Pantethine, a derivative of vitamin B5 used as a nutritional supplement, favorably alters low-density lipoprotein cholesterol metabolism in low- to moderate-cardiovascular risk North American subjects: a triple-blinded placebo and diet-controlled investigation

Safety and efficacy of a biologically active derivative of vitamin B₅ (pantethine) on total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) metabolism was studied in North American subjects at conventional low to moderate cardiovascular disease (CVD) risk. A total of 120 subjects initiated a therapeutic lifestyle change (TLC) diet 4 weeks before randomization (baseline) and maintained the diet throughout a 16-week study period; at baseline, subjects were randomized in a triple-blinded manner to either pantethine (600 mg/d, baseline to week 8, and 900 mg/d, weeks 9-16) or identically labeled, nonbiologically active placebo (n = 60 per group). We hypothesized that pantethine would lower TC and low-density lipoprotein in low-CVD-risk North American subjects in a similar manner as reported in high-CVD-risk subjects studied mainly in Italy and Japan. While sustaining a TLC diet and in comparison with placebo, pantethine demonstrated significant (P < .005) and sustained reductions (from baseline to week 16) in TC (6 mg/dL, 0.16 mmol/L, 3%), LDL-C (4 mg/dL, 0.10 mmol/L, 4%), and apolipoprotein B (4 mg/dL, 0.04 g/L, 5%). Our data suggest that pantethine supplementation for 16 weeks (600 mg/d for weeks 1-8 then 900 mg/d for weeks 9-16) is safe and significantly lowers TC and LDL-C over and above the effect of TLC diet alone. Although the absolute magnitude of these effects was small in these low- to moderate-risk North Americans (4-6 mg/dL), the results are noteworthy as prior studies have shown that, for each 1 mg/dL (0.026 mmol/L) reduction in LDL-C, there is a concomitant 1% reduction in overall future CVD risk.     

Oral Supplement Containing Hydroxytyrosol and Punicalagin Improves Dyslipidemia in an Adult Population without Co-Adjuvant Treatment: A Randomized,Double-Blind,Controlled and Crossover Trial

Hydroxytyrosol (HT) and punicalagin (PC) exert cardioprotective and antiatherosclerotic effects. This study evaluated the effect of an oral supplement containing HT and PC (SAx) on dyslipidemia in an adult population. A randomized, double-blind, controlled, crossover trial was conducted over a 20-week period. SAx significantly reduced the plasma levels of triglycerides (TG) in subjects with hypertriglyceridemia (≥150 mg/dL) (from 200.67 ± 51.38 to 155.33 ± 42.44 mg/dL; p < 0.05), while no such effects were observed in these subjects after the placebo. SAx also significantly decreased the plasma levels of low-density lipoprotein cholesterol (LDL-C) in subjects with high plasma levels of LDL-C (≥160 mg/dL) (from 179.13 ± 16.18 to 162.93 ± 27.05 mg/dL; p < 0.01), while no such positive effect was observed with the placebo. In addition, the placebo significantly reduced the plasma levels of high-density lipoprotein cholesterol (HDL-C) in the total population (from 64.49 ± 12.65 to 62.55 ± 11.57 mg/dL; p < 0.05), while SAx significantly increased the plasma levels of HDL-C in subjects with low plasma levels of HDL-C (<50 mg/dL) (from 44.25 ± 3.99 to 48.00 ± 7.27 mg/dL; p < 0.05). In conclusion, the supplement containing HT and PC exerted antiatherosclerotic and cardio-protective effects by considerably improving dyslipidemia in an adult population, without co-adjuvant treatment or adverse effects.     

Maternal and paternal family history of type 2 diabetes differently influence lipid parameters in young nondiabetic Japanese women

Objectives

We assessed the association of family history of type 2 diabetes (T2D) with parameters used for health checkups in young Japanese women.

Methods

The subjects were 497 nondiabetic women aged 19–39 years. Among them, the mothers of 34 subjects and fathers of 50 had T2D (MD group and PD group, respectively). The subjects were assessed for levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG).

