协同家庭治疗对糖尿病高脂血症患者的影响

目的探究糖尿病合并高脂血症患者经协同护理联合系统家庭治疗对生活质量及血糖血脂控制的影响。方法选取2017年2月-2019年5月我院收治的糖尿病合并高脂血症患者83例,按照数字随机法分为试验组42例与参照组41例,参照组实施常规护理干预措施,试验组在上述基础上实施协同护理联合家庭治疗,对比分析干预后两组患者血糖水平、血脂水平及生活质量情况。结果经护理干预后,试验组LDL-C(低密度脂蛋白胆固醇,low density lipoprotein cholesterol)为(2.02±0.71)mmol/L、TC(总胆固醇,total cholesterol)为(5.08±0.76)mmol/L、TG(甘油三酯,triglyceride)为(0.51±0.42)mmol/L显著优于参照组的(3.18±0.96)mmol/L、(6.26±0.99)mmol/L、(1.38±0.54)mmol/L,有统计学差异,P<0.05;经护理干预后试验组空腹血糖水平、餐后血糖水平及糖化血红蛋白(HbAlc)显著低于参照组,有统计学差异,P<0.05;试验组生活质量评分为(92.58±9.05)分,参照组为(81.22±8.21)分,试验组显著优于参照组,有统计学差异,P<0.05。结论糖尿病合并高脂血症患者经协同护理联合系统家庭治疗,可有效改善血脂与血糖水平,提高患者生活质量,效果显著。     

Comparison of Effects of Long-Term Low-Fat vs High-Fat Diets on Blood Lipid Levels in Overweight or Obese Patients: A Systematic Review and Meta-Analysis

Dietary fat plays an important role in the primary prevention of cardiovascular disease, but long-term (≥12 months) effects of different percentages of fat in the diet on blood lipid levels remain to be established. Our systematic review and meta-analysis focused on randomized controlled trials assessing the long-term effects of low-fat diets compared with diets with high amounts of fat on blood lipid levels. Relevant randomized controlled trials were identified searching MEDLINE, EMBASE, and the Cochrane Trial Register until March 2013. Thirty-two studies were included in the meta-analysis. Decreases in total cholesterol (weighted mean difference –4.55 mg/dL [–0.12 mmol/L], 95% CI –8.03 to –1.07; P=0.01) and low-density lipoprotein (LDL) cholesterol (weighted mean difference –3.11 mg/dL [–0.08 mmol/L], 95% CI –4.51 to –1.71; P<0.0001) were significantly more pronounced following low-fat diets, whereas rise in high-density lipoprotein (HDL) cholesterol (weighted mean difference 2.35 mg/dL [0.06 mmol/L], 95% CI 1.29 to 3.42; P<0.0001) and reduction in triglyceride levels (weighted mean difference –8.38 mg/dL [–0.095 mmol/L], 95% CI –13.50 to –3.25; P=0.001) were more distinct in the high-fat diet groups. Including only hypocaloric diets, the effects of low-fat vs high-fat diets on total cholesterol and LDL cholesterol levels were abolished. Meta-regression revealed that lower total cholesterol level was associated with lower intakes of saturated fat and higher intakes of polyunsaturated fat, and increases in HDL cholesterol levels were related to higher amounts of total fat largely derived from monounsaturated fat (of either plant or animal origin) in high-fat diets (composition of which was ～17% of total energy content in the form of monounsaturated fatty acids, ～8% of total energy content in the form of polyunsaturated fatty acids), whereas increases in triglyceride levels were associated with higher intakes of carbohydrates. In addition, lower LDL cholesterol level was marginally associated with lower saturated fat intake. The results of our meta-analysis do not allow for an unequivocal recommendation of either low-fat or high-fat diets in the primary prevention of cardiovascular disease.     

