Baseline serum lipids and renal function in chronic kidney disease patients entering the LORD trial

OBJECTIVE: Previous studies investigating associations between serum lipids and renal disease have generally not taken into account dietary intake or physical activity both known to influence circulating lipids. Furthermore, inclusion of patients on HMG-CoA reductase inhibitors may also have influenced findings due to the pleiotropic effect of this medication. Therefore, the aim of this study is to determine the relationships between serum lipids and renal function in a group of patients not taking lipid-lowering medication and taking into account dietary intake and physical activity. METHODS: Data from 100 patients enrolled in the Lipid Lowering and Onset of Renal Disease (LORD) trial were used in this study. Patients were included with serum creatinine > 120 micromol/l, and excluded if they were taking lipid-lowering medication. Unadjusted and adjusted relationships were determined between fasting serum lipid concentrations (total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol/HDL ratio) and measures of renal function (estimated glomerular filtration rate (eGFR), creatinine clearance and serum creatinine) and urinary protein excretion. RESULTS: Significant (p < 0.05) negative unadjusted relationships were found between lipids (total cholesterol, LDL and HDL cholesterol) and serum creatinine. In support of these findings, logarithmically-transformed lipids (total cholesterol, LDL and HDL cholesterol) were significantly associated with eGFR and creatinine clearance although the effects were of a smaller magnitude. Adjustment for dietary saturated fat intake and physical activity did not substantially change these effects. CONCLUSION: These data do not support the premise that lipids are associated with renal dysfunction in patients with normocholesterolemia.     

Effect of hydroxycut intake on fasted and postprandial lipemia in rats

Hydroxycut, an herbal supplement not currently defined as a drug, is frequently sold over the counter to increase exercise performance, build muscles, and burn fat. The effects of 8 wk of hydroxycut-induced changes on blood lipid profile in rats fed with either regular or high-fat diet were evaluated. Regardless of fat content in the diet, the doses of hydroxycut used significantly decreased fasting serum concentrations of cholesterol, triacylglycerol (TAG), low-density lipoprotein (LDL) cholesterol, total apolipoprotein B (apo B), and LDL/high-density lipoprotein (HDL) cholesterol ratio. A significant increase in serum blood glucose level was observed with hydroxycut intake in the presence of a high-fat diet. No hydroxycut-related changes in serum activities of serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate dehydrogenase (SGPT), lactate dehydrogenase (LDH), and creatinine phosphokinase (CPK) enzymes were noted, indicating no liver damage occurred. A decrease in liver fat content was observed with hydroxycut intake. The drug did not affect the number and composition of secreted very-low-density lipoprotein (VLDL) particles except for a decrease in VLDL TAG when the fat content in the diet was high. Hydroxycut reduced significantly LDL apo B and LDL TAG and cholesterol concentrations. Hydroxycut increased TAG and cholesterol excretion in feces. A single intragastric food load containing hydroxycut reduced significantly postprandial plasma TAG concentration in a dose-dependent manner. In conclusion, hydroxycut intake in recommended doses exerts a beneficial impact on atherosclerosis, an effect attributed to improved clearance and metabolism of lipoprotein particles, and to a lesser extent to an increased excretion of TAG and cholesterol in the feces. More studies are needed to ensure the safety of long-term use of hydroxycut.     

EFFECT OF DIETARY FAT REDUCTION AND INCREASED AEROBIC EXERCISE ON CARDIOVASCULAR RISK FACTORS

1. The combined effect of dietary fat reduction and increased aerobic exercise on coronary heart disease (CHD) risk factors was investigated in healthy, normolipidaemic, normotensive, sedentary individuals. 2. After a baseline period of 2 weeks, 21 subjects were randomly allocated to one of two intervention groups (low fat exercise (LFEX) or low fat control (LFQ) for 8 weeks. Both groups were counselled to reduce their dietary fat intake to 20–25% energy from fat. The LFEX group was also required to commence an aerobic exercise programme (4X45 min per week). 3. In both groups, the falls in total cholesterol seen at week 4 were not maintained at the end of the study; however, the LFEX group maintained a fall in low-density lipoprotein (LDL) o. 0.21±0.11 mmol/L. At the end of the study, the LFC group experienced a fall in high-density lipoprotein (HDL)-cholesterol of 0.16±0.05 mmol/L, due to a 0.19±0.07 mmol/L fall in the HDL2 subfraction. The LFEX group experienced no change in HDL (?0.09 ±0.06 mmol/L) or HDL₂ (?0.09 ±0.05 mmol/L). 4. At the end of the study the LFEX and LFC groups experienced a 7±3 and 5±lmmHg fall in systolic blood pressure, respectively, while the LFEX group also observed a 4±2 mmHg fall in diastolic bloo. pressure. 5. The benefits of a low-fat diet combined with aerobic exercise include a reduction in LDL and blood pressure, while maintaining HDL through th. HDL₂ subfraction.     

