Carbamazepine-induced increases in total serum cholesterol: clinical and theoretical implications.

To assess the effect of carbamazepine (CBZ) upon total serum cholesterol, we examined 38 inpatients with affective illness and one with multiple personality disorder who received a course of CBZ monotherapy. CBZ therapy yielded significant increases in total serum cholesterol that became evident during the second week of therapy, persisted throughout therapy, and reversed in the first few weeks after discontinuation of therapy. CBZ-induced increases in total cholesterol appeared independent of initial mood state, diagnostic subtype, baseline cholesterol or thyroid indices; CBZ levels, doses, and level-to-dose ratios; and the degree of change in mood and thyroid indices. CBZ induction of enzymes mediating cholesterol synthesis is a possible mechanism of the increase in total cholesterol observed with CBZ therapy. Although preclinical studies suggest possible influence of cholesterol on neurotransmitter regulation and behavior, clinical studies have yielded conflicting data. There are insufficient data to support a role for cholesterol in the anticonvulsant and psychotropic mechanisms of CBZ. The increase in total serum cholesterol seen with CBZ therapy is likely due to an increase in the high density lipoprotein fraction and is thus not likely to be clinically problematic in relationship to atherosclerosis.     

Influence of hydrochlorothiazide on the plasma levels of triglycerides,total cholesterol and HDL-cholesterol in patients with essential hypertension

Summary

The influence of hydrochlorothiazide (HCT) treatment on the plasma levels of triglycerides, total cholesterol and high density lipoprotein cholesterol (HDL-cholesterol) was studied in lo patients with essential hypertension. After a placebo period of 4 weeks, 50?mg HCT twice daily was given for a period of 9 months, followed by a second placebo period of 4 weeks. Triglycerides, total cholesterol and HDL-cholesterol were determined at the end of both placebo periods and after 1, 3, 6 and 9 months of HCT. For the whole group, there were no significant changes in triglycerides or HDL-cholesterol, whereas total cholesterol significantly increased during HCT. In 6 patients, plasma triglycerides were higher during HCT as compared to both placebo periods. In only 4 patients did HDL-cholesterol increase during HCT. Changes in triglycerides, total cholesterol and HDL-cholesterol were not related and no correlation was found with changes in blood pressure, body weight or serum potassium. In conclusion, this study confirms a possible adverse effect of diuretic treatment on plasma lipids, which should be considered when determining therapeutic regimens for hypertension.     

Influence of hydrochlorothiazide on the plasma levels of triglycerides, total cholesterol and HDL-cholesterol in patients with essential hypertension.

The influence of hydrochlorothiazide (HCT) treatment on the plasma levels of triglycerides, total cholesterol and high density lipoprotein cholesterol (HDL-cholesterol) was studied in 10 patients with essential hypertension. After a placebo period of 4 weeks, 50 mg HCT twice daily was given for a period of 9 months, followed by a second placebo period of 4 weeks. Triglycerides, total cholesterol and HDL-cholesterol were determined at the end of both placebo periods and after 1, 3, 6 and 9 months of HCT. For the whole group, there were no significant changes in triglycerides or HDL-cholesterol, whereas total cholesterol significantly increased during HCT. In 6 patients, plasma triglycerides were higher during HCT as compared to both placebo periods. In only 4 patients did HDL-cholesterol increase during HCT. Changes in triglycerides, total cholesterol and HDL-cholesterol were not related and no correlation was found with changes in blood pressure, body weight or serum potassium. In conclusion, this study confirms a possible adverse effect of diuretic treatment on plasma lipids, which should be considered when determining therapeutic regimens for hypertension.     

High density lipoprotein cholesterol and other serum lipids in New Zealand Maoris.

The pattern of fasting serum lipids, with emphasis on high density lipoprotein cholesterol, and the relationship of the lipids with each other and with other risk factors is examined in a population based sample of New Zealand Maoris. There are no sex differences in the distribution of total cholesterol and cholesterol fractions but triglycerides are higher in men. High density lipoprotein cholesterol levels are lower in Maoris than reported in other populations. High density lipoprotein cholesterol is negatively correlated with low density lipoprotein cholesterol but not associated with total cholesterol. High density lipoprotein cholesterol is negatively correlated with body mass index and in men high density lipoprotein cholesterol levels are higher in current alcohol drinkers. The possible relationship between the low levels of high density lipoprotein cholesterol and the high risk of coronary heart disease in Maoris requires investigation.     

血清TC、ALB、PA和TBA测定在肝硬化中的临床意义

目的探讨血清总胆固醇（TC）、白蛋白（ALB）、前白蛋白（PA）和总胆汁酸（TBA）测定对肝硬化患者的早期诊断及疾病预后的临床应用价值。方法对临床确诊的肝硬化患者207例和健康对照组100例进行TC、ALB、PA、TBA检测。结果肝硬化组胆汁酸明显升高（P〈0.01）,而清蛋白、前清蛋白、胆固醇明显降低（P〈0.01）;随着肝功能减退,胆汁酸逐渐升高,而清蛋白、前清蛋白、胆固醇逐渐降低。且前清蛋白下降比清蛋白下降更早,阳性率更高。结论联合检测血清胆固醇、清蛋白、前清蛋白、胆汁酸对肝硬化患者肝功能评价及预后判断有重要意义。     

Plasma cholesterol and triglycerides in heroin addicts.

