Hydroxypropylmethylcellulose lowers cholesterol in statin-treated men and women with primary hypercholesterolemia.

BACKGROUND/OBJECTIVES: Consumption of hydroxypropylmethylcellulose (HPMC), a viscous dietary fiber, lowers total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). However, HPMC had not previously been studied in individuals receiving lipid drug therapy. SUBJECTS/METHODS: This randomized, double-blind crossover trial examined the lipid effects of HPMC in subjects with hypercholesterolemia on statin therapy. Men (n=5) and women (n=8) with LDL-C> or =2.59 mmol/l after at least 4 weeks of stable-dose statin therapy, and a mean age of 58.6 years, were enrolled. Subjects received twice daily doses of either 2.5 g HPMC or control, delivered in a lemonade beverage for 4 weeks, then crossed over to receive the opposite treatment for an additional 4 weeks. RESULTS: Mean baseline concentrations of TC, non-high-density lipoprotein cholesterol (non-HDL-C), LDL-C, HDL-C, triglyceride (TG), TC/HDL-C ratio and apolipoprotein (Apo) B were 4.95, 3.63, 3.03, 1.33, 1.30 and 3.89 mmol/l and 1.00 g/l, respectively. HPMC consumption resulted in significantly larger reductions (P<0.01 vs control for all) in TC (-10.9 vs -3.5%), non-HDL-C (-12.8 vs -2.9%), LDL-C (-15.7 vs -5.1%), TC/HDL-C ratio (-5.3 vs +1.3%) and Apo B (-8.7 vs -3.9%). There were no differences between treatments for changes in HDL-C (-5.2 vs -4.3%) or TG (+3.9 vs +8.9%). CONCLUSIONS: These results support the view that HPMC is an effective adjunct to statin therapy for further lowering atherogenic lipids and lipoproteins in men and women with primary hypercholesterolemia.

Chronic consumption of rebaudioside A, a steviol glycoside, in men and women with type 2 diabetes mellitus.

This trial evaluated the effects of 16 weeks of consumption of 1000mg rebaudioside A (n=60) a steviol glycoside with potential use as a sweetener, compared to placebo (n=62) in men and women (33-75 years of age) with type 2 diabetes mellitus. Mean+/-standard error changes in glycosylated hemoglobin levels did not differ significantly between the rebaudioside A (0.11+/-0.06%) and placebo (0.09+/-0.05%; p=0.355) groups. Changes from baseline for rebaudioside A and placebo, respectively, in fasting glucose (7.5+/-3.7mg/dL and 11.2+/-4.5mg/dL), insulin (1.0+/-0.64microU/mL and 3.3+/-1.5microU/mL), and C-peptide (0.13+/-0.09ng/mL and 0.42+/-0.14ng/mL) did not differ significantly (p>0.05 for all). Assessments of changes in blood pressure, body weight, and fasting lipids indicated no differences by treatment. Rebaudioside A was well-tolerated, and records of hypoglycemic episodes showed no excess vs. placebo. These results suggest that chronic use of 1000mg rebaudioside A does not alter glucose homeostasis or blood pressure in individuals with type 2 diabetes mellitus.

The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure.

Rebaudioside A and stevioside are steviol glycosides extracted from the plant Stevia rebaudiana Bertoni and are used in several countries as food and beverage sweeteners. This randomized, double-blind trial evaluated the hemodynamic effects of 4weeks consumption of 1000mg/day rebaudioside A vs. placebo in 100 individuals with normal and low-normal systolic blood pressure (SBP) and diastolic blood pressure (DBP). Subjects were predominantly female (76%, rebaudioside A and 82%, placebo) with a mean age of approximately 41 (range 18-73) years. At baseline, mean resting, seated SBP/DBP was 110.0/70.3mmHg and 110.7/71.2mmHg for the rebaudioside A and placebo groups, respectively. Compared with placebo, rebaudioside A did not significantly alter resting, seated SBP, DBP, mean arterial pressure (MAP), heart rate (HR) or 24-h ambulatory blood pressures responses. These results indicate that consumption of as much as 1000mg/day of rebaudioside A produced no clinically important changes in blood pressure in healthy adults with normal and low-normal blood pressure.

Complement in overt and asymptomatic nephritis after skin infection.

In an ongoing study of streptococcal skin infection and acute glomerulonephritis (AGN) begun in 1964, C'3 determinations were done in 784 patients. There were 126 patients with acute poststreptococcal nephritis, 172 of their siblings, and 486 patients with uncomplicated impetigo from families without an index case of nephritis.90% of the patients with nephritis were infected with one of the four prevalent streptococcal serotypes associated with nephritis in this population; only 12% of patients with uncomplicated impetigo were infected with similar serotypes.93% of the patients with overt nephritis had diminished complement levels. Low complement was more often observed (8%) in AGN siblings than was transient hypertension and/or hematuria (5%). Considering the relationship of low C'3 alone and low C'3 preceded hematuria in four others. Two (0.4%) of the patients with uncomplicated impetigo had low complement values, both of whom were infected with nephritogenic strains. Transient hematuria and/or hypertension was less frequently observed (2.7%) among patients with uncomplicated impetigo. Serial determinations in patients with low complement revealed a return to normal in a linear fashion within 2-12 wk. The validity of the hypothesis that the asymptomatic patients with low complement levels, with or without hematuria, likely had subclinical nephritis is strengthened by the accompanying epidemiologic data. The finding of low complement before the onset of, or in the absence of, hematuria or other evidence of nephritis supports the concept that an immunologic mechanism may precipitate the renal injury of acute streptococcal nephritis.