Serum lipid response to introducing ghee as a partial replacement for mustard oil in the diet of healthy young Indians

Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.     

Dietary fiber for reducing blood cholesterol

Soluble dietary fiber, including psyllium, has been shown to have mild to modest cholesterol lowering properties. Psyllium hydrophilic mucilloid (Metamucil, Procter and Gamble, Cincinnati, OH), a bulk laxative, when used as a dietary supplement in combination with a low fat diet, can lower total serum cholesterol and low-density lipoprotein (LDL) cholesterol, and raise high-density lipoprotein (HDL) cholesterol in hypercholesterolemic patients. The cholesterol lowering effects of psyllium are much less evident than those observed with cholestyramine and the HMG-CoA reductase inhibitors. The mechanism for the cholesterol lowering effect of psyllium is not known. The substance is well tolerated with long-term use.     

The addition of oatbran to a low fat diet has no effect on lipid values in hypercholesterolaemic subjects.

AIMS: to assess the hypocholesterolaemic effect of adding 50 g of oatbran to the diet of hypercholesterolaemic subjects already prescribed a diet with less than 30% of energy from fat. METHODS: twenty-nine volunteers aged 21-67 years with total serum cholesterol levels 5.59-8.5 mmol/L prescribed a diet containing less than 30% of energy intake as fat, and with a body mass index between 19.8 and 29.3, were enrolled in a crossover study to assess the effect of the addition to the diet of 50 g daily of oatbran. After six weeks of an oat-free control diet, subjects were randomised to eat 50 g daily of oatbran or to continue on the oat-free diet. Six weeks later the subjects crossed to the alternative diet for a further six week period. Lipid levels were assessed in weeks five and six of each study period. RESULTS: twenty-four subjects completed the study consuming 51.7 (SD 15.5) g of oatbran daily during the treatment phase. No significant difference was seen between the oatbran and control diet periods in body mass index, energy or fat intake, or in total cholesterol, LDL and HDL fractions, apolipoprotein A1 and B levels, or triglyceride levels. Considerable variation was observed between the paired lipid results. CONCLUSIONS: ingestion of 50 g of oatbran daily by hypercholesterolaemic subjects on a low fat diet showed no influence on serum lipid levels. The importance of using at least duplicate samples in assessing changes in lipid values is emphasised.     

板蓝根活性组分预防肥胖作用及机制研究

目的探讨板蓝根活性组分(ACIR)的预防肥胖作用及其可能的作用机制。方法高脂饮食诱导小鼠肥胖的同时给予不同剂量ACIR,观察小鼠体质量、进食量、脂肪重量、脂肪细胞形态、肝脏重量及血脂变化,并进行小鼠负重游泳实验;体外培养诱导分化3T3-L1前脂肪细胞,观察ACIR对脂肪细胞增殖、分化和脂滴形成的影响。结果 ACIR能显著降低小鼠体质量、脂肪系数及肝脏重量,使脂肪细胞变小;改善小鼠进食量,明显延长小鼠负重游泳时间,使血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)含量降低,但高密度脂蛋白(HDL)无明显变化;抑制前脂肪细胞增殖和分化,减少脂滴形成。结论 ACIR具有预防肥胖和降血脂作用,其可能的机制是抑制前脂肪细胞增殖和分化。     

车前子对高脂血症大鼠血脂水平及抗氧化作用的影响

目的:研究车前子对高脂血症大鼠血脂水平及抗氧化作用的影响.方法:用高脂饲料喂饲健康成年SD大鼠3个月,诱发高脂血症的同时,分别加入不同剂量的车前子,观察其对血脂及抗氧化作用的影响.结果:车前子可明显降低大鼠血清胆固醇(TC)、三酰甘油(TG)和脂质过氧化物(MDA)含量,提高高密度脂蛋白胆固醇(HDL-C)及HDL-C/TC比值,并且还能提高超氧化物歧化酶(SOD)、过氧化氢酶(CAT)活性及一氧化氮(NO)含量.结论:车前子能有效的降低高脂血症大鼠血脂水平,提高抗氧化能力.     

