Combination Therapy of Cuban Policosanol (Raydel®, 20 mg) and Intensive Exercise for 12 Weeks Resulted in Improvements in Obesity, Hypertension, and Dyslipidemia without a Decrease in Serum Coenzyme Q10: Enhancement of Lipoproteins Quality and Antioxidant Functionality in Obese Participants.

Obesity and overweight, frequently caused by a lack of exercise, are associated with many metabolic diseases, such as hypertension, diabetes, and dyslipidemia. Aerobic exercise effectively increases the high-density lipoproteins-cholesterol (HDL-C) levels and alleviates the triglyceride (TG) levels. The consumption of Cuban policosanol (Raydel®) is also effective in enhancing the HDL-C quantity and HDL functionality to treat dyslipidemia and hypertension. On the other hand, no study has examined the effects of a combination of high-intensity exercise and policosanol consumption in obese subjects to improve metabolic disorders. In the current study, 17 obese subjects (average BMI 30.1 ± 1.1 kg/m2, eight male and nine female) were recruited to participate in a program combining exercise and policosanol (20 mg) consumption for 12 weeks. After completion, their BMI, waist circumference, total fat mass, systolic blood pressure (SBP), and diastolic blood pressure (DBP) reduced significantly up to around -15%, -13%, -33%, -11%, and -13%, respectively. In the serum lipid profile, at Week 12, a significant reduction was observed in the total cholesterol (TC) and triglyceride (TG) levels, up to -17% and -54% from the baseline, respectively. The serum HDL-C was elevated by approximately +12% from the baseline, as well as the percentage of HDL-C in TC, and HDL-C/TC (%), was enhanced by up to +32% at Week 12. The serum coenzyme Q10 (CoQ10) level was increased 1.2-fold from the baseline in all participants at Week 12. In particular, the male participants exhibited a 1.4-fold increase from the baseline. The larger rise in serum CoQ10 was correlated with the larger increase in the serum HDL-C (r = 0.621, p = 0.018). The hepatic function parameters were improved; the serum γ-glutamyl transferase decreased at Week 12 by up to -55% (p < 0.007), while the aspartate aminotransferase and alanine transaminase levels diminished within the normal range. In the lipoprotein level, the extent of oxidation and glycation were reduced significantly with the reduction in TG content. The antioxidant abilities of HDL, such as paraoxonase (PON) and ferric ion reduction ability (FRA), were enhanced significantly by up to 1.8-fold and 1.6-fold at Week 12. The particle size and number of HDL were elevated up to +10% during the 12 weeks, with a remarkable decline in the TG content, glycation extent, and oxidation. The improvements in HDL quality and functionality were linked to the higher survivability of adult zebrafish and their embryos, under the co-presence of carboxymethyllysine (CML), a pro-inflammatory molecule known to cause acute death. In conclusion, 12 weeks of Cuban policosanol (Raydel®, 20 mg) consumption with high-intensity exercise displayed a significant improvement in blood pressure, body fat mass, blood lipid profile without liver damage, CoQ10 metabolism, and renal impairment.

Beneficial Effect of Cuban Policosanol on Blood Pressure and Serum Lipoproteins Accompanied with Lowered Glycated Hemoglobin and Enhanced High-Density Lipoprotein Functionalities in a Randomized, Placebo-Controlled, and Double-Blinded Trial with Healthy Japanese.

This study evaluated the efficacy and safety of 20 mg of Cuban policosanol in blood pressure (BP) and lipid/lipoprotein parameters of healthy Japanese subjects via a placebo-controlled, randomized, and double-blinded human trial. After 12 weeks of consumption, the policosanol group showed significantly lower BP, glycated hemoglobin (HbA1c), and blood urea nitrogen (BUN) levels. The policosanol group also showed lower aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transferase (γ-GTP) levels at week 12 than those at week 0: A decrease of up to 9% (p < 0.05), 17% (p < 0.05), and 15% (p < 0.05) was observed, respectively. The policosanol group showed significantly higher HDL-C level and HDL-C/TC (%), approximately 9.5% (p < 0.001) and 7.2% (p = 0.003), respectively, than the placebo group and a difference in the point of time and group interaction (p < 0.001). In lipoprotein analysis, the policosanol group showed a decrease in oxidation and glycation extent in VLDL and LDL with an improvement of particle shape and morphology after 12 weeks. HDL from the policosanol group showed in vitro stronger antioxidant and in vivo anti-inflammatory abilities. In conclusion, 12 weeks of Cuban policosanolconsumption in Japanese subjects showed significant improvement in blood pressure, lipid profiles, hepatic functions, and HbA1c with enhancement of HDL functionalities.

Elevated Serum Low-Density Lipoproteins-Cholesterol Levels and B1B2/B2B2 CETP Genotype Are Positively Associated with Nonalcoholic Fatty Liver Disease in Women with Gallstone Disease.

Background: Nonalcoholic fatty liver disease (NAFLD) is generated by the interaction between environmental and genetic factors, and the presence of metabolic alterations. Since Taq1B cholesteryl ester transfer protein (CETP) polymorphism is associated with abnormal serum lipid values, it could be related to NAFLD. The aim of this study was to determine the role of the Taq1B CETP polymorphism with serum lipids, anthropometric variables, and the extent of steatosis in Mexican-mestizo women with gallstone disease (GD). Methods: Sixty-two women were enrolled in this cross-sectional study. Serum lipids were determined by dry chemistry. The Taq1B CETP polymorphism was determined by allelic discrimination. CETP serum levels were measured by enzyme-linked immunosorbent assay, and the extent of steatosis with a biopsy staining with Oil-Red-O. Results: Subjects with the B1B2/B2B2 genotype had higher percentage of degree of steatosis than those with B1B1 (11.95% vs. 2.19%, P = 0.008). The B1B2/B2B2 genotype (odds ratio [OR] 3.90 [confidence interval {CI} 95% 1.891-8.536], P = 0.04) and an elevated low-density lipoproteins (LDL)-cholesterol (OR 3.54 [CI 95% 1.042-2.058, P = 0.039) significantly increase the risk for NAFLD. Conclusions: This study provides evidence that the B1B2/B2B2 genotype of CETP and the elevated LDL-cholesterol serum levels increase the risk of NAFLD in women with GD.

