Changes in the intake of vitamins and minerals by men and women with hyperlipidemia and overweight during dietetic treatment.

OBJECTIVES: To assess the influence of a low-fat, low-energy diet on the intake of vitamins and minerals in patients with overweight and hyperlipidemia. SETTING: Outpatient clinic for hyperlipidemia treatment. SUBJECTS: A total of 134 subjects chosen from patients attending Outpatient Clinic of Metabolic Diseases. INTERVENTIONS: Patients were assigned to a hypolipidemic, low-energy diet of 4.18-6.27 MJ/day (1000 or 1500 kcal/day), where fat provided less than 30% of energy, saturated fatty acids less than 10% of energy and daily supply of cholesterol was below 300 mg. Dietary assessment with the use of 3 days dietary records were performed at baseline and after 8 weeks of the diet. RESULTS: The implementation of a low-fat, low-energy diet resulted in a decrease of the intake of nutrients assessed, statistically significant for phosphorus, magnesium, iron and vitamin B(1), B(2) and niacin in men and for iron in women. No marked and statistically significant reduction in the percentage of the RDA was found, except magnesium, thiamin and riboflavin in men and iron in women. Nutritional density was statistically improved for phosphorus, potassium, magnesium and vitamins E, C and B(6) in men and for all nutrients assessed in women. CONCLUSIONS: In comparison with a habitual diet, the low-fat, low-energy diet did not cause any marked and statistically significant decrease in the intake of minerals and vitamins or in the adherence to the RDA, with the exception of magnesium, thiamin and riboflavin in men and iron in women.

[Efficacy and safety of treating hyperlipidemia type II with fluvastatin in patients with arterial hypertension]. / Skutecznosc i bezpieczenstwo leczenia hiperlipidemii typu II za pomoca fluwastatyny u chorych z nadcisnieniem tetniczym.

62 patients with hyperlipidemia II and hypertension were 8 weeks on low fat and low cholesterol diet (acc. to EAS recommendations). If LDL-Ch > or = 4.1 mmol/l the diet was continued and 12 weeks treatment by fluvastatin (Lescol, Sandoz Pharma Ltd) started with control every 4 weeks Preliminary dosage 20 mg once daily in the evening increased to 40 mg if LDL-Ch > 3.5 mmol/l. After 12 weeks the mean level of T.Chol decreased by 21%, LDL-Ch by 29%, LDL-Ch/HDL-Ch by 31% and T.Chol/HDL-Ch by 24%. HDL-Ch increased by 8% and TG decreased by 5% but not significantly. The first goal of treatment (LDL-Ch < 4.14 mmol/l) achieved 73% and second (LDL-Ch < or = 3.5 mmol/l)-43.3% patients. In 2 patients treatment was discontinued (in one due to severe alimentary symptoms and in second-due to infection of respiratory tract with increase of SGOT and SGPT) and in next 2 the dosage was decreased to 20 mg/day (due to transitory alimentary symptoms).

[Risk factors for coronary heart disease in 1002 patients with hyperlipidemia]. / Czynniki ryzyka choroby niedokrwiennej serca u 1002 pacjentów z hiperlipidemia.

The aim of this study was to estimate the coexistence of risk factors for coronary heart disease (CHD) in hyperlipidemic patients. Studies were performed in 1002 (601 women, 401 men) subjects who referred to our outpatient clinic among 12 months. Hypercholesterolemia was the predominant lipid disorder found in 66% of patients, mixed hyperlipidemia in 31.8%, and hypertriglyceridemia only in 2.2%. Overweight and obesity remain a major health burden among our patients: BMI > or = 25 was observed in 66%. Hypertension was recognized in 37.5% of subjects, and diabetes mellitus in 11.2%, 17% were long-term smokers. Familial aggregation of hyperlipidemia was observed in 15.7% of subjects, and more than 44% had a positive family history of cardiovascular disease. Low HDL cholesterol levels (< 35 mg/dl) were seen frequently in men (24.7%) and rare in women (7%). Lp(a) excess (> or = 30 mg/dl) was observed in 12% of patients. Myocardial infarction (MI) had already 11.7% subjects (7% women, 18.7% men). In these patients CHD risk factors were observed more frequently. The higher apo B and Lp(a) levels and lower HDL cholesterol levels were recognized in the patients who suffered from MI. More than 83% of our hyperlipidemic patients had coexistence CHD risk factors. The multiple coexisting risk factors cause the high risk for CHD and they require intensive correction.

[Liver steatosis assessed by ultrasonographic examination in patients with hyperlipoproteinemia]. / Stluszczenie watroby oceniane badaniem ultrasonograficznym u osób z hiperlipoproteinemia.