女性绝经状态与血脂代谢的关系研究

目的 通过调查围绝经期和绝经后妇女血脂水平,探讨围绝经和绝经后妇女心血管疾病的防治策略.方法 于2013年4月至2014年12月在上海交通大学附属第六人民医院体检中心健康体检的年龄在40~65岁自然绝经妇女500例,按照生殖衰老分期系统STRAW+10分类分析血脂水平.结果 研究对象的年龄为(53.84±4.86)岁,总胆固醇水平为(5.55±0.97)mmol/L、甘油三酯水平为(1.27±0.80)mmol/L、高密度脂蛋白为(1.63±0.35)mmol/L、低密度脂蛋白水平为(3.45±0.82)mmol/L,其中血脂异常率占38.60%~72.80%.绝经后妇女的总胆固醇(5.69±0.89mmol/L vs 5.47±1.01mmol/L)、甘油三酯(1.38±0.93 mmol/L vs 1.20±0.70mmol/L)及低密度脂蛋白(3.59±0.75mmol/L vs 3.41±0.86mmol/L)均高于围绝经期妇女,且都存在统计学差异(t值分别为6.046、5.804、5.872,均P<0.05).结论 围绝经期和绝经后妇女血脂异常率高,患者干预率低,常规进行血脂检查十分必要.     

Women and Men with Hypercholesterolemia Respond Similarly to an American Heart Association Step 1 Diet

Objective To compare serum lipid level responses of women and men with hypercholesterolemia to an American Heart Association (AHA) step 1 diet.Design Sixty-three women and 99 men with varying degrees of hypercholesterolemia were instructed on an AHA step 1 diet. Subjects were followed up on a biweekly basis with individual visits and group classes for 8 weeks.Setting Outpatient clinic facility of the Metabolic Research Group, University of Kentucky, Lexington.Subjects/samples Through community cholesterol screenings, we recruited 76 women and 108 men aged 30 to 70 years who were within 80% to 130% of their ideal body weight. Serum cholesterol levels were between 5.17 mmol/L and 8.99 mmol/L and serum triglyceride levels when subjects were fasting were less than 5.08 mmol/L. Sixty-three women and 99 men completed the study.Intervention Subjects followed an AHA step 1 diet (30% of energy from fat, 50 to 60% of energy from carbohydrate, 10 to 20% of energy from protein, and less than 300 mg cholesterol per day) for 8 weeks.Main outcome measures Serum lipid levels, nutrient intake, and body weight.Statistical analyses performed Subjects were divided into three groups according to initial serum cholesterol levels (mild=5.17 to 6.17 mmol/L; MODERATE=6.20 to 6.95 mmol/L; SEVERE = 6.98 mmol/L). Within-individual changes in nutrient intakes, body weights, and serum lipid levels were analyzed using dependent t tests. Between-group comparisons were made using analysis of variance (ANOVA). When significant differences were found using ANOVA, differences between groups were evaluated with the Tukey test.Results All subjects tolerated the diet well and average dietary adherence was good, as assessed by a food frequency questionnaire and analysis of 3-day diet records. Serum total cholesterol levels decreased 9.2% overall for women (P<.001) and 7.2% for men (P<.001); serum low-density lipoprotein cholesterol levels decreased 9.2% for women and 9.8% for men; and serum high-density lipoprotein cholesterol levels decreased 3.6% for women and 2.8% for men. Mean serum triglyceride levels decreased significantly for women but not for men. No significant differences were found in the responses of women and men in the corresponding groups. Women and men with higher initial serum cholesterol values showed significantly greater hypocholesterolemic responses to diet than those with lower initial serum cholesterol values.Applications/conclusions The findings of this study confirm the beneficial role of dietary intervention for reducing atherogenic serum lipid levels in women and men. J Am Diet Assoc. 1995; 95:436–441.     

上海市松江区泗泾地区健康人群血脂水平调查与分析

目的调查泗泾地区人群血脂水平和血脂谱现状,探讨泗泾镇高脂血症发病情况及高脂血症与年龄、血致动脉硬化指数（AIP）水平关系,为血脂异常防治提供客观依据。方法收集2010年4—12月在泗泾医院体检的8098例人员资料,并测定甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）,计算出非高密度脂蚕白胆固醇（non—HDL—C）、AIP,并按不同年龄段进行分组,将各组进行比较分析。结果TC水平最高男性为4．83mmol/L,女性为5．24mmol／L,高水平年龄在61—70岁;TG水平最高男性为2．02mmol/L,女性为1．67mmol／L,年龄在41-70岁：HDL-C最低水平为1．12mmol／L,各年龄段均在合适水平;LDL—C最高男性为2．36mmol／L,女性为2．47mmol／L,年龄在31～70岁．健康人异常脂蛋白血症发生率（按2007年《中国成人血脂异常防治指南》中血脂水平划分方案划1分为TC38．89％、TG32．21％、HDL—C24．92％和LDL—C5．09％。结论该地区健康人TC、TC、HDL—C和LDL—C整体水平明显高于2002年中国营养与健康调查血脂在人群中的水平。血脂谱以异常高TC占首位,依次为TG、HDL—C和LDL—C．高TG血症发生率（32．21％）与高TC血症发生率（38．49％）相差不多,应重视高TG血症防治。     