Increased Circulating Levels of PCSK9 and Pro-Atherogenic Lipoprotein Profile in Pregnant Women with Maternal Supraphysiological Hypercholesterolemia.

Maternal physiological hypercholesterolemia (MPH) occurs during pregnancy to assure fetal development. Some pregnant women develop maternal supraphysiological hypercholesterolemia (MSPH) characterized by increased levels of low-density lipoprotein (LDL). We aim to determine if proprotein convertase subtilisin/kexin type 9 (PCSK9) levels (a protein that regulate the availability of LDL receptor in the cells surface), as well as the composition and function of LDL, are modulated in MSPH women. This study included 122 pregnant women. Maternal total cholesterol (TC), LDL, triglycerides and PCSK9 increased from first (T1) to third trimester (T3) in MPH women. At T3, maternal TC, LDL, PCSK9 and placental abundances of PCSK9 were significantly higher in MPSH compared to MPH. Circulating PCSK9 levels were correlated with LDL at T3. In MSPH women, the levels of lipid peroxidation and oxidized LDL were significantly higher compared to MPH. LDL isolated from MSPH women presented significantly higher triglycerides and ApoB but lower levels of ApoAI compared to MPH. The formation of conjugated dienes was earlier in LDL from MSPH and in endothelial cells incubated with these LDLs; the levels of reactive oxygen species were significantly higher compared to LDL from MPH. We conclude that increased maternal PCSK9 would contribute to the maternal elevated levels of pro-atherogenic LDL in MSPH, which could eventually be related to maternal vascular dysfunction.

Triglyceride-Rich Lipoproteins: Their Role in Atherosclerosis.

The term "triglyceride-rich lipoproteins" (TRLs) includes chylomicrons and their remnants, very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). In this manuscript, the mechanisms by which atherogenic TRLs contribute to the formation of atheroma plaques are reviewed. Cholesterol from TRLs that can be retained in the subendothelial space (i.e., remnants, DLs, and small VLDLs) contributes to the genesis of atherosclerosis. Triglycerides of atherogenic TRLs induce inflammation of the arterial wall. Mechanisms that explain the involvement of TRLs in atherosclerosis are the generation of pro-atherogenic changes in high-density lipoproteins and low-density lipoproteins, accumulation of TRLs in plasma, and their passage to the subendothelial space where they cause endothelial dysfunction and inflammation of the vascular wall. Furthermore, plasma accumulation of TRLs causes hyperviscosity and a procoagulant state. Finally, this manuscript summarizes the controversial aspects of the clinical approach and the treatment of cases with dyslipidemia explained by atherogenic TRLs.

Effect of low-density lipoproteins and trehalose on the quality of cryopreserved bovine semen / Efecto de las lipoproteínas de baja densidad y la trehalosa en la calidad del semen bovino criopreservado / Efeito das lipoproteínas de baixa densidade e trealose na qualidade do sêmen bovino criopreservado

Abstract Background: In artificial insemination, chicken egg yolk is added to bovine semen to protect it during the cryopreservation process, although it contains substances that can affect the microbiological quality and metabolism of sperm. Objective: To evaluate post-thaw quality of bovine cryopreserved semen added with centrifuged and non-centrifuged egg yolk, low-density lipoproteins (LDL), and trehalose (T). Methods: Ten ejaculates from five bulls were cryopreserved under the treatments T1: pure egg yolk (PEY) at 20% v/v, T2: centrifuged egg yolk (CEY) at 20% v/v, T3: LDL at 8% v/v, T4: T at 100 mM, and T5: T at 100 mM plus LDL at 8% v/v (TLDL). Spermatic motility and kinetics, functional membrane integrity (FMI), structural membrane integrity (SMI), sperm vitality (SV) and abnormal morphology (AM) were assessed using the Sperm Class Analyzer (SCA®) system, hypoosmotic test (HOST), SYBR/PI probes, and eosin-nigrosin staining, respectively. A completely randomized design was used. Normal distribution of the variables was validated through the Kolmogórov- Smirnov test. A generalized linear model was used to determine sources of variation. Means were compared using the Tukey test. Results: Inclusion of CEY or LDL had a similar effect on sperm protection, and were superior for motility, kinetics and membrane integrity compared to the other treatments (p<0.05). CEY was superior for progressive motility (p<0.05). The cryoprotective action of LDL was similar to TLDL for motility and kinetics, SMI, SV, and AM (p<0.05). Inclusion of PEY and T resulted in the lowest semen quality (p<0.05). The use of T resulted in a reduction in FMI and SMI (p<0.05). No differences in AM between treatments were found (p>0.05). Conclusions: Egg yolk can be replaced by centrifuged egg yolk or low-density lipoproteins in the freezing extender used for bovine semen used in artificial insemination.