Results

TC and LDL-C level showed a tendency to increase in the MD group compared with subjects without family history of T2D. LDL-C/HDL-C ratio ≥2.14 was found in 32.4 and 18.0 % of subjects in the MD and PD groups, respectively. When adjusted for differences in age, body mass index, smoking status, and drinking habits, the MD group was found to have a higher risk of abnormal TC and LDL-C levels than the PD group. LDL-C/HDL-C ratio was independently associated with maternal family history but not with paternal family history (odds ratio 3.44 [99 % confidence interval 1.11–10.6] and 1.21 [0.38–3.89], respectively). There was no association between TG/HDL-C ratio and family history type of T2D.

Conclusions

Maternal family history of T2D had a more pronounced effect on the lipid parameters generally evaluated during health checkups than did paternal family history of T2D. Therefore, we recommend systematic screening for early detection and appropriate healthcare guidance for Japanese women, particularly those with maternal family history of T2D.     

Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.     

Influence of fish consumption on the distribution of serum cholesterol in lipoprotein fractions: comparative study among fish-consuming and non-fish-consuming populations

The objective of this study was to investigate serum lipoprotein levels in order to assess cardiovascular disease (CVD) risk factors between fish-consuming populations and non-fish-consuming populations, as it has been speculated that fish intake reduces CVD risk. A representative sample of one thousand subjects (529 men and 471 women) were selected, with ages ranging from 20 to 70 years, from 40 villages belonging to fish-consuming (500) or non-fish-consuming (500) populations. Serum lipoprotein lipids such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were analysed biochemically using standard procedures. The ratios of TC: HDL-C and LDL-C: HDL-C were computed. Mean values of serum LDL-C and the ratios of LDL-C: HDL-C and TC: HDL-C were significantly lower and HDL-C levels were higher in fish-consumers than in non-fish-consumers. The concentrations of HDL-C decreased with increasing age, while the reverse was true for LDL-C and for the LDL-C: HDL-C and TC: HDL-C ratios. There were significant sex differences for certain age groups in both of the population groups. The 5th, 50th and 95th percentile cut-off values for these parameters were lower in fish-consumers than in non-fish-consumers. The prevalence of individuals at risk of CVD because of low HDL-C (<35 mg/dL), high LDL-C (>130 mg/dL) and their atherogenic ratios (LDL-C: HDL-C >3.5 and TC: HDL-C>4.5) was significantly greater in non-fish-consumers. This study highlights that the fish-consuming population had a lower atherogenic risk than the non-fish-consuming population. The intake of fish may have substantial implications for public health and health economy by decreasing the risk of CVD. However, more studies are warranted to better define the mechanisms of cardioprotection by dietary fish and fish oils.     

Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized,placebo-controlled crossover trial

This randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a dietary supplement (tablet form) providing 1.8 g/day free (non-esterified) plant sterols and stanols versus placebo for 6 weeks as part of a therapeutic lifestyle changes (TLC) diet in 32 men and women with primary hypercholesterolaemia. Mean ± SE baseline (end of a 5-week TLC diet lead-in) lipid concentrations (mmol/l) were total cholesterol (TC), 5.88 ± 0.08; non-high-density lipoprotein cholesterol (non-HDL-C), 4.71 ± 0.09; low-density lipoprotein cholesterol (LDL-C), 4.02 ± 0.08; HDL-C, 1.17 ± 0.06 and triglycerides (TGs), 1.51 ± 0.12. Differences from control in responses (plant sterol/stanol ? control) were significant (p < 0.05) for LDL-C ( ? 4.9%), non-HDL-C ( ? 3.6%) and TC ( ? 2.8%). HDL-C and TG responses were not significantly different between treatment conditions. These results indicate that 1.8 g/day free plant sterols/stanols administered in a tablet produced favourable lipoprotein lipid changes in men and women with hypercholesterolaemia.     