We examined total cholesterolemia, triglyceridemia, high density lipoproteins- (HDL) cholesterolemia, apolipoproteins A1 and B, body mass index, albuminemia and alanine aminotransferase in 60 heroin addicts. After comparing 23 control subjects with the heroin addicts the result was that the latter have significantly lower mean values of total cholesterolemia and of HDL-cholesterolemia and higher values of triglyceridemia. They also have significantly higher prevalences of cases of hypocholesterolemia and of hypo-HDL-cholesterolemia. Within the addict group there is no linear correlation between total cholesterolemia and body mass index; there is, however, an inverse linear correlation between total cholesterolemia and alanine aminotransferase. Therefore, the alterations found in the lipid pattern of heroin addicts are not due to malnutrition but hypothetically to liver diseases which are frequent in these patients.     

Declining levels of total serum cholesterol in adult New Zealanders

AIM: To measure the average serum concentration of total cholesterol and high density lipoprotein cholesterol in a representative sample of New Zealanders. METHODS: Serum total and high density lipoprotein cholesterol levels were measured in a representative sample of 1,412 men and 1,741 :women aged 15 years or older who participated in the National Nutrition Survey (1997) of New Zealanders. RESULTS: The average serum total cholesterol concentration in men was the same as in women (5.7 mmol/L); however, younger women (44 years and under) tended to have lower levels and older women (55 years and over) higher levels of total cholesterol than men. Women in all age groups had higher average levels of high density lipoprotein cholesterol (1.4 mmol/L) than men (1.2 mmol/L). Ethnic differences were apparent with Maori men having significantly higher average levels of total cholesterol than their New Zealand European counterparts. CONCLUSIONS: Mean serum total cholesterol concentration in women has declined by 0.3 mmol/L from 6.0 mmol/L (p<0.05) since the previous representative survey of New Zealanders (Life in New Zealand Survey, 1989), but by only 0.1 mmol/L in men, despite a similar reduction amongst men and women in the proportion of dietary energy derived from total and saturated fat. It is possible that weight gain in men and women during the last nine years is having a differential effect on serum cholesterol concentrations.     

Cold swimming stress: effects on serum lipids, lipoproteins and LCAT activity in male and female rats

Effects of consistent cold swimming stress on lipid and lipoprotein metabolism parameters were studied using male and female rats over a period of 60 and 20 days respectively. At the end of treatment serum total cholesterol, high density lipoproteins (HDL-C) and lecithin:cholesterol acetyltransferase (LCAT) activity declined in both male and female rats. TC/HDL-C ratio declined in 20 days in females, while in males it did not change. Free fatty acids increased, while triglycerides remained unchanged in both sexes. %Lipoprotein distribution in male animals did not show any phenotype alteration except in the group of 40 days where %VLDL declined and %LDL-C increased. Body weights did not change, except in males in 60 days. Consistent cold swimming stress by lowering HDL-C and LCAT activity seems to influence lipoprotein metabolism.     

Enzymatic determination of total cholesterol in serum by flow injection analysis

Several methods are proposed for the enzymatic determination of total cholesterol in serum by flow injection analysis (FIA). The use of the merging-zones mode, with or without halting of the reacting plug in the photometric or fluorimetric detector, has allowed the development of four precise methods for the determination of this analyte; calibration curves were linear for ranges of 0.02-0.2 and 0.005-0.05 gl(-1). These methods have been applied to the determination of cholesterol in serum with excellent results.     

Biliary lipids, cholesterol and bile synthesis: different adaptive mechanisms to dietary cholesterol in lean and obese subjects

BACKGROUND: Increased biliary cholesterol secretion together with elevated cholesterol synthesis may predispose obese subjects to cholesterol gallstone formation. AIM: To investigate whether processing of dietary cholesterol is altered in obesity, we enrolled eight lean and seven obese subjects in a double-blind crossover study. METHODS: Cholesterol consumption was 300 mg/day on low and 1300 mg/day on high cholesterol diet. After 3 weeks on either diet, hepatic bile was collected to determine biliary lipid secretion, and bile salt composition by high-performance liquid chromatography and cholesterol saturation index was calculated. Cholesterol synthesis was measured employing mass isotopomer distribution analysis. Bile acid synthesis via neutral and acidic pathway was assessed by serum levels of 7alpha-hydroxy-4-cholesten-3-one and 27-hydroxycholesterol. RESULTS: Cholesterol synthesis was increased in obese compared with lean and feedback inhibited only in obese. On low cholesterol diet, cholesterol secretion was doubled in obese but bile acid composition and synthesis was similar between the two groups. After high cholesterol diet, cholesterol saturation index and bile secretion were unchanged. In contrast to obese, lean increased bile acid synthesis only via the acidic pathway. CONCLUSIONS: Dietary cholesterol appears to preferentially induce bile acid synthesis via the acidic pathway in lean, whereas cholesterol synthesis was inhibited in obese. Thus, stable cholesterol saturation index may be achieved by different mechanisms.     

