ABSTRACT
OBJECTIVE: We studied the effect of pioglitazone on insulin levels, inflammation markers, high-density lipoprotein (HDL) composition and subclasses distribution, in young women with uncomplicated systemic lupus erythematosus (SLE). METHODS: This double-blind trial included 30 premenopausal women (30 ±8 years old) with SLE, who were randomized to pioglitazone (30 mg/day) or placebo treatment for 3 months. Plasma and HDL lipids were determined by colorimetric enzymatic assays, insulin by radioimmunometric assay, inflammation by immunonephelometry and HDL size and subclasses distribution by a native 4-30% polyacrylamide gradient gel electrophoresis. RESULTS: Compared with placebo, pioglitazone significantly increased HDL-cholesterol plasma levels (14.2%), reduced fasting insulin plasma levels (23.6%) and the homeostasis model assessment-insulin resistance (31.7%). C-reactive protein (70.9%) and serum amyloid A (34.9%) were also significantly reduced with the pioglitazone use, whereas the HDL particle size was increased (8.80 nm vs. 8.95 nm; p = 0.044) by changes in the distribution of HDL(2b), HDL(3b), and HDL(3c) subclasses. The change in HDL size correlated with a rise in free and cholesterol-ester content in the HDL particles. CONCLUSION: Pioglitazone significantly enhanced insulin sensitivity, reduced inflammation, and modified HDL characteristics, suggesting a potential beneficial effect of this drug in patients with SLE with a risk to develop cardiovascular disease. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov Protocol Registration System, with the number NCT01322308.
Subject(s)
Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Hypoglycemic Agents/therapeutic use , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Thiazolidinediones/therapeutic use , Adult , Double-Blind Method , Female , Humans , Pioglitazone , Placebos/therapeutic use , Prospective Studies , Young AdultABSTRACT
UNLABELLED: Primary and secondary prevention trials have demonstrated that niacin improves the lipid profile and reduces coronary morbidity and mortality. OBJECTIVE: To investigate the safety and efficacy of niacin in daily doses of 1.5 and 3.0 g in patients with ischemic heart disease and dyslipidemia. PATIENTS AND METHODS: Sixty one male and female patients, aged 30 to 70 years were included. Thirty two patients were later excluded; 18 for adverse events and 14 for causes not related to niacin. RESULTS: In the 29 patients that finished the study, niacin in a dose-dependent manner, significantly reduced the levels of total cholesterol, LDL-cholesterol, triglycerides, apoB and LDL-C/HDL-C ratio, and significantly increased HDL-Cholesterol concentrations; a decrease in lipoprotein(a) was observed with both dosages, but the change was significant only with the 3.0 g/day. In 11 patients (38%) lipids and lipoproteins reached ideal concentrations. In 15 patients (52%) C-LDL/C-HDL was lower than or equal to 3.5 at the end of the study. CONCLUSIONS: Our results suggest that niacin is well tolerated by 62% of the patients. Niacin is a safe, effective and a low cost alternative in the treatment of patients with ischemic heart disease and dyslipidemia.
Subject(s)
Coronary Disease/drug therapy , Hyperlipidemias/drug therapy , Hypolipidemic Agents/therapeutic use , Niacin/therapeutic use , Adult , Aged , Analysis of Variance , Dosage Forms , Female , Humans , Hypolipidemic Agents/adverse effects , Middle Aged , Niacin/adverse effectsABSTRACT
The purpose of this study was to investigate the effects of long-term high level physical exertion on plasma lipids and lipoproteins. Ninety-one young athletes, 70 men and 21 women, who practiced sports such as running, swimming, rowing, boxing and soccer, were studied. The control group included 101 healthy subjects, 77 men and 24 women, with sedentary life style. The mean plasma levels of total cholesterol (TC) (p = 0.04), low-density lipoprotein cholesterol (LDL-C) (p = 0.04) and the atherogenic index (p = 0.01) were lower, and high-density lipoprotein cholesterol (HDL-C) (p < 0.005) significantly higher in male athletes than in controls. Mean plasma lipids and lipoproteins concentrations were not significantly different in sportswomen when compared with their controls. The prevalence of hypercholesterolemia, hypertriglyceridemia and low HDL-C levels, were lower in male and female athletes of the five sport disciplines than in sedentary controls; however, only hypercholesterolemia (p < 0.05) and the atherogenic index (p < 0.01) were statistically different. These results, consistent with data previously published, show that low plasma levels of TG and high levels of HDL-C characterizes the athletes who practice an aerobic physical activity; additionally, in male athletes we found that long-term exercise appears to reduce LDL-C plasma levels. This latter finding agree with most, but not all, studies in the literature. We conclude that athletes have a lipid profile that may be protective against the development of atherosclerosis.