紫苏油和松籽油对大鼠机体脂类和脂质过氧化的影响

在高脂饲料中分别加入６％的紫苏油和松籽油，在实验动物总能量与主要营养素摄入基本相同、脂肪占总能量３２．６％的条件下饲喂Ｗｉｓｔａｒ雄性成年大鼠３周。结果表明，紫苏油和松籽油对高脂血症大鼠均有一定的调整血脂作用。紫苏油和松籽油组大鼠血清甘油三酯（ＴＧ）、总胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、ＬＤＬ－Ｃ与高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）的比值（ＬＤＬ－Ｃ／ＨＤ－Ｌ－Ｃ）、致动脉粥样硬化指数（ＡＩ）的增加值和ＨＤＬ－Ｃ／ＴＣ、卵磷脂胆固醇酰基转移酶（ＬＣＡＴ）活性的下降均不同程度地低于单纯食猪油的高脂对照组。紫苏油尚可提高高脂血症大鼠血清ＨＤＬ－Ｃ、高密度脂蛋白亚组分Ⅱ胆固醇（ＨＤＬ２Ｃ）水平及ＨＤＬ２－Ｃ与高密度脂蛋白亚组分Ⅲ胆固醇（ＨＤＬ３－Ｃ）比值（ＨＤＬ２－Ｃ／ＨＤＬ３－Ｃ）；松籽油未见显著升高ＨＤＬ－Ｃ作用。各组动物血清ＨＤＬ３－Ｃ水平无显著差异。紫苏油和松籽油组大鼠肝体比值低于高脂对照组。紫苏油组大鼠肝脏过氧化脂质（ＬＰＯ）含量高于松籽油和高脂对照组。但与正常组比较，紫苏油、松籽油和高脂对照组大鼠肝体比值、肝脂质含量、肝组织病理学检查显示的肝脂变程度和肝脏ＬＰＯ含量均增高，而肝组织中谷胱?     

甘油三酯和高密度脂蛋白胆固醇比值与胰岛素抵抗的关系

目的分析甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）的浓度比值与胰岛素抵抗的关系,为筛查胰岛素抵抗的高危人群提供依据。方法利用2012年江苏省慢性病及危险因素监测流动人口专题调查资料,采用问卷调查、体格测量、实验室检测等方法收集人口统计学信息、慢性病防治情况、行为危险因素情况及血脂等信息。采用多元线性回归分析指标的影响大小,采用受试者工作特征曲线（ROC）及非条件logistic回归分析指标的筛查价值。结果 TG/HDL-C比值对空腹胰岛素水平具有显著影响（标准化偏回归系数：男性为0.243,女性为0.254,P〈0.01）,对于胰岛素抵抗的ROC曲线下面积：男性为0.73（95%CI：0.69-0.77）,女性为0.63（95%CI：0.58-0.67）。以TG/HDL-C比值男性≥1.12、女性≥0.71作为筛查胰岛素抵抗的适宜切点,比值高于切点人群的胰岛素抵抗患病率是比值低于切点人群的2.43倍,患病风险是低于切点人群的2.7倍（95%CI：2.1-3.5）。结论 TG/HDL-C比值与空腹胰岛素水平密切相关,对于在成年非糖尿病人群中筛查胰岛素抵抗具有一定价值。     

Total cardiovascular risk profile of Taiwanese vegetarians

BACKGROUND: Although the health benefits of vegetarian diets have been well documented among Western population, there are geographic differences of vegetarian diets and the health benefits of the Taiwanese vegetarian diet have not been studied extensively. In addition to conventional risk factors, homocysteine and high-sensitivity C-reactive protein (hs-CRP) levels have been found to predict first atherothrombotic events. We undertook this study to examine the total risk profile of Taiwanese vegetarians. METHODS: A total of 198 healthy subjects (99 vegetarians and 99 omnivores) were recruited. Fasting blood samples were analyzed for glucose, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), white blood cell count, hs-CRP and homocysteine. RESULTS: There was no significant difference in age, body mass index, blood glucose, white blood cell count, triglyceride and HDL-C between the two groups. The vegetarian group had significantly more females (65.7 vs 46.5%); lower body weight (58.66+/-11.13 vs 62.88+/-12.24 kg); shorter height (159.14+/-7.88 vs 162.53 +/-8.14 cm); lower total cholesterol (184.74+/-33.23 vs 202.01+/-41.05 mg/dl); and lower LDL-C (119.63+/-31.59 vs 135.89+/-39.50 mg/dl). Hs-CRP was significantly lower (0.14+/-0.23 vs 0.23+/-0.44 mg/dl, P=0.025), whereas homocysteine was significantly higher (10.97+/-6.69 vs 8.44+/-2.50 micromol/l, P=0.001) in vegetarians than omnivores. CONCLUSIONS: Taiwanese vegetarians have lower total cholesterol, LDL-C and hs-CRP levels, and higher homocysteine levels than omnivores. Owing to different predictive value of each risk factor, the Taiwanese vegetarians had a better cardiovascular risk profile than omnivores. Whether the Taiwanese vegetarian diet should be supplemented with vitamin B(12) to lower serum homocysteine level remains to be addressed.     