The effects of an omega-3 ethyl ester concentrate on blood lipid concentrations in patients with hyperlipidaemia

The objective of this study was to investigate the effects and tolerability of an omega-3 ethyl ester concentrate (Omacor(trade mark)) on serum lipid concentrations in patients with hyperlipidaemia. A multicentre, double-blind, randomised, placebo-controlled trial was performed in the hospital and general practice setting. 84 patients with hyperlipidaemia were given a therapeutic lipid-lowering diet for 10 weeks. Of these, 55 patients were randomised to a 12-week treatment period. 47 patients completed the study and two patients withdrew because of adverse events. Randomised patients received omega-3 ethyl ester concentrate or corn oil (placebo), both administered at a dose of 2g twice daily in soft gelatin capsules. Main outcome measures included changes in eicosapentaenoic acid (EPA)/ docosahexaenoic acid (DHA) content of serum phospholipids, total serum triglycerides, total serum cholesterol, and high density lipoprotein (HDL) cholesterol between baseline (week 10) and the end of treatment (week 22). After 12 weeks of treatment, patients receiving the omega-3 ethyl ester concentrate showed a significant increase in the EPA/DHA content of serum phospholipids (p < 0.0001). No significant changes in serum phospholipids were observed in the patients given placebo. A mean [standard deviation (SD)] reduction in serum triglyceride of 28.3 (19.1)% (p = 0.0001) occurred in patients given the omega-3 ethyl ester concentrate. Patients receiving corn oil showed a nonsignificant mean (SD) increase in serum triglyceride of 9.1 (24.8)%. Therefore, a difference between the groups of 37.4% in favour of active treatment was found (p < 0.0001). Total serum cholesterol did not change significantly in either treatment group. Mean (SD) HDL cholesterol concentrations showed an increase of 0.9 (21.6)% in patients receiving omega-3 ethyl ester concentrate and 3.6 (24.3)% in the corn-oil group; however, neither increase was significant. In conclusion, omega-3 ethyl ester concentrate, 4 g/day, produced a significant reduction in mean serum triglyceride concentration in patients with hyperlipidaemia and was well tolerated.     

High-carbohydrate diets and insulin-dependent diabetics.

A high-carbohydrate-(HC)-modified fat diet was compared with a standard low-carbohydrate (LC) diabetic diet in 11 insulin-dependent diabetics. Basal and preprandial plasma glucose concentrations were appreciably lower when the patients received the HC diet derived chiefly from readily available cereal and vegetable sources (mean (+/- SE of mean) basal concentrations 6.7 +/- 1.2 mmol/l (121 +/- 22 mg/100 ml) with the LC diet and 4.3 +/- 0.7 mmol/l (77 +/- 13 mg/100 ml) with the HC diet; mean preprandial concentrations 11.1 +/- 1.2 mmol/l (200 +/- 22 mg/100 ml) LC diet and 8.9 +/- 1.3 mmol/l (160 +/- 23 mg/100 ml) HC diet). total and low-density lipoprotein cholesterol concentrations were lower when patients took the HC diet (mean 4.4 +/- 0.2 and 2.4 +/- 0.2 mmol/l (189 +/- 8 and 124 +/- 8 mg/100 ml) respectively), and the ratio of high-density lipoprotein cholesterol to total cholesterol tended to rise. The average percentage of glycosylated haemoglobin did not differ between the two diets. Thus several measures of carbohydrate and lipid metabolism appear to be more satisfactory when patients receive a HC diet, which is an acceptable alternative to that still recommended to most insulin-requiring patients.     

Protective potentials of wild rice (Zizania latifolia (Griseb) Turcz) against obesity and lipotoxicity induced by a high-fat/cholesterol diet in rats

The study evaluates the protective potentials of wild rice against obesity and lipotoxicity induced by a high-fat/cholesterol diet in rats. In addition to the rats of low-fat diet group, others animals were exposed to a high-fat/cholesterol diet condition for 8 weeks. The city diet (CD) is based on the diet consumed by urban residents in modern China, which is rich in fat/cholesterol and high in carbohydrates from white rice and processed wheat starch. The chief source of dietary carbohydrates of wild rice diet (WRD) is from Chinese wild rice and other compositions are the same with CD. Rats fed CD showed elevated body and liver organ weights, lipid profiles, free fatty acids (FFA) and leptin comparable with rats fed high-fat/cholesterol diet (HFD) known to induce obesity and hyperlipidaemia in this species. However, rats consuming WRD suppressed the increase of lipid droplets accumulation, FFA, and leptin, and the decrease of lipoprotein lipase and adipose triglyceride lipase. Meanwhile, WRD prevented high-fat/cholesterol diet-induced elevation in protein expression of sterol-regulatory element binding protein-1c, and gene expression of fatty acid synthase and acetyl-CoA carboxylase. These findings indicate that wild rice as a natural food has the potentials of preventing obesity and liver lipotoxicity induced by a high-fat/cholesterol diet in rats.     

