing normal human serum. The addition of HDL inhibited the SAA-induced TNF-α release in a dose-dependent manner. This inhibitory effect was specific for HDL and was not affected by low-density lipoprotein or very low-density lipoprotein. In human peripheral blood mononuclear cells, the inhibitory effect of HDL on TNF-α production induced by SAA was less pronounced. However, this effect was significant when HDL was added to lipoprotein-deficient medium. In addition, a similar inhibitory effect was observed for interleukin-1 beta release. These findings confirm the important role of HDL and support our previous hypothesis that HDL inhibits the effects of SAA during SAA transport in the bloodstream. Moreover, the HDL-induced reduction in the proinflammatory activity of SAA emphasizes the involvement of SAA in diseases, such as atherosclerosis, that are characterized by low levels of HDL.

Effects of kale (Brassica oleracea L. var. acephala DC) leaves extracts on the susceptibility of very low and low density lipoproteins to oxidation.

Of Brassicaceous plants, kale (Brassica oleraceae L. var. acephala DC) contains polyphenols, flavonoids, isoflavones and glucosinolates and so has antioxidant and anticarcinogenic properties. Antioxidants inhibit negative effects of free radicals and may, therefore, protect tissues against oxidative damage. Oxidation of lipoproteins is a key event in the development of atherosclerosis. In the current study, the levels of total phenolic and flavonoid contents and total antioxidant capacity of methanolic and aqueous extracts of kale leaves were determined. In addition, the susceptibility of isolated lipoproteins — very low density lipoprotein (VLDL) and low density lipoprotein (LDL) to the Cu2+-induced oxidation with various concentrations of metanolic and aqueous extracts was evaluated as t-lag values. Although aqueous extract had higher total antioxidant capacity, methanolic extract had higher total phenolic and flavonoid content (P<0.05). On the other hand, both extracts inhibited lipid peroxidation in both isolated VLDL and LDL. Inhibitory effect of extracts or increasing t-lag values, mainly in methanolic extract was found to be related to increasing the concentration of extracts. It was concluded that because of high antioxidant capacity and phenolic content, kale showed a protective effect on the oxidation of lipoproteins. Therefore, it may be speculated that kale consumption may play an important protective role in the cardiovascular and other related diseases resulting from imbalance of oxidant and antioxidant status.

Prevention of high fructose-induced metabolic syndrome in male wistar rats by aqueous extract of Tamarindus indica seed

Tamarindus indica is used as a traditional treatment for diabetes. To elucidate whether Tamarindus indica seed aqueous extract [TSE] ameliorates metabolic syndrome in hyperinsulinemic rats, we evaluated serum insulin, dehydroepiandrosterone sulfate [DHEAS], triglyceride [TG], total cholesterol [TC], very low density lipoprotein [VLDL], low density lipoprotein [LDL], high density lipoprotein [HDL], and glucose levels in fructose-fed rats. Animals were divided into three groups; control [C] receiving tap water, fructose-fed [F] and TSE-treated fructose-fed rats [F-T] both receiving tap water supplemented with 10% [w/v] fructose. Water was prepared every day for a period of 8 weeks for all three groups. F-T rats were fed with TSE via gavage feeding at the dose of 20 mg/0.5 ml distilled water/100 g body weight per day. Fasting serum glucose levels of three groups were comparable. TSE treatment prevented the increase in fasting serum insulin, TG, TC, VLDL, and LDL in the F-T group [P<0.01] when comparing with the F group. Fructose feeding led to a decrease in fasting serum DHEAS, and HDL levels in the F group [P<0.01] compared with the control. TSE treatment prevented the decrease in fasting serum DHEAS, and HDL levels in the F-T group [P<0.01] while these results were not seen in control rats. It is indicated that the hyperinsulinemia in fructose-fed insulin resistant rats are associated with low levels of DHEAS, and HDL; and high levels of TC, VLDL, LDL, and TG. TSE supplementation probably ameliorates metabolic syndrome due to the improved insulin action