Ultrasonographic examinations were carried out in 174 patients with various types of hyperlipoproteinaemia, determining the incidence of the features of liver steatosis. In the group of 77 patients with hypercholesterolaemia (TCH > 200 mg%) the features of liver steatosis occurred in 13 cases (16.9%). In 90 patients with mixed hyperlipidaemia (TCH > 200 mg%, TG > 2.3 mmol/l) the features of liver steatosis were found in 50% of cases. Both in the groups of patients with hypercholesterolaemia and with mixed HLP, the patients with liver steatosis had significantly higher body mass index. In the group of patients with hypercholesterolaemia (without and with the features of liver steatosis) no differences were found in the concentrations of total cholesterol (TCH), triglycerides (TG) and high density lipoprotein fraction (HDL). In the patients with mixed HLP and the features of liver steatosis in USG examination, the mean serum triglyceride concentration was 6.2 mmol/l and was almost twice higher than that in the group without steatosis. The serum HDL concentration in the patients with mixed HLP was 39.2 mg% and was significantly lower than that in the patients with the same type of lipid concentration disturbances but without liver steatosis (48.2 mg%). The total serum cholesterol concentration was not differing significantly between the patients with liver steatosis and those without this pathological condition.

[Effect of combined treatment with lovastatin and colestipol on serum lipids and lipoproteins]. / Wplyw skojarzonego leczenia lovastatinem i kolestipolem na lipidy i lipoproteiny surowicy.

In 20 men with hypercholesterolaemia or mixed hyperlipaemia the effect was evaluated of treatment with Lovastatin and Colestipol on lipoproteins. Administration of the drugs in combination or alone decreased significantly the concentrations of total cholesterol (TC), LDL cholesterol (LDL-chol), and apolipoprotein B (apo B). The combination of Lovastatin in dose of 40 mg with Colestipol in dose of 10 g decreased more favourably the concentrations of TC (34.7%), LDL-chol (44.3%), and apo B (22.4%) than administration of each of the drugs alone in higher doses i.e. Lovastatin 80 mg (TC--26.8%, LDL-chol--31.8%, apo B--16.9%) or Colestipol 20 g (TC -20.0%, LDL-chol-26.3%, apo B-10.8%). The treatment with Lovastatin and Colestipol failed to change significantly the concentrations of triglycerides, HDL cholesterol and AI and AII apolipoproteins. The combined therapy was better tolerated than monotherapy.

Comparative studies on the influence of different fibrates on serum lipoproteins in endogenous hyperlipoproteinaemia.

Two trials have been performed in the same patients with hyperlipoproteinaemia Types IIb (12 cases), III (6 cases) and IV (11 cases). In the first study the lipid-lowering properties of bezafibrate, fenofibrate, gemfibrozil, etofibrate and etofylline clofibrate were compared and in a separate trial the influence of combined treatment with gemfibrozil plus colestipol and bezafibrate plus probucol on lipoproteins were investigated. The mean percentage lipid-lowering effect of each fibrate on serum and VLDL fraction was significant in the Types IIb, III and IV patients, but there were significant differences between the fibrates. In general, gemfibrozil and bezafibrate decreased plasma lipid levels more than etofibrate and etofylline clofibrate in Type IIb patients. In Type IV cases gemfibrozil and bezafibrate were significantly potent in reducing the triglyceride level than fenofibrate, etofibrate or etofylline clofibrate. All the fibrates produced an increase in HDL cholesterol, but there were significant differences between them were in the Type IV patients. The influence of fibrates on the LDL fraction was much more variable. In hyperlipoproteinaemia Type IIb, a decrease in both LDL cholesterol and LDL apolipoprotein B was observed. In Type III and IV patients, however, an increase in LDL concentration occurred. The addition of colestipol to gemfibrozil therapy led to a further decrease in total cholesterol, LDL cholesterol and LDL apolipoprotein B in Type IIb patients. In patients with hyperlipoproteinaemia Types III and IV colestipol prevented the increase in LDL concentration after treatment with gemfibrozil alone. The effect of probucol on LDL cholesterol was comparable to that of colestipol. Combined treatment with gemfibrozil and colestipol caused an increase in HDL cholesterol concentration in contrast to combined treatment with bezafibrate and probucol.(ABSTRACT TRUNCATED AT 250 WORDS)

Modification of low density lipoproteins from hypertriglyceridemic patients by macrophages in vitro and the effect of bezafibrate treatment.

After 30 days of bezafibrate administration to 5 patients with hypertriglyceridaemia and hyperapobetalipoproteinaemia a rise was found in the concentrations of cholesterol and vitamin E in the LDL fraction. In consequence the susceptibility of the LDL fraction to oxidation by macrophages was reduced. The uptake of modified LDL by these cells was decreased in relation to the uptake before treatment.

Influence of bezafibrate and colestipol on LDL-cholesterol, LDL-apolipoprotein B and HDL-cholesterol in hyperlipoproteinaemia.

A significant increase of LDL-apolipoprotein B by 13% and LDL-cholesterol by 19% was observed in a group of 9 patients with hyperlipoproteinaemia Type III after bezafibrate treatment. Additional administration of colestipol caused a significant decrease of both LDL-apolipoprotein B by 18% and LDL-cholesterol by 25%. In 10 patients of hyperlipoproteinaemia Type IIb a significant decrease of both LDL-apolipoprotein B by 28% and LDL-apolipoprotein B by 18% was observed after bezafibrate therapy. When bezafibrate was given together with colestipol a further decrease of both LDL-cholesterol by 17% and LDL-apolipoprotein B by 16% occurred. HDL-cholesterol concentration increased significantly in both groups of hyperlipaemic patients during therapy. This may be the effect of both bezafibrate and colestipol. It is concluded that bile acid resins may effectively prevent the LDL-cholesterol concentration increase observed sometimes after clofibrate analogues.