Low-Density Lipoprotein Cholesterol and the Risk of Rheumatoid Arthritis: A Prospective Study in a Chinese Cohort

Objective: This study aimed to investigate whether low-density lipoprotein cholesterol (LDL-C) concentration was associated with the risk of rheumatoid arthritis (RA) in Chinese adults. Methods: The study included the 97,411 participants in the Kailuan Study without RA, with complete baseline LDL-C data, and who did not use lipid-lowering medications at baseline or during follow-up. We used Cox proportional hazards modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to baseline LDL-C tertiles, adjusting for age, sex, body mass index, HDL-C, triglycerides, diabetes, hypertension, alcohol consumption, and smoking. We also calculated the HR and 95% CI of RA using updated LDL-C measurements prior to the end of follow-up, adjusting for covariates. Results: We identified 97 incident RA cases between 2006 and 2018. After adjusting for potential confounders, updated LDL-C concentration—rather than baseline LDL-C—was inversely associated with RA risk. The adjusted HR of RA was 0.64 (95% CI: 0.38, 1.09; p-trend = 0.10) comparing the two extreme baseline LDL-C tertiles, and 0.38 (95% CI: 0.22, 0.64; p-trend < 0.01) comparing the two extreme tertiles of the updated LDL-C concentrations. Conclusions: In this prospective study, high LDL-C concentrations, when measured closest to RA diagnosis or the end of follow-up, were associated with a low risk of RA. These findings highlight the changes in LDL-C prior to RA diagnosis, and the importance of including lipid analyses into studies of the pathogenesis of RA.     

常州市成人血脂异常的流行特征分析

目的探讨常州地区当前一般人群血脂异常的流行特点。方法利用2012年1 259名健康检查者资料,分析并比较不同性别、不同年龄人群血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的异常率以及TG与TC、LDL-C、HDL-C的关系。结果①男性TG、TC、LDL-C、HDL-C异常率均高于女性,按年龄分层,男女TC、LDL-C异常率均随年龄增加呈上升趋势,但男性TG异常率与年龄不呈正比。无论男性还是女性,不同年龄段HDL-C异常率未见统计学差别。②男性血脂异常者中有49.9%为混合型,女性则有52.2%为混合型。③logistic回归分析表明,校正性别、年龄后,TG异常与TC异常呈正相关（OR 95%CI=1.563~3.409）,与HDL-C异常呈负相关（OR 95%CI=0.246~0.974）。结论常州地区成年人血脂异常率较高,且混合型血脂异常占较高比例,今后应积极开展预防血脂异常的健康教育。     

Effects of Egg Consumption on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Background: It is widely agreed that egg consumption only modestly influences serum lipid concentrations. However, there is no meta-analysis summarizing existing randomized controlled trials.

Objective: The purpose of this study was to conduct a meta-analysis of published randomized controlled trials to explore the quantitative effect of egg consumption on serum lipid concentrations.

Design: Online databases including MEDLINE, Proquest and Google Scholar were systematically searched. Studies that were published after 2000 and compared serum lipids concentrations in egg-consumers and non egg-consumers were included. The data were obtained from 28 studies. Weighted mean differences were calculated as the ultimate effect using random effects model.

