[Effect of n-3 polyunsaturated fatty acids on plasma lipid, LDL lipoperoxidation, homocysteine and inflammation indicators in diabetic dyslipidemia treated with statin + fibrate combination]. / Vliv vícenenasycených mastných kyselin rady n-3 na plazmatické lipidy, lipoperoxidaci LDL, homocystein a ukazatele zánetu u diabetické dyslipidémie, lécené kombinací statin + fibrát.

BACKGROUND: The aim of the study was to determine how addition of n-3 polyenic fatty acids (PUFA) to the present treatment with statin + fibrate combination in diabetic dyslipidemia effects plasma lipids and lipoproteins, LDL lipoperoxidation, glucose homeostasis, concentration of serum homocysteine and selected inflammation indicators. METHODS AND RESULTS: 24 patients with type 2 diabetes, who after the combined hypolipidemic treatment (pravastatin 20 mg + micronized fenofibrate 200 mg per day) cannot reach the recommended target values for long time, received for three consecutive months supplementation of 3,6 g PUFA n-3 per day or a placebo (olive oil). At the beginning of the study, after three months of PUFA supplementation and after another three months of placebo administration, concentrations of plasma lipids, composition of fatty acids, plasma phosphatidylcholine (PC), cholesterol esters (CE) and triglycerides (TG), concentration of tHcy, conjugated diens (CD) in LDL and selected inflammation indicators (IL-6, TNFalpha, VCAM-1) were determined. n-3 PUFA supplementation resulted in the significant decrease of tHcy concentration (-29%, P < 0.01) and TG (-28%, P < 0.05) in plasma. During the period of placebo administration, values returned to base line levels. CD concentration in LDL after n-3 PUFA increased by 15% (P < 0.15, not significant), meanwhile after the placebo containing oleic acid it decreased by 18% (P < 0.05). CONCLUSIONS: Our results show that n-3 PUFA supplementation together with statin + fibrate combination in DDL patients can significantly decrease the risk of cardiovascular diseases.

Homocysteinemia and endothelial damage after methionine load.

Homocysteinemia increased significantly after a methionine load of 50 mg/kg in patients with peripheral artery occlusive disease but this load was insufficient to increase circulating endothelial cell count as a marker of endothelial damage. Only after an increased load of 100 mg/kg methionine circulating endothelial cells also increased markedly confirming the results of a previous experimental study. These data indicate a threshold concentration of homocysteine in blood necessary to induce endothelial lesions.

[Lipoperoxides and their clinical importance]. / Lipoperoxidy a jejich klinický význam.

BACKGROUND: Research and investigations in the sphere of lipid peroxides has been pursued so far for a relatively short time. Therefore every new finding is a great asset for this branch of medicine. An elevated lipid peroxide level signalizes pathological changes in the organism. Malondialdehyde is an indicator of lipid peroxidation. The authors focused their experimental work on assessment of malondialdehyde in human serum. They tested the effect of increased radical peroxidation caused by diabetes and investigated whether it raises the lipid peroxide level in a group of patients suffering from ischaemic heart disease. METHODS AND RESULTS: Two groups were formed--one comprising 10 patients with ischaemic heart disease and another one of 8 patients with ischaemic heart disease and type II diabetes. The malondialdehyde concentrations were moreover compared with a control group of healthy subjects. The mean age of the first group was 72 years, of the second group 69 years. The mean age of the control group was 64 years. Lipid peroxidation was assessed from the concentration of malondialdehyde using an analytical method--spectrophotometry with fluorescence detection. CONCLUSIONS: Statistical evaluation of lipid peroxide levels in the two groups of patients with ischaemic heart disease led to the conclusion that the differences were not significant. Type II diabetes did not cause a greater increase of lipid peroxides in patients with IHD.

[Fatty acid composition of plasma lipids in hyperlipidemia associated with ischemic heart disease]. / Slození mastných kyselin plazmatických lipidu u hyperlipidemiku s ischemickou chorobou srdecní.

The authors compared plasma lipid and lipoprotein values and the fatty acid composition in plasma lipids of a group of 38 men with primary hyperlipoproteinaemia (HLP) type II B and IV with a history of myocardial infarction (IM) and in a control group of 63 men with the same type of HLP without a history of ischaemic heart disease (IHD). Hyperlipidaemic subjects after IM differed from controls by the apolipoprotein (apo) B concentration in LDL lipoproteins and by the composition of fatty acids in plasma phosphatidylcholine (PC) and triglycerides (TG). In the discriminating function which makes it possible in the given group of patients to classify correctly hyperlipidaemic subjects after IM and without detectable IHD the independent variables are apo-B concentration in LDL, apo-A-I in plasma, eicosapentaenoic acid in TG, gamma-linolenic acid in cholesterol esters and stearic and oleic acid in PC. These findings confirm the practical value of assessment of apolipoproteins for detection of hyperlipidaemic subjects with a specially high risk of IHD and indicate also the role of essential FA in the pathogenesis of IM.