Resumen Antecedentes: la yema de huevo de gallina se agrega al semen bovino usado en inseminación artificial para protegerlo durante el proceso de criopreservación, aunque ésta tiene sustancias que pueden afectar el metabolismo espermatico y la calidad microbiológica del semen. Objetivo: evaluar la calidad post-descongelación del semen bovino criopreservado agregado con yema de huevo centrifugada y no centrifugada, lipoproteínas de baja densidad (LDL) y trehalosa (T). Métodos: diez eyaculados de cinco toros se criopreservaron bajo los tratamientos, T1: yema de huevo pura (PEY) al 20% v/v, T2: yema de huevo centrifugada (CEY) al 20% v/v, T3: LDL al 8% v/v, T4: T a 100 mM, y T5: T a 100 mM más LDL al 8% v/v (TLDL). La movilidad y la cinética espermática, la integridad funcional de la membrana (FMI), la integridad estructural de la membrana (SMI), la vitalidad espermática (SV) y la morfología anormal (AM), se determinaron mediante el sistema Sperm Class Analyzer (SCA®), la prueba hipoosmótica (HOST), las sondas SYBR/PI y la tinción con eosina-nigrosina, respectivamente. Se utilizó un diseño completamente al azar. La normalidad de las variables se validó mediante la prueba de Kolmogórov-Smirnov. Se utilizó un modelo lineal generalizado para determinar las fuentes de variación. Las medias de los tratamientos se compararon mediante la prueba de Tukey. Resultados: CEY y LDL tuvieron un efecto similar en la protección de los espermatozoides, siendo superiores a los demás tratamientos respecto a movilidad, cinética e integridad de la membrana (p<0,05). CEY fue superior para la movilidad progresiva (p<0,05). La acción crioprotectora de LDL fue similar a TLDL para movilidad y cinética, SMI, AM y SV (p<0,05). PEY y T resultaron en la más baja calidad seminal (p<0,05). El uso de T redujo la FMI y la SMI (p<0,05). No se encontraron diferencias en AM entre los tratamientos (p>0,05). Conclusiones: la yema de huevo puede reemplazarse por yema de huevo centrifugada o por lipoproteinas de baja densidad en el diluyente de congelación usado para semen bovino destinado a inseminacion artificial.

Resumo Antecedentes: a gema de ovo de galinha tem sido utilizada com a finalidade de proteger o sêmen bovino durante o processo de criopreservação, embora tenha substâncias que possam afetar o metabolismo dos espermatozóides e a qualidade microbiológica do sêmen utilizado para a inseminação artificial. Objetivo: avaliar a qualidade pós-descongelamento do sêmen bovino criopreservado com gema de ovo centrifugada e não centrifugada, lipoproteínas de baixa densidade (LDL) e trealose (T). Métodos: dez ejaculados de cinco touros foram criopreservados sob os tratamentos, T1: gema de ovo pura (PEY) 20% v/v, T2: gema de ovo centrifugada (CEY) 20% v/v, T3: LDL 8% v/v, T4: T 100 mM e T5: T 100 mM mais LDL 8% v/v (TLDL). Mobilidade e cinética espermática, integridade funcional da membrana (FMI), integridade estrutural da membrana (SMI), vitalidade espermática (SV) e morfologia anormal (AM) foram determinadas por o sistema Sperm Class Analyzer (SCA®), teste hiposmótico (HOST), coloração com SYBR/PI e eosina-nigrosina, respectivamente. Um design completamente aleatoriedade foi usado. A normalidade das variáveis foi validada pelo teste de Kolmogorov-Smirnov. Um modelo linear generalizado foi utilizado para determinar as fontes de variação. As médias dos tratamentos foram comparadas pelo teste de Tukey. Resultados: T2 (CEY) e T3 (LDL) tiveram efeito similar na proteção espermática, sendo superior aos demais tratamentos para mobilidade, cinética e integridade da membrana (p<0,05). T2 (CEY) foi superior para mobilidade progressiva (p<0,05). A ação crioprotetora de T3 (LDL) foi semelhante à T5 (TLDL) para motilidade e cinética, SMI, SV e AM (p<0,05). T1 (PEY) e T4 (T) tiveram a menor qualidade seminal (p<0,05). O uso de T4 (T) produziu uma redução na SMI e FMI (p<0,05). Não foram encontradas diferenças na AM entre os tratamentos (p>0,05). Conclusões: a gema de ovo pode ser substituída por gema de ovo centrifugada ou lipoproteínas de baixa densidade no diluente de congelamento de sêmen bovino.

Reaching LDL-C Targets in Patients with Moderate, High, and Very High Risk for Cardiovascular Disease After Bariatric Surgery According to Different Guidelines.

BACKGROUND: Cardiovascular disease (CVD) is highly prevalent in obese patients and is the leading cause of death. High levels of plasma low-density lipoprotein cholesterol (LDL-C) are associated with higher coronary artery disease (CAD) risk. The aim of the study was to assess the impact of the Roux-en-Y gastric bypass on the achievement of the currently proposed cardiovascular prevention goals after 1 year. PATIENTS AND METHODS: We performed a retrospective analysis from a prospectively built database of patients who underwent a primary Roux-en-Y gastric bypass (RYGB) from 2004 to 2018. Patients with intermediate, high, or very high risk for CVD according to the 2018 AHA/ACC or the 2019 ESC/EAS guidelines were selected. An analysis of clinical and biochemical variables in 1 year was performed. Logistic multivariate regressions were made to assess the impact of preoperative and weight loss parameters in the achievement of LDL-C goals. RESULTS: From 1039 patients, 70 met the selection criteria and were included in the analysis of the 2018 AHA/ACC guidelines, and 75 in the 2019 ESC/EAS guidelines. Mean decrease in LDL-C levels was 21.1 ± 40.2 mg/dL 1 year after surgery, and 29/34 patients were off medications. The percentage of patients achieving LDL-C goals according to the 2018 AHA/ACC guidelines was 27.1%, whereas according to the 2019 ESC/EAS guidelines, the percentages was 9.3%. The %TWL was associated with achieving LDL-C goals according to the 2018 AHA/ACC at 1 year. CONCLUSIONS: RYGB induces a significant weight loss and an improvement in LDL-C levels 1 year after surgery. The number of patients that reached the goals varies according to the guidelines used and ranged from 9.3 to 27.1%.

Short-Term Consumption of Cuban Policosanol Lowers Aortic and Peripheral Blood Pressure and Ameliorates Serum Lipid Parameters in Healthy Korean Participants: Randomized, Double-Blinded, and Placebo-Controlled Study.