Results: Overall, egg consumption increased total cholesterol (TC) by 5.60 mg/dL (95% CI: 3.11, 8.09; P<0.0001), low density lipoprotein-cholesterol (LDL-C) by 5.55 mg/dL (95% CI: 3.14, 7.69; P<0.0001) and high density lipoprotein-cholesterol (HDL-C) by 2.13 mg/dL (95% CI: 1.10, 3.16; P<0.0001) compared with the control group. Heterogeneity found between studies was explained partly by study design and participant response to dietary cholesterol. No effect of increased egg consumption on LDL-C:HDL-C and TC:HDL-C ratios, and triglyceride (TG) concentrations were found. No association was observed between number of eggs consumed per day or study duration and any of the serum lipid markers.

Conclusion: Consumption of egg increases total cholesterol, LDL-C and HDL-C, but not LDL-C:HDL-C, TC:HDL-C and TG compared with low egg control diets. To assess the risk of coronary events, future studies should focus on the postprandial effect of egg consumption and effects on coronary risk.     

A palm oil-rich diet may reduce serum lipids in healthy young individuals

OBJECTIVE: The literature on palm oil as a cholesterol-raising oil is conflicting, requiring further studies. This study tested the influence of a palm oil-rich diet on plasma lipids of healthy young individuals. METHODS: Thirty-four medical students, 18-26 y old, with a total cholesterol level <200 mg/dL, high-density lipoprotein cholesterol (HDL-C) level >40 mg/dL, low-density lipoprotein cholesterol (LDL-C) level <130 mg/dL, triacylglycerol level <150 mg/dL, glycemic level <100 mg/dL, blood pressure <140/90 mmHg, and a body mass index of 18 to <25 kg/m(2) were studied. Once a day for 2 wk, the students ingested 10 mL of previously boiled crude palm oil after lunch or dinner, as preferred. Palm oil was consumed in the same way and quantity that it is consumed in one serving of a very popular typical Brazilian seafood dish. Total cholesterol, LDL-C, HDL-C, very LDL-C, non-HDL-C, and triacylglycerol were measured at baseline, after the palm oil-enriched diet, and after the washout period. RESULTS: A decrease in all lipid fractions was observed, with a mild, statistically significant decrease in concentrations of very LDL-C (19.41 +/- 4.21 versus 17.18 +/- 4.0 mg/dL, P = 0.002) and triacylglycerol (97.07 +/- 21.08 versus 85.91 +/- 20.02 mg/dL, P = 0.002). Males (61.9%) also showed a mildly significant increase in LDL-C, whereas females showed a mildly significant decrease in all lipid fractions, except for HDL-C. CONCLUSION: This study shows that boiled crude palm oil may have a mild, triacylglycerol-reducing effect in young, healthy individuals and may also show a mild LDL-C-increasing effect in males.     

脂蛋白胆固醇和载脂蛋白水平对乳腺癌发生及预后的预测价值

目的 探讨脂蛋白胆固醇和载脂蛋白水平对乳腺癌发病风险及预后的预测价值。方法 收集病例组418例首诊乳腺癌女性患者初次入院时和对照组418例正常女性健康体检时的高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、载脂蛋白A1（ApoA1）和载脂蛋白B（ApoB）等资料,并对所有乳腺癌病例进行76个月的随访。采用logistic和cox回归模型分析脂蛋白胆固醇和载脂蛋白与乳腺癌风险和预后的相关性。结果 HDL - C（OR = 3.70, 95%CI:2.29～5.96）的增加与乳腺癌发生的风险相关,而LDL - C（OR = 0.47, 95%CI:0.39～0.58）则可降低风险。ROC曲线显示HDL - C与LDL - C联合时,AUC为0.702,对罹患乳腺癌的预测能力优于单一指标。50岁以下乳腺癌患者ApoA1水平与乳腺癌的预后有关,高ApoA1（≥1.32 g/L）可降低50岁以下乳腺癌患者的死亡风险。结论 脂蛋白胆固醇和载脂蛋白的水平变化在乳腺癌发生发展中具有重要作用,与乳腺癌的发病风险和预后有关。     

Efficacy of fish oil supplementation for treatment of moderate elevation of serum cholesterol