Chickpeas may influence fatty acid and fiber intake in an ad libitum diet, leading to small improvements in serum lipid profile and glycemic control

Optimal replacement macronutrient/s for dietary saturated fat to reduce cardiovascular disease risk remains controversial. Chickpeas are rich in dietary fiber and polyunsaturated fatty acids. This exploratory study, conducted from September 2004 to May 2005, assessed the effect of incorporating chickpeas in the ad libitum diet of 45 free-living adults. Participants consumed a minimum of 728 g of canned, drained chickpeas per week (the amount in four 300-g cans) as part of their habitual diet for 12 weeks (chickpea phase), followed by 4 weeks of habitual diet without chickpeas (usual phase). In the chickpea phase, mean dietary fiber intake was 6.77 g/day more and mean polyunsaturated fatty acid consumption (as a percentage of total fat) was 2.66% more (both P<0.001), causing the polyunsaturated to saturated fatty acids ratio to change from 0.39 to 0.47 (P=0.045). Serum total cholesterol and low-density lipoprotein cholesterol were 7.7 mg/dL (0.20 mmol/L) and 7.3 mg/dL (0.19 mmol/L) less, respectively, after the chickpea phase (P相似文献   

Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial.

BACKGROUND: Effects of diet on blood lipids are best known in white men, and effects of type of carbohydrate on triacylglycerol concentrations are not well defined. OBJECTIVE: Our goal was to determine the effects of diet on plasma lipids, focusing on subgroups by sex, race, and baseline lipid concentrations. DESIGN: This was a randomized controlled outpatient feeding trial conducted in 4 field centers. The subjects were 436 participants of the Dietary Approaches to Stop Hypertension (DASH) Trial [mean age: 44.6 y; 60% African American; baseline total cholesterol: < or = 6.7 mmol/L (< or = 260 mg/dL)]. The intervention consisted of 8 wk of a control diet, a diet increased in fruit and vegetables, or a diet increased in fruit, vegetables, and low-fat dairy products and reduced in saturated fat, total fat, and cholesterol (DASH diet), during which time subjects remained weight stable. The main outcome measures were fasting total cholesterol, LDL cholesterol, HDL cholesterol, and triacylglycerol. RESULTS: Relative to the control diet, the DASH diet resulted in lower total (-0.35 mmol/L, or -13.7 mg/dL), LDL- (-0.28 mmol/L, or -10.7 mg/dL), and HDL- (-0.09 mmol/L, or -3.7 mg/dL) cholesterol concentrations (all P < 0.0001), without significant effects on triacylglycerol. The net reductions in total and LDL cholesterol in men were greater than those in women by 0.27 mmol/L, or 10.3 mg/dL (P = 0.052), and by 0.29 mmol/L, or 11.2 mg/dL (P < 0.02), respectively. Changes in lipids did not differ significantly by race or baseline lipid concentrations, except for HDL, which decreased more in participants with higher baseline HDL-cholesterol concentrations than in those with lower baseline HDL-cholesterol concentrations. The fruit and vegetable diet produced few significant lipid changes. CONCLUSIONS: The DASH diet is likely to reduce coronary heart disease risk. The possible opposing effect on coronary heart disease risk of HDL reduction needs further study.     

Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria

BACKGROUND: Replacement of red meat in the diet with chicken has reduced the urinary albumin excretion rate (UAER) and serum cholesterol in microalbuminuric type 2 diabetes patients. The effects of withdrawing red meat are unknown in the more advanced stages of diabetic nephropathy. OBJECTIVE: Our objective was to assess the effects of replacing red meat in the usual diet (UD) with chicken (CD) and of consuming a lactovegetarian low-protein diet (LPD) on renal function, fatty acid, and lipid profile in macroalbuminuric type 2 diabetes patients. DESIGN: A crossover controlled trial was conducted in 17 type 2 diabetes patients with macroalbuminuria (24-h UAER > or = 200 microg/min). Each patient followed the UD, CD, and LPD in a random order for 4 wk. After each diet, glomerular filtration rate, UAER, serum fatty acid, lipid profile, glycemic control, anthropometric indexes, and blood pressure were measured. RESULTS: UAER [median CD: 269.4 (range: 111-1128) microg/min; LPD: 229.3 (76.6-999.3) microg/min; UD: 312.8 (223.7-1223.7) microg/min; P < 0.01] and mean (+/-SD) non-HDL cholesterol (CD: 3.92 +/- 0.99 mmol/L; LPD: 3.92 +/- 0.93 mmol/L; UD: 4.23 +/- 1.06 mmol/L; P = 0.042) were lower after CD and LPD than after UD. Compared with the UD, an increase in serum total polyunsaturated fatty acids was also observed (CD: 39.8 +/- 2.6%; LPD: 39.7 +/- 4.4%; UD: 37.3 +/- 3.1%; P = 0.029). CONCLUSION: In macroalbuminuric patients with type 2 diabetes, withdrawing red meat from the diet reduces the UAER.     

男性青年饮用牛奶和豆浆后血脂血糖变化的研究

目的研究饮用牛奶或豆浆后健康男性青年血脂血糖的变化情况。方法 30名男性健康大学生随机分入牛奶组、豆浆组和纯净水组,每天饮用相应饮品1L,连续饮用4周。测定干预前后血浆中甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、葡萄糖(GLU)水平的变化。结果干预后牛奶组的LDL-C水平从(2.28±0.33)mmol/L下降至(1.95±0.41)mmol/L(P﹤0.05),豆浆组从(2.23±0.27)mmol/L下降至(1.94±0.37)mmol/L(P﹤0.05)。与纯净水对照组比较,牛奶组和豆浆组降LDL-C作用更为明显(P﹤0.01)。另外豆浆组的TG水平也明显降低(P﹤0.05)。各组的TC、GLU水平未见明显变化。结论饮用牛奶或豆浆对血糖没有明显影响但有一定降血脂作用,可以预防动脉粥样硬化等心血管疾病。     

基于家庭为中心的护理干预对颈动脉狭窄患者血脂水平及护理风险的影响

目的 探讨基于家庭为中心的护理干预对颈动脉狭窄患者血脂水平及护理风险事件的影响。方法 选取2017年1月—2019年1月在某医院接受治疗的颈动脉狭窄患者84例,按随机数字表法分为两组,各42例。对照组给予常规护理,观察组采用基于家庭为中心的护理干预。对比两组干预前后血脂水平及护理风险事件发生率。结果 观察组甘油三酯(1.48±0.28)mmol/L、胆固醇(4.21±0.64)mmol/L、低密度脂蛋白水平为(2.54±0.36)mmol/L,均低于对照组的(1.66±0.31)mmol/L、(4.72±0.61)mmol/L、(2.87±0.42)mmol/L,差异均有统计学意义(P值均<0.05)。观察组护理风险事件总发生率为4.76%,低于对照组的21.43%,(χ2=5.126,P<0.05)。结论 基于家庭为中心的护理干预可有效降低颈动脉狭窄患者血脂水平,降低护理风险事件发生率,值得推广应用。     

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.     

对2型糖尿病患者实施门诊健康教育的效果分析

[目的]评价糖尿病门诊健康教育的临床效果。[方法]将在我院门诊接受治疗的120例2型糖尿病患者随机分为2组,干预组60例接受健康教育,对照组60例不接受健康教育,两组均接受原有的药物治疗。分别在干预实施前后检测患者的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂(TG、TC、HDL-C、LDL-C)水平。[结果]干预实施前后,干预组FPG、2hPG、HbA1c水平分别为(8.0±1.4)mmol/L、(12.2±2.9)mmol/L、(7.5±1.5)%和(6.5±1.1)mmol/L、(8.3±2.2)mmol/L、(6.1±0.7)%,差异均有统计学意义(P<0.05)。TG、TC、HDL-C水平分别为(2.05±0.99)mmol/L、(5.44±1.04)mmol/L、(1.42±0.36)mmol/L和(1.39±0.63)mmol/L、(4.04±0.78)mmol/L、(1.94±1.01)mmol/L,差异均有统计学意义(P<0.05)。[结论]糖尿病门诊健康教育不但可以改善患者的血糖水平,而且可以降低患者的TC和TG水平,提高HDL-C水平。     