The current study was designed to investigate the short-term effects of policosanol consumption on blood pressure (BP) and the lipid parameters in healthy Korean participants with prehypertension. A total of 84 healthy participants were randomly allocated to three groups receiving placebo, 10 mg of policosanol, or 20 mg of policosanol for 12 weeks. Based on an average of three measurements of peripheral BP, the policosanol 20 mg group exhibited the most significant reduction, that is, up to 7.7% reduction of average systolic BP (SBP) from 136.3 ± 6.1 mmHg (week 0) to 125.9 ± 8.6 mmHg (week 12, p < 0.001). Between group comparisons using repeated measures ANOVA showed that the policosanol 20 mg group had a significant reduction of SBP at 12 weeks (p = 0.020) and a reduction of diastolic BP (DBP) at 8 weeks (p = 0.041) and 12 weeks (p = 0.035). The policosanol 10 mg and 20 mg groups showed significant reductions in aortic SBP of 7.4% and 8.3%, respectively. The policosanol groups showed significant reductions of total cholesterol (TC) of 9.6% and 8.6% and low-density lipoproteins (LDL-C) of 21% and 18% for 10 mg and 20 mg of policosanol, respectively. Between group comparisons using repeated measures ANOVA showed that the policosanol (10 mg and 20 mg) groups at 12 weeks had a significant reduction of TC (p = 0.0004 and p = 0.001) and LDL-C (p = 0.00005 and p = 0.0001) and elevation of %HDL-C (p = 0.048 and p = 0.014). In conclusion, 12-week consumption of policosanol resulted in significant reductions of peripheral SBP and DBP, aortic SBP and DBP, mean arterial pressure (MAP), and serum TC and LDL-C with elevation of % HDL-C.

Boar sperm protein tyrosine phosphorylation in the presence of egg yolk soluble and low density lipoprotein fractions during cooling.

Increased protein tyrosine phosphorylation and the appearance of a phosphorylated protein of 32 kD (p32) are reported among the capacitation-like changes in cryopreserved boar sperm. Egg yolk freezing extenders are composed by two fractions: insoluble granules and soluble plasma, which contains the low density lipoproteins (LDL) proposed as responsible for the egg yolk cryoprotective action. The aim of this work was to analyze the effects of complete egg yolk and its insoluble, soluble and LDL fractions on boar sperm quality and protein tyrosine phosphorylation after the first stage of a standard cryopreservation protocol. Semen samples in Androstar® Plus diluent were centrifuged and resuspended in the different egg yolk extenders. Temperature was decreased from 17 °C to 5 °C and sperm quality, protein tyrosine phosphorylation and protein pattern were analyzed. Results showed that complete egg yolk as well as soluble and LDL egg yolk fractions maintained sperm quality after temperature decrease. Cooling without any lipid component or in the presence of the insoluble fraction, significantly reduced sperm motility. About sperm protein tyrosine phosphorylation analysis, the p32 band appeared before treatments or after cooling in Androstar® Plus diluent. Complete egg yolk and its insoluble fraction interfered with sperm tyrosine phosphorylation even after cells were extensively washed. Analysis of extenders revealed a high amount of tyrosine phosphorylated proteins in the insoluble fraction, which may have co-precipitate with sperm in experiments. Samples submitted to temperature decrease from 17 °C to 5 °C in the presence of soluble and LDL egg yolk fractions in Androstar® Plus diluent did not show any change in the p32 band associated with sperm capacitation. However, a tyrosine-phosphorylated protein of 33 kD present in clarified egg yolk was also observed in sperm treated with this extender. Protein transference from plasma and LDL egg yolk extenders was also observed in sperm protein profile. Results suggested that soluble and LDL fractions might have a protective action preventing sperm protein tyrosine phosphorylation during cooling from 17 °C to 5 °C. Further studies are needed to expand the knowledge of the LDL protection mechanism as well as to determine the possible benefits of clarified egg yolk in freezing protocols.

Data on association of mitochondrial heteroplasmy and cardiovascular risk factors: Comparison of samples from Russian and Mexican populations.

Despite the fact that the role of mitochondrial genome mutations in a number of human diseases is widely studied, the effect of mitochondrial heteroplasmy in the development of cardiovascular disease has not been adequately investigated. In this study, we compared the heteroplasmy levels of mtDNA from leukocytes for m.3256C>T, m.3336T>C, m.12315G>A, m.5178C>A, m.13513G>A, m.14459G>A, m.14846G>A, m.15059G>A, m.652insG and m.1555A>G mutations in CVD-free subjects and CVD patients in samples derived from Russian and Mexican populations. It was demonstrated that heteroplasmy level of m.5178C>A was associated with CVD in Russian men, and m.14459G>A - in Russian women. Mitochondrial heteroplasmy level of m.13513G>A and m.652insG were associated with CVD in Mexican men, and only m.652insG- in Mexican women. The levels of heteroplasmy for mitochondrial mutations m.3336T>C, m.5178C>A, m.14459G>A, m.14846G>A and m.1555A>G were significantly higher in CVD-free Mexican men, and for m.3256C>T, m.3336T>C, and m.14459G>A - in CVD-free Mexican women.

Derivación y validación de una ecuación para estimar el colesterol ligado a lipoproteínas de baja densidad en una población de Lima, Perú / Derivation and validation of an equation to determine cholesterol-low density lipoproteins in a population of Lima, Peru