Hyperlipidemia in hepatic MED1 deficient mice in response to fasting / 生物工程学报

MED1 is a key transcription co-activator subunit of the Mediator complex that is essential for RNA polymerase II-dependent transcription. MED1 functions as a co-activator for PPARs and other nuclear receptors and transcription factors, and plays an important role in lipid metabolism. To examine how MED1 might affect plasma lipids, plasma triglyceride, cholesterol levels, and lipoprotein profiles, were measured in MED1(deltaLiv) mice fasted for 24, 48 and 72 hours. Histological changes in liver sections from MED1(deltaLiv) mice after 72 hours of fasting were also examined using H&E staining. There was no fat accumulation in livers of MED1(deltaLiv) mice compared to MED1(fl/fl) and PPARalpha -/- control mice after 72 hours of fasting. Compared with MEDl(fl/fl) mice, plasma triglycerides in MED1(deltaLiv) mice were significantly increased after 24, 48 and 72 hours of fasting, and plasma cholesterol was significantly increased after 48 and 72 hours of fasting. Lipoprotein profiles were similar in fed MED1(fl/fl) and MED1(deltaLiv) mice. However, very low density lipoprotein (VLDL) was significantly increased in MED1(deltaLiv) mice after 24 hours of fasting. We conclude that, hyperlipidemia in MED1(deltaLiv) mice in response to fasting is due to the accumulation of VLDL, which suggests that MED1 plays a pivotal role in the regulation of plasma triglyceride and cholesterol levels.

Proliferation of renal mesangial cells induced by very low density lipoprotein is mediated by p42/44 mitogen activated protein kinase / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The plasma concentration of very low density lipoprotein (VLDL) is negatively correlated to renal function in glomerular diseases. Effects of VLDL on renal function have been partially attributed to the proliferation of mesangial cells. This study examined the potential role of the p42/44 mitogen activated protein kinase (MAPK) in mesangial cell proliferation induced by VLDL.</p><p><b>METHODS</b>Mesangial cells were treated with VLDL at different concentrations or for different time. The cell cycle of the mesangial cells was analyzed by XTT assay and flow-cytometry; MAPK activity was also assayed. In some experiments, cells were treated with VLDL together with or without 0.1 µmol/L PD 98059.</p><p><b>RESULTS</b>Ten to 500 µg/ml VLDL stimulated the proliferation of mesangial cells cultured in vitro in a concentration-dependent manner. The effect was associated with an increase in p42/44 MAPK activity. Increased proliferation of mesangial cells by VLDL was significantly attenuated by PD98059, a specific p42/44 MAPK inhibitor.</p><p><b>CONCLUSION</b>These results indicate that the p42/44 MAPK pathway is an important regulator of mesangial cell proliferation and of renal functions.</p>

Plasma endothelin-1, homocysteine, and nitric oxide levels in a multiethnic hypertensive cohort from the United Arab Emirates

Hypertension is a major cause of morbidity and mortality in the United Arab Emirates [UAE]. However, little is known regarding vasoactive biomarkers and lipid profiles in hypertensives versus normotensives in this heterogeneous ethnic population. This study aimed to evaluate plasma endothelin-1 [ET-1], homocysteine [Hcy], nitric oxide [NO], and lipid parameters among hypertensive subjects and normotensives controls in a heterogeneous ethnic population from the UAE. We collected venous samples from 164 hypertensive and 112 normotensive subjects matched for age, gender and ethnicity to determine their plasma levels of ET-1, Hcy and NO as well as their lipid profile. Hypertensive subjects displayed significantly higher plasma levels of ET-1 [p < 0.001] and NO [p < 0.001] but lower insulin levels [P<0.006] than normotensives. In contrast, there was no statistically significant difference with regard to Hcy concentrations. Very low-density lipoprotein [VLDL] and triglycerides [TG] levels were significantly [p < 0.01] higher in hypertensives than controls. Total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and non-esterified fatty acids [NEFA] were significantly lower [p < 0.01] in hypertensives than normotensives. In our heterogeneous ethnic population, levels of ET-1 and NO, but not of Hcy, were found to be associated with hypertension and may possibly contribute to an increased systemic vascular resistance among hypertensives. Whether the elevated ET-1 results are because of overproduction or decreased clearance remains to be ascertained Elevated levels of TG and VLDL, alongside with unaltered TC levels, seem to indicate the presence of type IV hypertriglyceridaemia