Coaching patients with coronary heart disease to achieve the target cholesterol: a method to bridge the gap between evidence-based medicine and the "real world"--randomized controlled trial

Community studies have demonstrated suboptimal achievement of lipid targets in the management of patients with coronary heart disease (CHD). An effective strategy is required for the application of evidence-based prevention therapy for CHD. The objective of this study was to test coaching as a technique to assist patients in achieving the target cholesterol level of <4.5 mmol/L. Patients with established CHD (n = 245) underwent a stratified randomization by cardiac procedure (coronary artery bypass graft surgery or percutaneous coronary intervention) to receive either the coaching intervention (n = 121) or usual medical care (n = 124). The primary outcome measure was fasting serum total cholesterol (TC), serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and calculated low-density lipoprotein cholesterol (LDL-C) level, measured at 6 months post-randomization. At 6 months, the serum TC and LDL-C levels were significantly lower in the coaching intervention group (n = 107) than the usual care group (n = 112): mean TC (95%CI) 5.00 (4.82-5.17) mmol/L versus 5.54 (5.36-5.72) mmol/L (P <.0001); mean LDL-C (95%CI) 3.11 (2.94-3.29) mmol/L versus 3.57 (3.39-3.75) mmol/L (P <.0004), respectively. Coaching had no impact on TG or on HDL-C levels. Multivariate analysis showed that being coached (P <.001) had an effect of equal magnitude to being prescribed lipid-lowering drug therapy (P <.001). The effectiveness of the coaching intervention is best explained by both adherence to drug therapy and to dietary advice given. Coaching may be an appropriate method to reduce the treatment gap in applying evidence-based medicine to the "real world."     

A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women

Frequent consumption of nuts is associated with decreased risk of cardiovascular disease. We investigated the effect of pecans rich in monounsaturated fat as an alternative to the Step 1 diet in modifying serum lipids and lipoproteins in men and women with normal to moderately high serum cholesterol. In a single-blind, randomized, controlled, crossover feeding study, we assigned 23 subjects (mean age: 38 y; 9 women, 14 men) to follow two diets, each for 4 wk: a Step I diet and a pecan-enriched diet (accomplished by proportionately reducing all food items in a Step I diet by one fifth for a 20% isoenergetic replacement with pecans). The percentage of energy from fat in the two diets was 28.3 and 39.6%, respectively. Both diets improved the lipid profile; however, the pecan-enriched diet decreased both serum total and LDL cholesterol by 0.32 mmol/L (6.7 and 10.4%, respectively) and triglyceride by 0.14 mmol/L (11.1%) beyond the Step I diet, while increasing HDL cholesterol by 0.06 mmol/L (2.5 mg/dL). Serum apolipoprotein B and lipoprotein(a) decreased by 11.6 and 11.1%, respectively, and apolipoprotein A1 increased by 2.2% when subjects consumed the pecan compared with the Step I diet. These differences were all significant (P < 0.05). A 20% isoenergetic replacement of a Step I diet with pecans favorably altered the serum lipid profile beyond the Step I diet, without increasing body weight. Nuts such as pecans that are rich in monounsaturated fat may therefore be recommended as part of prescribed cholesterol-lowering diet of patients or habitual diet of healthy individuals.     

