Effects of two low-dose oral contraceptives containing ethinylestradiol and either desogestrel or levonorgestrel on serum lipids and lipoproteins with particular regard to LDL size.

This study was designed to determine the effects of two low-dose oral contraceptives, most frequently given in our area, monophasic desogestrel/ethinylestradiol (DG/EE) and triphasic levonorgestrel/ethinylestradiol (LNG/EE), on lipoprotein parameters, especially LDL particle size and HDL subclass distribution (determined by lipid-stained 2%-20% polyacrylamide gradient gel electrophoresis) in 37 healthy normolipidemic women aged 19 to 27 years. Lipid and lipoprotein parameters were measured before the start of treatment and in the third month of oral contraceptive use. Results reflected the estrogen-progestin balance. As compared with baseline values, with both formulations, plasma total cholesterol, phospholipids, and HDL3 cholesterol increased, and LDL-predominant peak size decreased, with a translation of LDL pattern A towards pattern I. With DG/EE, plasma triglycerides, apolipoproteins AI and B increased. With LNG/EE, LDL cholesterol increased, and HDL2 cholesterol decreased. All these modifications were moderate, within threshold limits. Estrogen-dominant monophasic DG/EE appears to be more favorable than progestin-dominant triphasic LNG/EE, since the reduction in LDL-predominant peak size is not associated with an increase in LDL cholesterol or with a decrease in HDL2 cholesterol.

Plasma fatty acid status in Moroccan children: increased lipid peroxidation and impaired polyunsaturated fatty acid metabolism in protein-calorie malnutrition.

In previous studies on plasma fatty acid and antioxidant status in 29 malnourished Moroccan children (12 with mild protein-calorie malnutrition, 17 with severe protein-calorie malnutrition) compared to 15 healthy control children from the same area, we pointed out that these populations were heterogeneous in terms of their essential fatty acid and antioxidant status. The aim of the present study was to classify the children using the Waterlow classification and their essential fatty acid status. The discrepancies in lipid parameters, nutritional and inflammatory markers, blood oxidative indexes, antioxidant micronutrients or trace elements (selenium, zinc, vitamin E) related to polyunsaturated fatty acids were checked in these populations. Eight of the control subjects and nine of the severe protein-calorie malnutrition children were essential fatty acid-deficient, compared to only one of the mild protein-calorie malnutrition group. Examination of the essential fatty acid-sufficient subjects with mild protein-calorie malnutrition, compared to the essential fatty acid-sufficient control subjects, showed only a decrease in Z scores and a non-significant decrease in selenium and vitamin E. In severely malnourished children, albumin, cholesterol and low density lipoprotein (LDL) cholesterol, plasma selenium, vitamin E and zinc were low, whereas inflammatory proteins and triglycerides were high. These features worsened with essential fatty acid deficiency. In all protein-calorie malnutrition subjects, there was oxidative stress (increase in thiobarbituric-acid reactants, imbalance between plasma polyunsaturated fatty acid, vitamin E and selenium levels), even in the absence of essential fatty acid deficiency. Monounsaturated fatty acids, oleic acid/stearic acid (C18:1 n-9/C18:0) delta9 desaturase and n-3 and n-6 elongase activity indexes increased. The C18:1/C18:0 delta9 desaturase activity index was negatively correlated to Z scores (r = -0.44, P< 0.01 for Z score weight, r = -0.39, P < 0.01 for Z score height), albumin (r = -0.82, P < 0.01) and zinc (r = -0.51, P< 0.01) levels. In essential fatty acid-deficient, severe protein-calorie malnutrition subjects, delta6 desaturase activity was impaired, and there was a non-significant decrease in arachidonic acid. Essential fatty acid deficiency is a type of malnutrition, and is associated with an aggravation of all parameters in severe protein-calorie malnutrition. The increase in the C18:1/C18:0 delta9 desaturase activity and enhanced lipid peroxidation without any essential fatty acid deficiency could be early markers of protein-calorie malnutrition.

[Effects of oral contraceptive preparations and smoking on lipoprotein repartition]. / Effets de la contraception orale et du tabac sur la répartition des lipoprotéines.