Effects of monosodium glutamate (MSG) on serum lipids, blood glucose and cholesterol in adult male mice

Monosodium glutamate (MSG) was administered to adult male mice for 6 d at dose levels of 2, 4 and 8 mg/g b.w. Dose levels of 4 and 8 mg/g MSG resulted in significant changes in serum total lipids, triglycerides, phospholipids, free fatty acids and blood glucose 31 d after cessation of exposure. Administration of 2 mg/g MSG resulted in a decrease in blood glucose concentration but had no effect on the other measured end-points. No change in serum cholesterol was observed, either in free or esterified form or in different fractions of lipoproteins.     

血清总胆固醇含量与上消化道出血的相关性探讨

目的:探讨血清总胆固醇含量与上消化道出血的相关性。方法:采用胆固醇氧化酶法测定轻和中度上消化道出血患者70例,上消化道大出血患者24例和65例健康体检者血清总胆固醇含量。结果:轻度、中度上消化道出血和消化道大出血患者血清总胆固醇含量明显低于正常健康对照组(P<0.01)。结论:血清总胆固醇含量与上消化道出血严重程度呈明显的负相关性。     

Dietary cholesterol induced changes in serum lipoproteins in healthy females.

We studied the effect of high cholesterol fat breakfast containing approximately 527 mg cholesterol and 33 gm fat given for seven days in 10 healthy females of young age (18 to 21 years) and in healthy older females of age group (48 to 60 years). Serum total cholesterol and low density lipoprotein did not alter significantly after feeding and after withdrawal of high cholesterol fat breakfast. Serum high density lipoprotein increased significantly in young females after feeding and further increased after withdrawal for seven days, while in older females no appreciable change occurred. Serum triglyceride showed a significant decline in young persons after feeding but gradually increased after withdrawal while in older females no significant change occurred.     

Effect of pindolol on changes in serum lipids induced by hydrochlorthiazide

Forty-two patients with essential hypertension, WHO I-II, and a diastolic blood pressure greater than or equal to 100 mm Hg, were initially given 25 mg hydrochlorthiazide alone. After treatment for 3 months 10 mg pindolol was also given to 16 of them as the diastolic blood pressure had not been reduced to less than or equal to 90 mm Hg. After 3 months treatment on hydrochlorthiazide alone there was a significant increase in serum cholesterol, low density lipoprotein cholesterol and triglyceride concentrations, and a decrease in high density lipoprotein cholesterol concentration, and this pattern persisted after a further 3 months on the single drug regimen. In contrast, in those patients who received additional treatment with pindolol after the first 3 months, there was a significant decrease in the low density lipoprotein cholesterol and an increase in high density lipoprotein cholesterol during the following 3 months. Thus, the addition of pindolol to hydrochlorthiazide therapy appeared to reverse the negative effects on the lipid profile induced by the diuretic alone.     

Binding of quinidine in sera with different levels of triglycerides, cholesterol, and orosomucoid protein

Serum binding of quinidine was determined in vitro by equilibrium dialysis in sera from twenty-five healthy individuals. The sera had different levels of triglycerides, cholesterol and orosomucoid (α₁-acid glycoprotein), but with small variations in serum albumin concentration. Binding ratio (bound/free) and per cent binding varied from 2.0 to 5.4 and from 67.1 to 84.3% respectively. Binding ratios were linearly related to serum concentration of triglycerides (r = 0.437, P < 0.05), cholesterol (r = 0.400 P < 0.05) and orosomucoid (r = 0.841, P < 0.001), but not to serum concentrations of albumin. When five persons with orosomucoid serum levels exceeding the accepted normal range were excluded, a better linear relation was observed for the triglycerides (r = 0.765, P < 0.001). The observed binding ratios were linearly related to binding ratios calculated from previous observations on binding parameters of lipoprotein and albumin fractions of human sera when all persons were included (r = 0.465, P < 0.05) and when those with high levels of orosomucoid were excluded (r = 0.753, P < 0.001).     

Sudden death of athletes: is it due to long-term changes in serum magnesium, lipids and blood sugar?

In young, apparently healthy, trained Israeli men, strenuous effort was reported to give rise to persistent magnesium (Mg) deficiency and a parallel long-term increase of cholesterol, triglycerides and blood sugar parallel 1-3. The relationship of Mg deficiency to the pathogenesis of cardiovascular disease has been increasingly documented during the last decade. Several authors have highlighted the phenomenon of sudden deaths in sport and have suggested that it is associated with cardiovascular disease. The association is discussed between Mg deficiency and increase of blood lipids and sugar, found as a sequel to strenuous effort, and cardiovascular morbidity and mortality risk reported in athletes. It is postulated that sudden death of athletes and other intensely training individuals during exertion, is mediated by the deleterious cardiovascular effects of persistent magnesium deficiency and the resultant hyperlipaemia and hyperglycaemia, which, as we have documented, follows strenuous effort.