深海鱼油对血脂异常人群的血脂和血糖影响

目的探究深海鱼油对血脂异常人群的血脂和血糖影响。方法采用随机、2×2交叉实验设计的方法,对60名血脂异常患者分别进行3月的深海鱼油干预和3月的空白对照,深海鱼油干预剂量为1.8 g/d。采用全自动生化仪,对患者的血脂和血糖指标进行检测。运用交叉设计资料的方差分析方法探讨鱼油对血脂和血糖水平的影响。结果与空白对照组相比,深海鱼油干预可降低血清总胆固醇(鱼油干预组vs空白对照组,[(5.09±0.79)mmol/L vs(5.60±0.89)mmol/L,P=0.003]、甘油三酯(鱼油干预组vs空白对照组,[(1.67±0.09)mmol/L vs(2.10±0.09)mmol/L,P=0.003]和低密度脂蛋白(鱼油干预组vs空白对照组,[(3.51±0.92)mmol/L vs(3.88±0.95)mmol/L,P=0.020]水平,而两组人群的高密度脂蛋白、空腹血糖和餐后血糖水平无统计学差异。结论鱼油干预可以明显改善血脂异常人群血脂水平,对血糖水平并未产生影响。     

Diet and serum lipids in vegan vegetarians: a model for risk reduction.

The lipid levels and dietary habits of 31 Seventh-Day Adventist vegan vegetarians (aged 5 to 46 years) who consume no animal products were assessed. Mean serum total cholesterol (3.4 mmol/L), low-density-lipoprotein cholesterol (1.8 mmol/L), and triglyceride (0.8 mmol/L) levels were lower than expected values derived from the Lipid Research Clinics Population Studies prevalence data. Mean high-density-lipoprotein cholesterol (1.3 mmol/L) was comparable to expected values. Analysis of quantitative food frequency data showed that vegans had a significantly lower daily intake of total energy, percentage of energy from fat (31% vs 38%), total fat, saturated fat, monounsaturated fatty acids, cholesterol, and protein and a significantly higher intake of fiber than a sample of matched omnivore controls. Vegans' food intake was also compared with expected values, matched for sex and age, derived from the second National Health and Nutrition Examination Survey and Continuing Survey of Food Intakes by Individuals 24-hour recall data. The vegan diet was characterized by increased consumption of almonds, cashews, and their nut butters; dried fruits; citrus fruits; soy milk; and greens. We conclude from the present study that a strict vegan diet, which is typically very low in saturated fat and dietary cholesterol and high in fiber, can help children and adults maintain or achieve desirable blood lipid levels.     

Oat bran lowers plasma cholesterol levels in mildly hypercholesterolemic men.

The effects of oat bran and wheat bran on plasma lipid concentrations were compared in a crossover study. Each bran (123 g oat bran or 54 g wheat bran) added nearly 18 g of nonstarch polysaccharide to a background diet containing about 10 g nonstarch polysaccharide. Twenty-three men (average plasma cholesterol level = 5.84 mmol/L, and low-density-lipoprotein (LDL) cholesterol level = 4.11 mmol/L) were randomly assigned to either the oat or wheat bran diet for 4 weeks and then changed to the alternate bran diet for a similar period. The oat bran diet produced significantly lower levels of plasma total cholesterol and LDL cholesterol: 5.65 +/- 0.16 and 3.88 +/- 0.15 mmol/L (mean +/- standard error) for oat bran vs 5.89 +/- 0.16 and 4.11 +/- 0.16 mmol/L for wheat bran. Food intake diaries showed that average consumption of total fat and saturated fat was identical during the two test periods, which excluded displacement of fat as an explanation for lowering of plasma cholesterol by oat bran. Our results indicate that in mildly hypercholesterolemic men, a diet high in soluble oat fiber can significantly lower plasma total cholesterol and LDL cholesterol and thus potentially lower the risk of coronary heart disease.     

Puberty-associated differences in total cholesterol and triglyceride levels according to sex in French children aged 10-13 years