Introducción. Numerosos estudios han demostrado una fuerte asociación entre el aumento de la concentración sérica del colesterol de las lipoproteínas de baja densidad (LDLc) y la incidencia de la enfermedad coronaria (EC). Objetivos. Derivar y validar la performance de una nueva ecuación para estimar el LDLc. Diseño. Estudio observacional y descriptivo. Institución. Hospital Edgardo Rebagliati Martins, Lima, Perú. Material. Informes de perfil lipídico. Intervenciones. La muestra de 4 644 informes de perfil lipídico extraídos de los archivos del laboratorio central, correspondiente a sujetos de ambos sexos, que presentaban edades entre 18 a 75 años, fue repartida en dos grupos. Del primer grupo conformado por 2 136 informes se derivó la ecuación para estimar el LDLc, mediante análisis de regresión múltiple. El segundo grupo conformado por 2 508 informes sirvieron para validar la performance de la nueva ecuación mediante la comparación con la medida del LDLc por el método directo homogéneo y estimado por la fórmula de Friedewald. Principal medida de resultados. Concentración sérica del LDLc. Resultados. La fórmula de Friedewald y la nueva ecuación infraestimaron el LDLc, obteniéndose sesgos de 14,01 mg/dL y 5,52 mg/dL, respectivamente, con respecto al método directo. Los errores sistemáticos en los tres niveles de decisión clínica para el LDLc resultaron ser mayores para la fórmula de Friedewald (12,6%, 12,0% y 11,7%) comparados a la nueva ecuación (4,2%, 5,7% y 6,7%). El factor de corrección de sesgo, que valora la exactitud, resultó ser más alto y más cerca de la línea de perfecta concordancia para la nueva ecuación, en toda la muestra y cuando esta se estratificó por niveles de triglicéridos. Conclusiones. La nueva ecuación ofrece una mayor exactitud y bajo error analítico comparada a la fórmula de Friedewald para estimar el LDLc, en los tres niveles de decisión clínica y en sueros con diferentes valores de triglicéridos.

Introduction: Various studies have shown a strong association between the increase in cholesterol low density lipoproteins (LDLc) serum concentration and the incidence of coronary heart disease. Objectives: To derive and validate the performance of a new equation to estimate the LDLc. Design: Observational and descriptive study. Institution: Hospital Edgardo Rebagliati Martins, Lima, Peru. Material: 4 644 lipid profile reports taken from the files of the hospital's central laboratory, belonging to subjects of bot. sexes, between 18 and 75 years old. Interventions: The sample consisted of 4 644 lipid profile reports obtained from the files of the hospital's central laboratory, and belonged to subjects of both sexes aged 18-75 years. It was divided into two groups: the first group was represented by 2 136 reports, and was used to derive the equation to estimate the LDLc by using multiple regression analysis; the second group comprised 2 508 reports that served to validate the performance of the new equation compared with the LDLc measurement by the homogeneous direct method and estimated by the Friedewald formula. Main outcome measure: LDLc serum concentration. Results: The Friedewald formula and the new equation underestimated the LDLc with a shortfall of 14.01 mg/dL and 5.52 mg/dL, respectively, with regard to the direct method. Systematic errors in the three clinical decision levels for LDL cholesterol were found to be higher for the Friedewald formula (12.6%, 12.0 %, and 11.7%) compared to the new equation (4.2%, 5.7% and 6.7%). The bias correction factor, which assessed accuracy, turned out to be higher and closer to the line of perfect match for the new equation, both in the whole sample and when the entire sample was stratified by levels of triglycerides. Conclusions: The new equation provided greater accuracy and lower analytical error compared to the Friedewald formula to estimate the LDL cholesterol in the three clinical decision levels and with different values of serum triglycerides.

Terapia con anticuerpos monoclonales en Cardiología y Medicina Interna / Monoclonal antibody therapy in Cardiology and Internal Medicine

La terapia biológica basada en anticuerpos monoclonales, constituyen una nueva herramienta terapéutica, que de la mano del desarrollo de la biología molecular permiten intervenir puntos claves en la etiopatogenia de la enfermedad, permitiendo una terapia personalizada. Se han desarrollado nuevos anticuerpos monoclonales que intervienen en las enfermedades cardiovasculares, por lo que el entendimiento de los principios terapéuticos, los tipos y el mecanismo de acción de estos fármacos es esencial para un uso adecuado. En este artículo se discutirá el perfil de los anticuerpos monoclonales en la enfermedad cardiovascular, como los inhibidores de la PCSK-9 y el antídoto del Dabigatran, pasando por las moléculas ya conocidas como el abciximab, el antídoto de la digoxina y la terapia inmunomoduladora en el trasplante cardiaco. Del mismo modo, se evalúa una posible aplicación de los anticuerpos monoclonales usados en reumatología que podrían tener un papel importante en el manejo de las enfermedades cardiovasculares.

The monoclonal antibodies (mAb) constitute a new therapeutic tool in cardiovascular medicine, based in the development of the molecular biology in this area. The understanding of therapeutic principles, types and mechanism of action of these drugs is essential for proper use and management of adverse reactions. We discuss the profile of the PCSK-9 inhibitors, the Dabigatran antidote, the abciximab, the digoxin antidote, the therapy in heart transplantation, and a possible cardiovascular use of monoclonal antibodies used in rheumatology.

Sperm characteristics following freezing in extenders supplemented with whole egg yolk and different concentrations of low-density lipoproteins in the collared peccary (Pecari tajacu).

The aim of the current study was to compare sperm quality characteristics of the collared peccary (Pecari tajacu) following freezing in extenders supplemented with whole egg yolk and different concentrations of low-density lipoproteins (LDL). Semen from 11 adult males was obtained by electroejaculation and evaluated for sperm motility, vigor, morphology as well as membrane integrity analyzed by the hypo-osmotic swelling (HOS) test and a fluorescent staining. Moreover, the semen was diluted in a Tris-based extender containing 20% egg yolk (control group) or 5, 10 or 20% LDL (treatment groups). The semen samples were frozen in liquid nitrogen and thawed in a water bath for 60s at 37°C. The treatments did not affect (p>0.05) sperm vigor, morphology or membrane integrity analyzed by the HOS test. However, post-thaw sperm motility was significantly higher (p<0.05) in the extender supplemented with 20% LDL (36.4 ± 5.3%) compared with the egg yolk extender and extender supplemented with 10% LDL. Furthermore, the percentage of membrane-intact frozen-thawed spermatozoa analyzed by the fluorescent staining was significantly higher (p<0.05) in the extender supplemented with 20% LDL (27.4 ± 6.5%) than in the other groups. In conclusion, 20% LDL can be used to substitute the whole egg yolk as a cryoprotective additive for freezing semen of the collared peccary.

ADIPOQ single nucleotide polymorphism: Association with adiponectin and lipoproteins levels restricted to men.

