Immune Modulatory Effects of Hypercholesterolemia: Can Atorvastatin Convert the Detrimental Effect of Hypercholesterolemia on the Immune System?

Many observations showed that hypercholesterolemia can disrupt immune response. Statin drugs that were used for the treatment of hypercholesterolemia patients can interfere in the regulation of the immune response and cytokine secretion. The primary aim of the current study was to investigate the immune response among treatment-naïve patients with hypercholesterolemia and healthy subjects. The secondary goal of the study was to determine whether atorvastatin can reverse the detrimental effect of hypercholesterolemia on the immune system. Peripheral blood mononuclear cells (PBMCs) were isolated from 50 patients afflicted with hypercholesterolemia who were treatment-naïve along with 50 sex/age-matched hypercholesterolemia patients receiving atorvastatin, and 50 sex/age-matched healthy subjects. Quantitative PCR and ELISA methods were used for gene and protein expression analysis of T helper 1 (Th1) and Th2 related cytokines. Additionally, the expression of the cluster of differentiation (CD) markers on T, B, and natural killer (NK) cells was measured by flow cytometry method. The results showed that hypercholesterolemia and atorvastatin down-regulated the expression of Th1-related cytokines and elevated the levels of Th2-related cytokines. The expression of cell surface markers, CD25 and CD69, was significantly decreased in the treatment-naïve, and atorvastatin groups. It seems that atorvastatin is not able to repair the deleterious effects of hypercholesterolemia on the immune system. Moreover, elevated levels of cholesterol along with the administration of atorvastatin tilt the Th1/Th2 balance in favor of Th2 and reduce T cell activation.

The effects of helicobacter pylori eradication on modification of metabolic syndrome parameters in patients with functional dyspepsia.

BACKGROUND: Helicobactor pylori (H. pylori) have the potential role in the pathogenesis of various extra-gastric disorders such as metabolic disorders. But, it is now questioned about whether H. pylori eradication reduces or induces the risk for metabolic disorders especially in patients with dyspepsia. Hence, the present study aimed to assess the effects of H. pylori eradication on criteria of metabolic syndrome. METHODS: H. pylori infected patients with dyspepsia were included. The patients were treated with omeprazole (20mg, q12h), amoxicillin (1g, q12h), and clarithromycin (500mg, q12h) for two weeks, then H. pylori eradication was evaluated by C14 Breathing test (UBT) 6 weeks after the end of the treatment. Demographic data, clinical manifestation and metabolic parameters were recorded before and three months after completing treatment regimen. The data was analyzed by SPSS version 16.0. RESULTS: Of 110 patients were initially enrolled, 91 patients completed the study. Overall eradication rate was 61.5%. Significant differences in the serum level of total cholesterol(180.7±34 vs. 172.1±28, p=0.001), LDL(107.0±25 vs. 100.8±20, p<0.001), HDL(46.2±8.7 vs. 48.9±8.6, p<0.001), fasting blood sugar (93.7±12 vs. 90.9±10, p=0.001), hemoglobin A1c(5.37±0.52 vs 5.25±0.53, p=0.006), and as well as for waist circumference(92.2±14 vs. 91.4±13.9, p=0.03) was found after treatment. Data for body weight, systolic and diastolic blood pressure and triglyceride level remained without any significant changes. CONCLUSION: H. pylori eradication could relatively reduce the risk of metabolic syndrome criteria such as fasting blood sugar, hemoglobin A1c, lipid profile and waist circumference.

Iron deficiency anemia and megaloblastic anemia in obese patients.

BACKGROUND: The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. METHODS AND MATERIALS: This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. RESULTS: BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients' age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. CONCLUSION: Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.

Depression and Hypothyroidism in a Population-Based Study of Iranian Women.

BACKGROUND: Recent biochemical and physiological investigations have focused on the fundament of mood disorders in thyroid dysfunction. The present study aimed to address depressive disorder in a sample of Iranian hypothyroid women compared to euthyroid individuals. METHODS: Thirty consecutive hypothyroid female patients aged 25 to 40 years who referred to the Endocrinology and Metabolism Clinic at Rasoul-e-Akram Hospital in Tehran within a four-month period in 2015 were assessed. Thirty healthy euthyroid subjects matched for sex, age, and educational level were selected as the control. For assessment of depression status, Depression Anxiety Stress Scale-21 (DASS-21) was employed. RESULTS: The study showed higher mean depression score in hypothyroid patients when compared to euthyroid ones (13.8 ± 9.5 versus 5.8 ± 5.2, p = 0.010). No significant association was revealed between mean depression score and patients' education level (p = 0.627), age (p = 0.967), occupation status (p = 0.211), and marital status (p = 0.556). CONCLUSION: Hypothyroid women are predisposed to depressive symptoms independent of their baseline demographic and socioeconomic characteristics.