PURPOSE: To assess the relationships between lipid levels and sexual maturity, independently of age-related differences, and to investigate possible differences related to sexual maturity across the percentiles of the lipid distributions. METHODS: Fasting serum total cholesterol and triglyceride concentrations were measured in 6577 boys and 6605 girls, aged from 10 to 13 years, with different Tanner stages. The total cholesterol and triglyceride mean and percentile levels were estimated according to age and Tanner stage by ordinary least squares and percentile regression models, separately in both sexes. RESULTS: In boys and girls, total cholesterol levels were significantly associated with pubertal stage after controlling for age. At age 12, the estimated mean levels in boys varied from 4.82 mmol/L for Tanner 1 to 4.41 for Tanner 5. The corresponding values were 5.05 and 4.62 mmol/L in girls, for whom the association with maturity was stronger in the upper than in the lower percentiles (p < 0.0001); between the extreme Tanner stages, the 95th percentiles of total cholesterol differed by 0.80 mmol/L, in comparison to 0.19 mmol/L for the 5th percentiles. Therefore, 1. 8% of girls and 0.7% of boys were classified differently whether Tanner stage was used or not to assess hypercholesterolemia (concentrations in the upper 5% of the distributions). Triglycerides were positively related to sexual maturity independently of age, but the discrepancies between classifications were lower; 1.1% in girls and 0.4% in boys. CONCLUSIONS: Our findings emphasize the importance of sexual maturity, even for a given age, for interpreting lipid levels in children.     

Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis

Green tea catechins (GTCs) have been studied in randomized control trials for their lipid-lowering effects. Studies, however, have been small and demonstrated conflicting results. The objective of this study was to perform a systematic review and meta-analysis of randomized controlled trials evaluating the relationship between GTCs and serum lipid levels, including total, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, and triglycerides. A systematic literature search of MEDLINE, EMBASE, Cochrane CENTRAL, and the Natural Medicines Comprehensive Database was conducted through March 2010. Randomized controlled trials evaluating GTCs vs control in human beings and reporting efficacy data on at least one of the aforementioned serum lipid endpoints were included. Weighted mean differences for changes from baseline (with 95% confidence intervals [CIs]) for lipid endpoints were calculated using random-effects models. Twenty trials (N=1,415) met all inclusion criteria. Upon meta-analysis, GTCs at doses ranging from 145 to 3,000 mg/day taken for 3 to 24 weeks reduced total (−5.46 mg/dL [−0.14 mmol/L]; 95% CI −9.59 to −1.32) and LDL cholesterol (−5.30 mg/dL [−0.14 mmol/L]; 95% CI −9.99 to −0.62) compared to control. GTCs did not significantly alter HDL cholesterol (−0.27 mg/dL [−0.007 mmol/L]; 95% CI −1.62 to 1.09) or triglyceride (3.00 mg/dL [−0.034 mmol/L]; 95% CI −2.73 to 8.73) levels. The consumption of GTCs is associated with a statistically significant reduction in total and LDL cholesterol levels; however, there was no significant effect on HDL cholesterol or triglyceride levels.     

Treatment of hypertriglyceridemia in patients receiving parenteral nutrition

Background: This study aims to evaluate whether withdrawal of a soy oil–based lipid emulsion from the parenteral nutrition (PN) regimen in humans is associated with improved triglyceride and liver enzyme concentrations. Methods: In this retrospective study, patients with hypertriglyceridemia (>4.50 mmol/L) while receiving PN were retrieved from a prospective complication registration database. Patients received Intralipid 20% as part of an all‐in‐one system containing all necessary macro‐ and micronutrients, electrolytes, trace elements, and vitamins. Results: Forty patients with hypertriglyceridemia were included. Lipid emulsions were withdrawn from the all‐in‐one mixture for a median of 5 (range, 1‐23) days, after which triglyceride concentrations decreased significantly (mean difference ?2.5 ± 0.30 mmol/L, P < .001). Aspartate aminotransaminase and leukocyte count decreased significantly (mean difference ?35 ± 17 U/L, P = .049 and ?3.8 ± 1.7*10E9/L, P = .028, respectively), whereas albumin level increased significantly (mean difference 2.1 ± 0.9 g/L, P = .027). Alanine aminotransaminase showed a nonsignificant reduction (mean difference ?30 ± 22 U/L, P = .194). In 11 patients, the lipid emulsion was reintroduced, after which triglyceride levels showed a significant increase (mean difference 1.5 ± 0.30 mmol/L, P = .001).Conclusions: Short‐term withdrawal of the lipid fraction in the PN mixture is associated with a significant reduction of plasma triglyceride concentration. Reintroduction was related to an increase of triglyceride concentration. In addition, liver enzyme abnormalities and leukocyte count reduced, whereas albumin levels increased, suggesting that even short withdrawal of the lipid emulsion diminished hepatocellular damage and systemic inflammation.