Effects of very low-density lipoprotein on cellular lipid accumulation and the expression of monocyte chemoattractant protein-1 in human mesangial cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effects of very low-density lipoprotein (VLDL) on cellular lipid accumulation and the expression of monocyte chemoattractant protein-1 (MCP-1) in human mesangial cells.</p><p><b>METHODS</b>An established stable human mesangial cell line (HMCL) was used in all experiments. VLDL-induced cellular lipid deposition was visualized by Oil Red O staining and analyzed quantitatively by standard enzymatic procedures. MCP-1 mRNA and protein expression levels in treated HMCLs were determined by real-time quantitative RT-PCR and enzyme-linked immunosorbent assay, respectively. For adhesion study, HMCLs were treated with VLDL for 12 hours, followed by a one-hour incubation with THP-1 cells.</p><p><b>RESULTS</b>VLDL induced cellular lipid accumulation in HMCLs in a time- (0-24 h) and dose- (0-200 microg/ml) dependent manner, and the principal component of accumulated lipid is triglyceride. In HMCLs, MCP-1 mRNA expression was promoted by VLDL in a time- (0-6 h) and dose- (0-100 microg/ml) dependent manner, and VLDL also enhanced MCP-1 secretion in a dose-dependent manner. Such an effect was accompanied by increased adhesion of monocytes to HMCLs.</p><p><b>CONCLUSIONS</b>VLDL can induce cellular triglyceride accumulation and upregulate the expression of MCP-1 in human mesangial cells. Hence, VLDL may be involved in the pathogenesis of lipid-mediated renal injury.</p>

Female pattern alopecia and lipoproteins

The meaningful association of androgenetic alopecia and coronary heart disease had been well documented, but few studies had been focused on the importance of lipid parameters in patients with androgenetic alopecia. To investigate the lipid profile and its relation to female pattern alopecia. This is a case controlled study conducted at the Department of Dermatology and Venereology-Baghdad Teaching Hospital, between January 2001 and April 2002. Sixty female patients with androgenetic alopecia were enrolled in this work. From each patient a detailed history and full clinical examination were performed regarding all demographic points relative to the disease, grading of alopecia and measurement of serum lipoproteins was done. Female pattern alopecia was classified according to Sharquei's classification Sixty age and weight matched females with normal hair status were considered as a control group. Measurement of serum lipoproteins also performed for them. Sixty patients, their ages ranged between 20-60 years with mean +/- SD of 30.3 +/- 9.4 years. Twenty [33.3%] patients were having grade I, 20 [33.3%] patients grade II and another 20 [33.3%] patients grade III. The mean levels of total serum cholesterol, triglycerides, low density lipoprotein and very low density lipoprotein in all patients and those with grade II and III separately were significantly higher when compared to the control group. On the other hand, the mean levels of high density lipoprotein in all patients and those with grade I and III separately were lower in comparison to the control. The atherogenic index or risk ratio was found to be significantly high in patients with female pattern alopecia and this goes parallel with the severity of baldness

Comparison of propofol and remifentanil administration on lipid profile

This study aimed to investigate the serum level of triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, and very low density lipoprotein during administration of propofol and comparing it with infusion of remifentanil in patients undergoing sedation in ICU of Masih Daneshvari Hospital during 2005-2007. All patients with pulmonary disease, undergoing intubation and mechanical ventilation were enrolled in our study. The patients were randomly divided into two groups, first receiving propofol and second receiving remifentanil as the sedative agent. Lipid profile [triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, and very low density lipoprotein] was checked before, immediately after, and the day after drug administration. A total of 40 patients were enrolled in this study, 20 of which took propofol and the remaining took remifentanil. The mean age of the patients was 58.67 +/- 18.57 yrs. Triglyceride and very low density lipoprotein[VLDL] were the two factors with statistically significant rise after infusion of propofol [p < 0.002]. Such a change was not detected in the remifentanil group. The other understudy factors did not show similar changes. Propofol infusion can induce dramatic rises in triglyceride and VLDL concentration even after low dose infusions and therefore special attention must be paid to patients prone to hyper-triglyceridemia and pancreatitis