We studied the effect of oral contraceptives and smoking on the lipid profile of 251 women and 72 men, 20-29-year-old. In women, taking estroprogestatives, cholesterol, triglycerides, apoproteins AI and B were higher than in controls; HDL-cholesterol was not modified. Lipoprotein analyses in polyacrylamide gradient gel exhibited an increase of the HDL3 fraction at the expense of the HDL2 fraction, with a reduced LDL size. Smoking in addition to estroprogestative absorption accentuated these modifications and led to a decreased HDL-cholesterol (HDL2 fraction essentially), with an increased LDL-cholesterol. In men, smoking resulted in higher levels of total cholesterol, apoprotein B and LDL-cholesterol, without any significant change in LDL size, higher levels of triglycerides and lower level of the HDL2 fraction without any change in HDL-cholesterol. In women, smoking led only to an increase in triglycerides. In summary, analysis of the distribution of HDL subclasses and of LDL size showed an evolution towards a supposed more atherogenic lipid profile in women taking oral contraceptives associated or not with smoking, and in male smokers.

Effects of fish oil fatty acids on plasma lipids and lipoproteins and oxidant-antioxidant imbalance in healthy subjects.

The purpose of this study was to investigate the effect of eicosapentaenoic and docosahexaenoic acids on plasma lipids and lipoproteins, lipid peroxidation and antioxidant status in healthy humans. A total of 19 healthy volunteers consumed 6 g/day Maxepa fish oil for 3 weeks (1.8 g n-3 fatty acids/day). At baseline and at day 21, we evaluated plasma lipoproteins, plasma and low-density lipoprotein fatty acids, lipid peroxidation markers (malondialdehyde concentration, low-density lipoprotein peroxidation in vitro), and the content of a number of antioxidants (reduced and oxidized glutathione in whole blood, plasma and erythrocyte glutathione peroxidases, plasma vitamin E and beta carotene). Plasma concentrations of total cholesterol, triglycerides, phospholipids, low-density lipoprotein cholesterol and low-density lipoprotein size did not differ significantly after 3 weeks of supplementation. Adding the fish oil to the diet increased the concentration of n-3 very-long-chain polyunsaturated fatty acids and decreased the concentration of n-6 fatty acid and oleic acid in plasma and low-density lipoprotein. Eicosapentaenoic and docosahexaenoic acid supplementation caused elevated values of the high-density lipoprotein cholesterol due to an increment of the high-density lipoprotein 2 fraction and reduced low-density lipoprotein peroxidation rate in vitro. However, we observed an imbalance between oxidizable substrates and antioxidants with an increased lipid peroxidation, whereas the content of reduced glutathione and beta carotene decreased without any variation in vitamin E. Association of antioxidants with n-3 PUFA could prevent lipid peroxidation and enhance the antiatherogenic effects of n-3 polyunsaturated fatty acids.

Lipids, lipoproteins, and fatty acids during infantile marasmus in the Fès area of Morocco.

The lipid composition of plasma, including total HDL and LDL cholesterol, triglycerides, apo AI, apo B, and fatty acids was investigated in 29 malnourished Moroccan children in two groups: 12 children with mild PCM, and 17 with severe PCM. Normally nourished children from the same area (n = 15) served as controls. The severe malnourished children showed a significant reduction of apo AI, total and LDL cholesterol, and an increase in the levels of triglycerides. Furthermore, these children showed a decrease in the saturated fatty acids myristic and stearic acid, and a similar decrease in the essential fatty acid (EFA) metabolites, especially eicosatrienoic acid, arachidonic acid, and eicosapentaenoic acid, with an increase in the oleic and cisvaccenic monounsaturated fatty acids. In contrast, the PCM group showed only an increase of docosatetraenoic and docosapentaenoic, with an associated decrease in myristic acid and palmitic acid. On the other hand, the indexes of delta 9 desaturase and elongase n-3 and n-6 were increased, and this was found to be related to the severity of the malnutrition. These results suggest that the severity of malnutrition is associated with an increase of desaturation and elongation of PUFA, EFA deficiency and/or peroxidation.