Adiponectin is an adipokine inversely correlated with obesity, which has beneficial effect on insulin resistance and lipid metabolism. Considering its potential as a therapeutic target in the metabolic disorder contexts, and in order to add knowledge in the area, our study evaluated the ADIPOQ 276G > T polymorphism effect on adiponectin levels, and on lipoproteins of clinical interest in a population sample composed of 211 healthy individuals. Significant effects were observed only among men: the carriers of heterozygous genotype (GT) showed high levels of adiponectin (p = 0.018), while the rare homozygous genotype (TT) gave its carriers a negative phenotype, represented by higher levels of low density lipoprotein cholesterol (LDL-C) (p = 0.004 and p = 0.005) and total cholesterol (TC) (p = 0.010 and p = 0.005) compared to carriers of other genotypes (GG and GT respectively), the independent effect of SNP on LDL-C and TC levels was confirmed by multiple regression analysis (p = 0.008 and p = 0.044). We found no evidence of correlation between circulating adiponectin levels and biochemical markers, which suggests, therefore, an SNP 276G > T independent effect on adiponectin levels and on lipoprotein metabolism in men enrolled in this study.

Interaction between SCO-spondin and low density lipoproteins from embryonic cerebrospinal fluid modulates their roles in early neurogenesis.

During early stages of development, encephalic vesicles are composed by a layer of neuroepithelial cells surrounding a central cavity filled with embryonic cerebrospinal fluid (eCSF). This fluid contains several morphogens that regulate proliferation and differentiation of neuroepithelial cells. One of these neurogenic factors is SCO-spondin, a giant protein secreted to the eCSF from early stages of development. Inhibition of this protein in vivo or in vitro drastically decreases the neurodifferentiation process. Other important neurogenic factors of the eCSF are low density lipoproteins (LDL), the depletion of which generates a 60% decrease in mesencephalic explant neurodifferentiation. The presence of several LDL receptor class A (LDLrA) domains (responsible for LDL binding in other proteins) in the SCO-spondin sequence suggests a possible interaction between both molecules. This possibility was analyzed using three different experimental approaches: (1) Bioinformatics analyses of the SCO-spondin region, that contains eight LDLrA domains in tandem, and of comparisons with the LDL receptor consensus sequence; (2) Analysis of the physical interactions of both molecules through immunohistochemical colocalization in embryonic chick brains and through the immunoprecipitation of LDL with anti-SCO-spondin antibodies; and (3) Analysis of functional interactions during the neurodifferentiation process when these molecules were added to a culture medium of mesencephalic explants. The results revealed that LDL and SCO-spondin interact to form a complex that diminishes the neurogenic capacities that both molecules have separately. Our work suggests that the eCSF is an active signaling center with a complex regulation system that allows for correct brain development.

Crioprotetor para sêmen de carneiro a base de plasma de gema mantém membrana acrossomal intacta após a descongelação / Ram semen cryoprotector based on egg yolk plasma maintain the viability of acrosomal membrane

O presente estudo teve como objetivo avaliar a capacidade crioprotetora das lipoproteínas de baixa densidade (LDL) presentes no plasma de gema de ovo, adicionado ao trihidroxiaminometano (TRIS) para congelar sêmen ovino. Trinta e seis ejaculados foram coletados para formar 12 "pool". Cada alíquota de sêmen foi diluída em TRIS-gema de ovo (TRISG) ou TRIS- plasma de gema de ovo (TRISP) antes de congelar o sêmen. Para a obtenção do plasma da gema de ovo, foi utilizado o método de ultracentrifugação. Após o descongelamento, não houve diferença entre os dois extensores em relação aos parâmetros seminais (motilidade, viabilidade, membrana acrossômica e plasma). No entanto, no Teste de Termo Resistência Lenta (TTRL - 4h/38°C), o sêmen congelado com TRISP resultou no aumento do número de espermatozoides com acrossoma intacto (P<0,032). Conclui-se que o diluente TRISP é uma alternativa para criopreservação do sêmen de carneiros, pois permite uma melhora da característica seminal em relação ao diluente TRIS gema, mas sem a necessidade do processo de purificação das LDL.

The present study aimed to evaluate the cryoprotectant low-density lipoprotein (LDL) present in the plasma of egg yolk added to the extender trihidroxiaminometano (TRIS) for freezing ram semen. Thirty-six ejaculates were collected to form 12 pool. Each aliquot of semen was diluted in TRIS-egg yolk (TRISG) or TRIS-egg yolk plasma (TRISP) before freezing the semen. The plasma of egg yolk was obtained by ultracentrifugation. After thawing, no difference was detected between the two extenders in relation to seminal parameters (motility, viability, plasma membrane and acrosome). However, in the thermal resistance slow test (4h in a water bath at 38°C), the semen frozen with TRISP resulted in higher number of sperm with intact acrosome than those with TRISG (P<0.032). It was concluded that the TRISP extender is an alternative for cryopreservation of ram semen, once it improves the semen characteristics in comparison to TRISG, avoiding the purification process of LDL.

Crioprotetor para sêmen de carneiro a base de plasma de gema mantém membrana acrossomal intacta após a descongelação / Ram semen cryoprotector based on egg yolk plasma maintain the viability of acrosomal membrane

O presente estudo teve como objetivo avaliar a capacidade crioprotetora das lipoproteínas de baixa densidade (LDL) presentes no plasma de gema de ovo, adicionado ao trihidroxiaminometano (TRIS) para congelar sêmen ovino. Trinta e seis ejaculados foram coletados para formar 12 "pool". Cada alíquota de sêmen foi diluída em TRIS-gema de ovo (TRISG) ou TRIS- plasma de gema de ovo (TRISP) antes de congelar o sêmen. Para a obtenção do plasma da gema de ovo, foi utilizado o método de ultracentrifugação. Após o descongelamento, não houve diferença entre os dois extensores em relação aos parâmetros seminais (motilidade, viabilidade, membrana acrossômica e plasma). No entanto, no Teste de Termo Resistência Lenta (TTRL - 4h/38°C), o sêmen congelado com TRISP resultou no aumento do número de espermatozoides com acrossoma intacto (P 0,032). Conclui-se que o diluente TRISP é uma alternativa para criopreservação do sêmen de carneiros, pois permite uma melhora da característica seminal em relação ao diluente TRIS gema, mas sem a necessidade do processo de purificação das LDL.(AU)