Hypolipidemic and antiatherogenesis effect of culinary-medicinal pink oyster mushroom, Pleurotus salmoneostramineus L. Vass. (higher Basidiomycetes), in hypercholesterolemic rats

The present study was conducted to investigate dietary supplementation of Pleurotus salmoneostramineus fruiting bodies on biochemical and histological effects in hyper- and normocholesterolemic rats. Six-week-old female Sprague-Dawley albino rats were divided into three groups of 10 rats each. Feeding of diet containing a 5% powder of the fruiting bodies of P. salmoneostramineus in hypercholesterolemic rats reduced plasma total cholesterol, triglyceride, low-density lipoprotein, total lipid, phospholipids, and LDL/HDL ratio by 22.55, 51.38, 69.23, 29.67, 16.61, and 65.31%, respectively. The mushroom also significantly reduced body weight in hypercholesterolemic rats. Moreover, it had no adverse effects on plasma albumin, total bilirubin, direct bilirubin, creatinine, blood urea nitrogen, uric acid, glucose, total protein, calcium, sodium, potassium, chloride, inorganic phosphate, magnesium, and enzyme profiles. Feeding mushroom increased total lipid and cholesterol excretion in feces. The plasma lipoprotein fraction, separated by agarose gel electrophoresis, indicated that P. salmoneostramineus significantly reduced plasma β and pre-β-lipoprotein, while it increased α-lipoprotein. A histological study of liver tissues by conventional hematoxylin-eosin and oil red O staining showed normal in mushroom feed hypercholesterolemic rat. This study suggests that the P. salmoneostramineus diet supplement provided health benefits by acting on the atherogenic lipid profile in hypercholesterolemic rats.     

Metrnl increases blood HDL-cholesterol and decreases blood triglyceride

OBJECTIVE Dyslipidemias are risk factors for both cardiovascular diseases and type 2 diabetes.Many adipose-derived proteins/adipokines participate in modulation of blood lipids. As a new identified adipokine,metrnlin adipose is involved in regulation of blood triglyceride, suggesting metrnl may play extensive roles in regulation of blood lipid. However, the exact effects and the underling mechanisms of Metrnl on regulation of blood lipid remain unexplored. METHODS Metrnl global knockout mice were generated and fed with normal chow diet or high fat diet. Major clinical lipid parameters including blood triglyceride(TG), total cholesterol(TC), high density lipoprotein(HDL) cholesterol, low density lipoprotein(LDL) cholesterol, and non-esterified fatty acid(NEFA)were detected with automatic biochemistry analyzer. Further,intestine and liver specific knockout mice were generated and the major clinical lipid parameters were detected to clarify which tissue contributes to metrnl regulated alterations of clinical lipid parameters. RESULTS Global knockout of metrnl had no effects on clinical parameters under normal chow diet, but increased blood triglyceride by 14%,which was consistent with our previous findings in metrnl adipose specific knockout mice, and decreased total cholesterol by 16% and HDL-cholesterol by 24% under high fat diet. Intestine specific knockout of metrnl failed to alter any of the clinical lipid parameters under both normal chow diet and high fat diet. Notably, liver specific knockout of metrnl downregulated HDL-cholesterol by 24%, TC by20% and LDL-cholesterol by 16% without alterations of blood TG and NEFA under high fat diet. CONCLUSION Global deficiency of metrnl downregulates blood HDLcholesterol and upregulates blood TG, and liver participates in the former and adipose tissue the latter.     

Effects of a novel hydrophilic phytostanol analog on plasma lipid concentrations in gerbils.