A study was performed to determine the efficacy and feasibility of using fish oil capsules for treatment of moderate hypercholesterolemia. Thirty-three subjects, randomized to fish or olive oil, took two 1-g capsules with each meal for 12 weeks. Each subject crossed over to the alternate treatment at 12 weeks. Patients maintained usual levels of exercise and diet for 24 weeks. Eight subjects dropped out. For the group starting fish oil (n = 13), the average baseline cholesterol level was 6.336 mmol/L (245.0 mg/dL) and was 6.341 mmol/L (245.2 mg/dL) after 12 weeks. High-density lipoprotein cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C) baseline levels were 1.459 mmol/L (56.4 mg/dL) and 4.332 mmol/L (167.5 mg/dL); 1.474 mmol/L (57.0 mg/dL) and 4.479 mmol/L (173.2 mg/dL), respectively, after fish oil supplementation. In the group that began with olive oil (n = 12), baseline total cholesterol level was 6.274 mmol/L (242.6 mg/dL); HDL-C and calculated LDL-C baseline levels were 1.386 mmol/L (53.6 mg/dL) and 3.988 mmol/L (154.2 mg/dL). When mean baseline levels were compared with post-fish-oil values for the entire population, no significant change in total cholesterol or LDL-HDL ratio was obtained. Triglyceride responses to fish oil were variable. Values after olive oil treatment were neither significantly different from baseline nor different from fish oil. It was concluded that fish oil in manufacturer's recommended dosage does not appear to lower moderately elevated cholesterol levels.     

中青年症状性动脉粥样硬化性颅内动脉狭窄患者中LDL—C／HDL—C比值分析

目的探讨LDL—C／HDL—C比值在中青年症状性动脉粥样硬化性颅内动脉狭窄（slCAS）发病机制中的意义。方法通过NIHSS评分对37例中青年slCAS新发患者分成两病例组,同时收集同期住院中青年头晕患者40例作为对照组,分析病例组和对照组LDL—C／HDL—C比值差异。治疗6个月后再次分析病例组血管病变、LDL—C／HDL—C比值前后对比情况。结果中青年slCAS患者LDL—c／HDL—C比值增大,与对照组比较差异有统计学意义;通过治疗后,研究组中64．71％的颅内血管狭窄好转,LDL—C／HDL—C此值变小,前后比较差异有统计学意义。结论LDL—C／HDL—C比值增大是中青年slCAS重要的危险因素;拜阿司匹林联合阿托伐他汀干预能降低LDL—C／HDL—C比值,缓解中青年sIG峪。     

Use of simvastatin treatment in patients with combined hyperlipidemia in clinical practice. For the Simvastatin Combined Hyperlipidemia Registry Group

OBJECTIVE: To describe and understand current care of simvastatin-treated patients with combined hyperlipidemia in routine clinical practice. DESIGN: A 6-month prospective observational study. Demographics, simvastatin dosage, cardiac risk factors, and lipid profile were collected from August 1997 to December 1998 at 20 sites (230 patients) across the United States. RESULTS: Overall mean percentage of reduction in total cholesterol levels was 27% (P<.001), low-density lipoprotein cholesterol (LDL-C) was 35% (P<.001), and triglyceride values was 28% (P<.001). Among those patients with low baseline high-density lipoprotein cholesterol (HDL-C) values (<0.91 mmol/L [<35 mg/dL]) (N = 49), there was a 17% increase in HDL-C (P< or =.001); 35% of these patients achieved National Cholesterol Education Program HDL-C goal (ie, < or =0.91 mmol/L [> or =35 mg/dL]). Coronary heart disease (CHD) patients were given significantly higher initial doses (mean, 15.1 mg) compared with non-CHD patients (mean, 11.5 mg) (P< or =.001). Overall, 74% of patients achieved LDL-C goal (52% on starting dose, 22% after 1 titration). Among those patients who were not at goal and had a follow-up lipid profile result available, only 1 patient (2%) was at the maximum dose (80 mg); 69% were receiving 20 mg or less. Approximately 63% of patients with CHD, 80% of patients with 2 or more risk factors, and 91% of patients with fewer than 2 risk factors achieved LDL-C goal. CONCLUSIONS: Multiple factors contribute to LDL-C goal achievement in a usual care setting. A significant opportunity exists to increase the number of patients who achieve LDL-C goal by appropriate dose titration and/or give patients a higher initial dose of simvastatin.     