The present study aimed to evaluate the cryoprotectant low-density lipoprotein (LDL) present in the plasma of egg yolk added to the extender trihidroxiaminometano (TRIS) for freezing ram semen. Thirty-six ejaculates were collected to form 12 pool. Each aliquot of semen was diluted in TRIS-egg yolk (TRISG) or TRIS-egg yolk plasma (TRISP) before freezing the semen. The plasma of egg yolk was obtained by ultracentrifugation. After thawing, no difference was detected between the two extenders in relation to seminal parameters (motility, viability, plasma membrane and acrosome). However, in the thermal resistance slow test (4h in a water bath at 38°C), the semen frozen with TRISP resulted in higher number of sperm with intact acrosome than those with TRISG (P 0.032). It was concluded that the TRISP extender is an alternative for cryopreservation of ram semen, once it improves the semen characteristics in comparison to TRISG, avoiding the purification process of LDL.

Low density lipoproteins added to an extender frozen or lyophilized are evenly efficient in cryoprotecting ovine sperm cells than when 16% whole egg yolk was added / Lipoproteínas de baixa densidade em meio diluidor congelado ou liofilizado exerce o mesmo efeito crioprotetor aos espermatozoides ovinos que meio contendo 16% de gema de ovo

The aim of this study was to test different concentrations of low density lipoprotein (LDL) in replacement of whole egg yolk in extenders preserved in the aqueous or lyophilized form, for ram sperm cryopreservation using two cooling curves (-40C/min from 5 to 140C and nitrogen vapor). One ejaculate from six Santa Inês rams was collected. Each ejaculate was divided into nine different diluents as follows: Tris-16% yolk (control), and Tris with 2, 4, 6 and 8% fresh LDL, and criopreserved in the aqueous or lyophilized form. The samples were diluted to a final concentration of 100 x 106 sperm/mL and filled into 0.25 ml straws. After thaw, sperm cells were evaluated for motility and sperm kinetics (CASA), and submitted to the hypoosmotic swelling test and the evaluation of the structural integrity of sperm membranes using fluorescent dyes (CFDA: PI), as well as sperm morphology and longevity. The experimental design was randomized blocks, and results were submitted to ANOVA and the averages were compared using the Scott-Knott test. There were no differences in progressive motility and functional and structural integrity of the membrane evaluated when different concentrations of aqueous or lyophilized low density lipoproteins or egg yolk were added to the extender (P>0.05). As for the velocity of sperm movement, the control medium had some kinetic scores similar to the extender containing LDL, both aqueous and lyophilized (P> 0.05). Results were similar between cooling curves. Therefore, we conclude that the media containing all concentrations of LDL, aqueous or lyophilized, were able to protect the ram sperm cells during the cryopreservation process, as whole egg yolk did.(AU)

O objetivo deste trabalho foi testar para criopreservação de sêmen ovino diferentes concentrações de lipoproteína de baixa densidade (LBD) em substituição à gema de ovo em meios diluidores, armazenados na forma aquosa e liofilizada, utilizando-se duas curvas de congelação (-40C/min de 5 à 140C ou vapor de nitrogênio). Os ejaculados de seis carneiros da raça Santa Inês foram fracionados e distribuídos em nove tratamentos, sendo o primeiro o meio controle (Tris-gema 16%) e os demais meios Tris contendo lipoproteínas de baixa densidade nas concentrações de 2, 4, 6 e 8% (v/v), criopreservados tanto na forma aquosa quanto liofilizada. As amostras foram diluídas para a concentração final de 100 x 106 espermatozoides/mL e envasadas em palhetas de 0,25 mL. Após a descongelação foram avaliadas a motilidade e cinética espermática (CASA), morfologia e longevidade espermáticas, além da integridade funcional (HOST) e estrutural (CFDA/IP) das membranas. O delineamento experimental foi blocos ao acaso e os resultados foram submetidos a ANOVA, sendo as médias comparadas pelo teste de Scott-Knott. Quanto aos parâmetros de motilidade progressiva e integridade funcional e estrutural da membrana, todos os tratamentos testados foram similares (P>0,05). Quanto às velocidades do movimento espermático, o meio controle obteve alguns valores similares aos meios contendo LBD, tanto na forma aquosa quanto liofilizada (P>0,05). Não houve diferenças entre curvas de congelação. Dessa forma, é possível concluir que os meios contendo todas as concentrações de LBD, aquosa ou liofilizada, foram igualmente capazes de proteger as células espermáticas de ovinos, durante o processo de criopreservação, tanto quanto o meio contendo gema de ovo total.(AU)

Low density lipoproteins added to an extender frozen or lyophilized are evenly efficient in cryoprotecting ovine sperm cells than when 16% whole egg yolk was added / Lipoproteínas de baixa densidade em meio diluidor congelado ou liofilizado exerce o mesmo efeito crioprotetor aos espermatozoides ovinos que meio contendo 16% de gema de ovo

The aim of this study was to test different concentrations of low density lipoprotein (LDL) in replacement of whole egg yolk in extenders preserved in the aqueous or lyophilized form, for ram sperm cryopreservation using two cooling curves (-40C/min from 5 to 140C and nitrogen vapor). One ejaculate from six Santa Inês rams was collected. Each ejaculate was divided into nine different diluents as follows: Tris-16% yolk (control), and Tris with 2, 4, 6 and 8% fresh LDL, and criopreserved in the aqueous or lyophilized form. The samples were diluted to a final concentration of 100 x 106 sperm/mL and filled into 0.25 ml straws. After thaw, sperm cells were evaluated for motility and sperm kinetics (CASA), and submitted to the hypoosmotic swelling test and the evaluation of the structural integrity of sperm membranes using fluorescent dyes (CFDA: PI), as well as sperm morphology and longevity. The experimental design was randomized blocks, and results were submitted to ANOVA and the averages were compared using the Scott-Knott test. There were no differences in progressive motility and functional and structural integrity of the membrane evaluated when different concentrations of aqueous or lyophilized low density lipoproteins or egg yolk were added to the extender (P>0.05). As for the velocity of sperm movement, the control medium had some kinetic scores similar to the extender containing LDL, both aqueous and lyophilized (P> 0.05). Results were similar between cooling curves. Therefore, we conclude that the media containing all concentrations of LDL, aqueous or lyophilized, were able to protect the ram sperm cells during the cryopreservation process, as whole egg yolk did.