This study was designed to determine the effects of a novel hydrophilic phytostanol analog, FM-VP4, on total plasma cholesterol, total plasma triglyceride, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol concentrations after acute oral administration to gerbils. Gerbils were administered a standard gerbil diet for 4 continuous weeks, and daily water and food intake was monitored and replaced. The diet contained either no FM-VP4 (control) or FM-VP4 at the following concentrations: 0.25, 0.50, 1.0, or 2.0% w/w; six gerbils were fed each diet formulation. After 4 weeks of receiving a single diet formulation, blood was obtained from each gerbil by cardiac puncture and the animals were sacrificed humanely. Plasma obtained from this blood was analyzed for total cholesterol, total triglyceride, and HDL cholesterol levels by standard enzymatic and precipitation techniques. LDL cholesterol levels were calculated using the Friedewald equation. Administration of dietary FM-VP4 resulted in significant decreases in total plasma cholesterol and LDL cholesterol concentrations compared with controls. Dietary FM-VP4 at concentrations of 1% and 2% (w/w) decreased total plasma cholesterol by 3.4 mmol/L compared with controls. This decrease was entirely due to the loss of cholesterol from the LDL pool because LDL cholesterol was decreased by 3.3 and 3.2 mmol/L after 1% and 2% (w/w) FM-VP4, respectively. There were no significant changes in plasma triglyceride or HDL cholesterol concentrations after the administration of FM-VP4. Animals administered 1% or 2% (w/w) FM-VP4 also had significantly lower body weight after 4 weeks of treatment compared with the other groups. However, no unusual behavior was observed in these animals. No major differences in daily water or food intake were observed throughout the study. These findings indicate that FM-VP4 decreases total and LDL cholesterol concentrations.     

饮食干预对肥胖型2型糖尿病患者血脂紊乱的影响

目的了解饮食干预对肥胖型2型糖尿病患者血脂紊乱的影响，以提供更合理的营养治疗方法。方法选择2006年5月至2008年3月在内分泌科门诊就诊的肥胖型2型糖尿病患者80例，按患者就诊顺序编号按1：1比例随机入组，治疗组、对照组各40例。治疗组食用依据由营养师制订食谱的要求制作的称重膳食，对照组自己控制饮食。观察2组患者膳食中热能和部分营养素的摄入情况比较以及治疗前后两组患者血糖和血脂的变化。结果对照组热能、三大产热营养素及胆固醇的摄入明显较高，而膳食纤维的摄入量明显较低，而脂肪的摄入量明显较高，占总热能的36％；脂肪来源中饱和脂肪酸、多不饱和脂肪酸及单不饱和脂肪酸所占总能量的比例分别为14．2％、13．1％和8．7％，与治疗组同项比较，差异均有统计学意义（P〈0．01）。治疗组在治疗后空腹血糖（FBG）、体重指数（BMI）、总胆固醇（TC）、三酰甘油（TG）及低密度脂蛋白（LDL）均有明显下降，高密度脂蛋白（HDL）显著增高，差异均有统计学意义（P〈0．05或P〈0．01）；而对照组在治疗后FBG、BMI、TC、TG、LDL及HDL的变化均不明显（P〉0．05）。结论营养干预能显著地降低患者的体质量，改善患者的脂代谢紊乱。     

Dietary cholesterol, atherosclerosis and coronary heart disease

As early as at the beginning of the last century, animal studies have pointed to a causal role of dietary cholesterol in atherogenesis. In humans, however, most observational studies have not provided convincing evidence for an impact of cholesterol intake on coronary heart disease (CHD). Rather, these studies have consistently established a close association between a certain eating pattern and the risk of CHD. This eating pattern has usually been characterized by a high intake of total fat, saturated fatty acids (SFA) and cholesterol, and a low intake of fiber and polyunsaturated fatty acids (PUFA). In typical western diets the amounts of total fat, SFA, and cholesterol are strongly correlated with each other, while they are negatively related to the intake of fiber and PUFA. Thus, it has not been possible to determine whether the association between the above mentioned eating pattern and CHD is due to the high consumption of SFA, cholesterol, both, or an insufficient supply of one or more protective factors such as fiber or PUFA. As the consumption of eggs leads to a high intake of cholesterol without necessarily resulting in high uptake levels of SFA and total fat, several groups have tried to elucidate the effect of cholesterol by investigating the relationship between the consumption of eggs and the development of CHD. Based on these studies, the association between dietary cholesterol and CHD risk is, if anything, minor in nature. This is consistent with the finding that an increase in dietary cholesterol intake results in only a minimal increase in the total/high-density lipoprotein cholesterol ratio. Taken together these studies suggest that the association between dietary cholesterol and CHD is small, as most subjects can effectively adapt to higher levels of cholesterol intake. Nevertheless, lowering dietary cholesterol content might reduce the risk of CHD considerably in a subgroup of individuals who are highly responsive to changes in cholesterol intake.     