Fatty acid nutriture in hospitalized elderly women.

OBJECTIVE: The aim of this study was to measure the fatty acid (FA) dietary intakes and the FA composition of plasma total lipids in a selected group of hospitalized elderly patients. METHODS: Twenty-three women aged 76 to 99 years were recruited. FA were analyzed in 5-day duplicate portions and in plasma by gas liquid chromatography. RESULTS: The hospitalized elderly women ingested an average of 5.22 megajoules (MJ) and 45.9 g of lipids per day. Polyunsaturated fatty acids (PUFA) represented 11.0% and saturated fatty acids (SFA) 53.6% of the lipid intake. Minimal recommendations for linoleic acid intake were reached in average, but 32% of the patients ingested less than 3 g of linoleic acid/d. Eighty-six percent received less than 0.5% of energy for alpha-linolenic acid and 64% had low intakes in very long-chain n-3 FA. In parallel, these patients presented several biochemical signs of essential fatty acids (EFA) insufficiency (decrease in linoleic acid, increase in monounsaturated fatty acids (MUFA), in n-7 FA and in indexes of delta-6 and delta-9 desaturase activities). CONCLUSIONS: Hospitalized elderly patients have low PUFA intakes and show biochemical indices of EFA insufficiency. These patients might benefit from a nutritional supplementation providing both EFA and antioxidant micronutrients to limit the risk of skin troubles, immune system impairment and vascular disease often observed in institutionalized elderly subjects.

[Plasma apolipoproteins AI and B: reference values in the Isère population and determination of individual values]. / Apolipoprotéines AI et B plasmatiques: valeurs usuelles de la population de l'lsère et détermination de valeurs seuil.

Reference ranges for apolipoprotein AI and B plasma concentrations were established in a population of unrelated apparently healthy volunteers (138 men and 186 women) living in the region of Grenoble. Apolipoproteins were measured using an immunoturbidimetric assay on a Cobas Fara II analyzer, with reagents and IFCC standardized calibrators from Orion. Apolipoprotein AI mean concentration was higher in women than in men and increased with age in both men and women older than 45. Apolipoprotein B mean concentration was higher in men and increased linearly with age in both sexes. Linear regression analysis was used to determine desirable and high risk values for apolipoproteins AI and B from the guidelines developed by the National Cholesterol Education Program for HDL cholesterol and LDL cholesterol, respectively. Our data indicate that an apolipoprotein AI value of 1.05 g/l is comparable to an HDL cholesterol value of 0.35 g/l. The apolipoprotein B cutpoints of 1.15 g/l for men and 1.05 g/l for women correspond to the accepted LDL cholesterol cutpoint of 1.60 g/l.

Is there an abnormal fasting duodenogastric reflux in nonulcer dyspepsia?

A quantitatively and/or qualitatively abnormal duodenogastric reflux (DGR) could be involved in the pathogenesis of nonulcer dyspepsia (NUD). The aims of this prospective study were to look for (1) a pathological DGR profile during fasting and (2) an eventual correlation between DGR profile and clinical symptoms. Twenty-six NUD patients were investigated. Seven other operated patients with a surgical procedure facilitating DGR episodes and 27 healthy volunteers served as control groups. A clinical score was determined for each patient from a standardized questionnaire. Gastric aspiration was performed for 6 hr in fasting subjects. The aspirates were pooled into 17 samples. In each sample the concentration and the output of total bile acids was determined. If the concentration was larger than 30 mumol/liter in pooled samples, the concentrations of free bile acids and the distribution of the conjugated bile acids was determined. The percentage of aliquots with a total bile acid concentration larger than 50 mumol/liter (without upper limit), and the percentage with a concentration larger than 2500 mumol/liter was also obtained. No significant difference was demonstrated between the healthy volunteers and NUD patients, whatever the parameter considered. However, there was a significant increase in each of the quantitative parameters for the group of operated patients in comparison with the NUD patient group. No significant correlation was found between the clinical score and the DGR profile in NUD patients. Apparently, DGR episodes do not play a primary role in the pathogenesis of NUD.