O objetivo deste trabalho foi testar para criopreservação de sêmen ovino diferentes concentrações de lipoproteína de baixa densidade (LBD) em substituição à gema de ovo em meios diluidores, armazenados na forma aquosa e liofilizada, utilizando-se duas curvas de congelação (-40C/min de 5 à 140C ou vapor de nitrogênio). Os ejaculados de seis carneiros da raça Santa Inês foram fracionados e distribuídos em nove tratamentos, sendo o primeiro o meio controle (Tris-gema 16%) e os demais meios Tris contendo lipoproteínas de baixa densidade nas concentrações de 2, 4, 6 e 8% (v/v), criopreservados tanto na forma aquosa quanto liofilizada. As amostras foram diluídas para a concentração final de 100 x 106 espermatozoides/mL e envasadas em palhetas de 0,25 mL. Após a descongelação foram avaliadas a motilidade e cinética espermática (CASA), morfologia e longevidade espermáticas, além da integridade funcional (HOST) e estrutural (CFDA/IP) das membranas. O delineamento experimental foi blocos ao acaso e os resultados foram submetidos a ANOVA, sendo as médias comparadas pelo teste de Scott-Knott. Quanto aos parâmetros de motilidade progressiva e integridade funcional e estrutural da membrana, todos os tratamentos testados foram similares (P>0,05). Quanto às velocidades do movimento espermático, o meio controle obteve alguns valores similares aos meios contendo LBD, tanto na forma aquosa quanto liofilizada (P>0,05). Não houve diferenças entre curvas de congelação. Dessa forma, é possível concluir que os meios contendo todas as concentrações de LBD, aquosa ou liofilizada, foram igualmente capazes de proteger as células espermáticas de ovinos, durante o processo de criopreservação, tanto quanto o meio contendo gema de ovo total.

Sobrepeso y dislipidemias en adolescentes / Overweight and dyslipidemias in teenagers

INTRODUCCIÓN: actualmente hay consenso en que el proceso aterosclerótico se inicia en la infancia, y la dislipidemia es uno de los principales factores de riesgo aterogénicos que deben ser estudiados, así como la valoración nutricional para una adecuada prevención. OBJETIVO: identificar algunas señales de aterosclerosis tempranas como el sobrepeso y las dislipidemias en adolescentes. MÉTODOS: se realizó un estudio descriptivo transversal de 372 adolescentes de la Secundaria Básica "Protesta de Baraguá". Se hicieron mediciones de peso, talla, índice de masa corporal y circunferencia de la cintura. Se tomó muestra de sangre venosa con ayuno de 12 horas. Se midió el colesterol total, el colesterol unido a lipoproteína baja y alta densidad, y triglicéridos. En el análisis estadístico se realizaron prueba de comprobación de media entre variables de valoración nutricional y lipídicas entre sexos (prueba t), y se trabajó con una probabilidad de error menor de 0,05. RESULTADOS: la media del peso, talla y circunferencia de la cintura fueron mayores en el sexo masculino (p< 0,05). El exceso de peso fue 23,7 %, y a partir del percentil 90-97 hubo un 21,8 % de exceso de grasa abdominal. La media del colesterol total, lipoproteínas de alta y baja densidad y triglicéridos, fue similar en los diferentes sexos, sin relación significativa (p> 0,05). El 18,5 % presentó colesterol total limítrofe alto, el 26,6 % tenía triglicéridos limítrofe alto y 7,5 % alto, con predominio del sexo femenino. CONCLUSIONES: alrededor de la cuarta parte de los adolescentes tenían exceso de peso e incremento de la grasa abdominal, casi la cuarta parte tenía el colesterol total limítrofe y alto, y la alteración lipídica observada con mayor frecuencia fue la hipertrigliceridemia.

INTRODUCTION: there is a current consensus that the atherosclerotic process begins at childhood and that dyslipidemia is one of the atherogenic risk factors to be studied together with the nutritional assessment for the adequate prevention of atherosclerosis. OBJECTIVE: to identify some early signs of atherosclerosis such as overweight and dyslipidemias in teenagers. METHODS: a cross-sectional descriptive study of 372 teenagers from "Protesta de Baragua" junior high school. Weight, height, body mass index and waist circumference were measured. Blood samples were taken after 12 hour fasting. Total cholesterol, low and high density lipoprotein cholesterol and triglyceride were all measured. The statistical analysis included the t test among nutritional assessment and lipid variables between sexes and the error probability was lower than 0.05. RESULTS: weight, height and waist circumference means were higher in males (p< 0.05). Overweight was 23.7 % and from the 90-97th percentile, the excessive abdominal fat was 21.8 %. The mean of total cholesterol, high and low density lipoproteins and triglycerides was similar in both sexes, with no significant relation (p> 0.05). In this group, 18.5 % of adolescents presented with borderline high total cholesterol, 26.6 % showed borderline high triglyceride rate and 7.5 % had high cholesterol, being females predominant. CONCLUSIONS: one fourth of adolescents approximately exhibited overweight and increased abdominal fat; almost 25 % had reached borderline and high total cholesterol whereas the most observed lipid disorder was hypertrigliceridemia.