Long-term feeding of red algae (Gelidium amansii) ameliorates glucose and lipid metabolism in a high fructose diet-impaired glucose tolerance rat model

This study was designed to investigate the effect of Gelidium amansii (GA) on carbohydrate and lipid metabolism in rats with high fructose (HF) diet (57.1% w/w). Five-week-old male Sprague-Dawley rats were fed a HF diet to induce glucose intolerance and hyperlipidemia. The experiment was divided into three groups: (1) control diet group (Con); (2) HF diet group (HF); and (3) HF with GA diet group (HF + 5% GA). The rats were fed the experimental diets and drinking water ad libitum for 23 weeks. The results showed that GA significantly decreased retroperitoneal fat mass weight of HF diet-fed rats. Supplementation of GA caused a decrease in plasma glucose, insulin, tumor necrosis factor-α, and leptin. HF diet increased hepatic lipid content. However, intake of GA reduced the accumulation of hepatic lipids including total cholesterol (TC) and triglyceride contents. GA elevated the excretion of fecal lipids and bile acid in HF diet-fed rats. Furthermore, GA significantly decreased plasma TC, triglyceride, low density lipoprotein plus very low density lipoprotein cholesterol, and TC/high density lipoprotein cholesterol ratio in HF diet-fed rats. HF diet induced an in plasma glucose and an impaired glucose tolerance, but GA supplementation decreased homeostasis model assessment equation-insulin resistance and improved impairment of glucose tolerance. Taken together, these results indicate that supplementation of GA can improve the impairment of glucose and lipid metabolism in an HF diet-fed rat model.     

间歇性禁食对肥胖患者的血糖血脂代谢的影响

目的观察间歇性禁食(IF)对肥胖患者的测量学指标及血糖血脂代谢的影响。方法23例肥胖患者,根据每例患者的体重、体力活动程度计算每日能量需要量,并估算间歇性禁食日的能量摄入量,根据禁食日的能量摄入量设计三餐食谱,每周不连续的2 d为禁食日并依照食谱进食,其余5 d不限制能量摄入,患者均经过8周的间歇性禁食干预。观察患者禁食干预前后体格检查指标、血糖和血脂变化情况。结果禁食干预8周后,男、女患者体重、体质量指数(BMI)、体脂率、内脏脂肪等级、腰围、臀围、腰臀比、收缩压、舒张压与同性别基线值比较差异无统计学意义(P>0.05),但均有较明显的下降趋势。男性患者体重减少3.8 kg,女性患者体重减少2.8 kg;体脂率分别下降了1.3%和1.9%。收缩压和舒张压均有下降,收缩压降低更明显。禁食干预8周后,患者空腹血糖、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白-B(Apo-B)、载脂蛋白-A1(Apo-A1)与基线值比较差异无统计学意义(P>0.05),但空腹血糖、TG、Apo-B有下降趋势,TC、LDL-C、HDL-C、Apo-A1无明显趋势。结论间歇性禁食对肥胖患者具有减体重、体脂,促进血脂代谢改善的作用。通过进一步在超重、肥胖、高血压、高血脂患者中推广间歇性禁食干预,可以向广大居民传递正确、科学的营养常识和减重指导,具有深远的疾病预防关口前移的意义。     

Changes in lipid and lipoprotein levels and Achilles tendon diameters and indices in familial hypercholesterolaemic patients with tendinous xanthomatosis treated by diet and bezafibrate for 2 years

Thirteen young adult patients suffering from heterozygotic familial hypercholesterolaemia with tendinous xanthomatosis, previously treated with a suitable special diet, were studied to assess the effect of bezafibrate, given for 2 years at a dose of 800 mg/day, on plasma lipid and lipoprotein levels and on changes in size of the Achilles tendon xanthomas. Measurements were made before and at intervals during treatment, the tendinous xanthomas being measured by an echographic procedure to give data on antero-posterior and lateral diameters, thus enabling an Achilles tendon index to be defined. The results confirm the hypolipidaemic activity of bezafibrate, changes in the levels of total cholesterol, triglycerides, lipids and lipoproteins (LDL, VLDL and HDL) being similar in direction and magnitude to those reported previously. A significant regression in the size of the Achilles tendon xanthomas was observed in 11 of the 13 patients, and the regression in the Achilles tendon index correlated significantly with a favourable change in the ratio HDL/LDL + VLDL. It is suggested that, as a result of this objective observation, a favourable effect of bezafibrate treatment would possibly be seen on the anatomical atheromatous lesions which are usual in this type of hyperlipidaemia.