Accuracy and precision of HDL cholesterol measurements using an office chemistry analyzer

BACKGROUND. A physician can obtain a patient's complete lipoprotein profile at the time of the office visit including assays of the total serum cholesterol, high-density lipoprotein cholesterol (HDL-C), and fasting triglyceride concentrations, and then calculate the low-density lipoprotein cholesterol (LDL-C). Until recently, this was not possible. Instruments are currently available that provide reliable rapid total serum cholesterol and fasting triglyceride measurements. METHODS. This study evaluated the accuracy and precision of a recently developed analytical method for the rapid measurement of HDL-C (Seralyzer Cholesterol System) as compared with a reference clinical laboratory method (Kodak Ektachem 700 XR). Blood specimens were taken from 90 participants and were analyzed in duplicate for HDL-C concentrations and total cholesterol using the Seralyzer and a standard Ektachem 700 XR. RESULTS. Nearly all (98.9%) of the initial Seralyzer HDL-C measures were within +/- 0.08 mmol/L (+/- 3 mg/dL) of the duplicate Seralyzer values. Most (98.3%) of the Seralyzer HDL-C results were within +/- 0.16 mmol/L (+/- 6 mg/dL) of the Kodak HDL-C values. CONCLUSIONS. The Seralyzer HDL-C test provides a reliable and accurate measure of the HDL-C concentration.     

Fruit and vegetables consumption in relation to health and diet of medical students in Crete, Greece

In Greece, prevalence of cardiovascular disease has been increasing during the last few decades. From a public health point of view, it is important to identify lifestyle practices associated with cardiovascular disease risk factors. As part of the Clinical Nutrition course at the University of Crete School of Medicine, 507 medical students (292 men, 215 women) were examined during the period 1995-2001. Individual 24-hour dietary recalls were taken, lifestyle questionnaires were completed, and anthropometric and serum lipid measurements were performed. Fruits and vegetables were consumed by 90% of men (370 +/- 275 g/day) and 94% of women (354 +/- 283 g/day). Among non/ex-smokers who ate fruit and vegetables, 41% consumed > or = 400 g/day, compared to 31% of current smokers (p = 0.05). The risk for high-density lipoprotein cholesterol (HDL-C) < 35 mg/dL, low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL, and total cholesterol/HDL-C ratio (TC:HDL-C) > or = 5 decreased with increasing quartile of fruit and vegetables consumption (trend p < 0.01). Fruit and vegetable intake was favorably related to intake of dietary fiber, calcium, magnesium, potassium, folate, and vitamins C, E, A, B1 and B6, and inversely related to saturated and trans fatty acids and cholesterol. Prospective studies should be performed within the general young adult population to assess the long-term effects of fruit and vegetable consumption on chronic disease risk development.     

Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials

BACKGROUND: The purpose of this study was to use the meta-analytic approach to examine the effects of walking on lipids and lipoproteins in adults. METHODS: Randomized controlled trials that examined the effects of walking on total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), the ratio of TC/HDL, and triglycerides (TG) in adults ages 18 years and older were retrieved via computerized literature searches, cross-referencing, hand-searching, and expert review of our reference list. RESULTS: Twenty-five studies that included 1,176 subjects (692 walkers, 484 controls) and up to 33 outcomes were available for pooling. Using random-effects modeling, statistically significant, walking-induced decreases of 5% and 6% were observed for LDL-C and TC/HDL-C (LDL-C, mean +/- SE, -5.5 +/- 2.2 mg/dL, 95% CI, -9.9 to -1.2 mg/dL; TC/HDL-C, mean +/- SE, -0.3 +/- 0.1, 95% CI, -0.6 to -0.1). No statistically significant changes were observed for TC, HDL, or TG (P > 0.05), although changes were in the direction of benefit. No statistically significant changes occurred in body composition (P > 0.05). CONCLUSIONS: Walking reduces LDL-C and TC/HDL-C in adults independent of changes in body composition.