Glucosyl hesperidin lowers serum triglyceride level in hypertriglyceridemic subjects through the improvement of very low-density lipoprotein metabolic abnormality

To examine the serum triglyceride (TG)-lowering effect of a soluble hesperidin derivative, glucosyl hesperidin (G-hesperidin), and its mechanisms, we carried out a G-hesperidin administration test in hypertriglyceridemic subjects. G-Hesperidin was administered to the subjects at 500 mg/d for 24 wk. In this study, the subjects were classified into high-TG type (TG > 150 mg/dL), borderline-TG type (TG 110-150 mg/dL) and normal-TG type (TG < 110 mg/dL) on the basis of their initial serum TG values. Among these phenotypes, serum TG level significantly decreased in the high-TG type during the G-hesperidin administration period. It was also observed that elevated values of serum remnant-like particle cholesterol (RLP-C), apolipoprotein (apo) B, apo C-II, apo C-III and apo E occurred in the high-TG type and that these serum levels were significantly reduced by G-hesperidin administration. Moreover, polyacrylamide gel electrophoresis analysis of serum lipoproteins revealed that the very low-density lipoprotein (VLDL)/low-density lipoprotein (LDL) ratio and LDL migration index of the high-TG type were remarkably higher than those of the other phenotypes but that their high values were significantly reduced by the administration. These results indicate that G-hesperidin preferentially lowers serum TG in hypertriglyceridemic subjects and that this effect is possibly caused by the improvement of VLDL metabolic abnormality, leading to the reduction of small dense LDL.     

Suppression of apolipoprotein B secretion from HepG2 cells by glucosyl hesperidin

Our previous study has shown that a soluble hesperidin derivative, glucosyl hesperidin (G-hesperidin), preferentially lowers serum triglyceride (TG) level in hypertriglyceridemic subjects through the improvement of very low-density lipoprotein (VLDL) metabolic abnormality. G-Hesperidin has also been found to decrease an elevated serum apolipoprotein B (apo B) level in the hypertriglyceridemic subjects, suggesting a possibility that this compound suppresses excess VLDL secretion in the liver. In the present study, to gain a better understanding of possible mechanisms by which G-hesperidin lowers serum TG, we examined whether this derivative affects apo B secretion from HepG2 human hepatoma cells, a model of hepatic VLDL secretion. As a result, G-hesperidin significantly reduced apo B secretion from the oleate-stimulated HepG2 cells. Furthermore, G-hesperidin significantly suppressed apo B secretion only in the oleate-stimulated cells and failed to act on the cells incubated without oleate. In the oleate-stimulated cells, G-hesperidin significantly decreased cellular cholesteryl ester (CE), although it had no effect on cellular TG or free cholesterol amounts. Moreover, the oleate-stimulated cells had a decrease in cellular apo B amounts by G-hesperidin exposure. These findings indicate that G-hesperidin down-regulates the assembly of apo B-containing lipoproteins via the reduction of CE synthesis augmented with oleate and results in suppressing excess apo B secretion from the cells. This effect is speculated to be associated with the improvement of VLDL metabolic abnormality in hypertriglyceridemic subjects and considered as a mechanism of lowering serum TG.     

Serum selenium and serum lipids in US adults

BACKGROUND: Selenium, an essential micronutrient, has received considerable attention for its antioxidant properties. In addition, selenium may affect several cardiometabolic risk factors, such as glucose homeostasis and lipid concentrations. However, the effects of selenium intake on the lipid profile in selenium-replete populations, such as the United States, are largely unknown. OBJECTIVE: We examined the relation of serum selenium concentrations with serum lipids in a representative sample of US adults. DESIGN: This was a cross-sectional analysis of 5452 men and women aged >/= 20 y participating in the third National Health and Nutrition Examination survey. Serum selenium was measured by atomic absorption spectrometry. RESULTS: The multivariable adjusted differences in total cholesterol, LDL cholesterol, HDL cholesterol, apolipoprotein B (apo B), and apolipoprotein A-I (apo A-I) comparing the highest with the lowest quartile of serum selenium were 16.6 mg/dL (95% CI: 11.6, 21.4 mg/dL), 10.9 mg/dL (95% CI: 6.4, 15.4 mg/dL), 3.2 mg/dL (95% CI: 1.6, 5.0 mg/dL), 8.9 mg/dL (95% CI: 5.6, 12.2 mg/dL), and 6.9 mg/dL (95% CI: 1.7, 12.1 mg/dL), respectively. Participants in the highest quartile of serum selenium had 10% higher concentrations of triacylglycerols than did participants in the lowest quartile (ratio of triacylglycerol concentrations: 1.10; 95% CI: 1.05, 1.17). The difference in the ratios of LDL cholesterol to HDL cholesterol and apo B to apo A-I that compared the highest with the lowest selenium quartiles were 0.11 (95% CI: -0.02, 0.25) and 0.03 (95% CI: 0.00, 0.06), respectively. CONCLUSION: Elevated serum selenium was associated with elevated serum concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols, apo B, and apo A-I among US adults, a selenium-replete population. Experimental studies are needed to determine cause and effect relations and the potential mechanisms underlying these associations.     

Relationship of coffee consumption with serum lipids and lipoproteins in Japanese men

PURPOSE: To examine the relationship of instant coffee and brewed coffee with serum lipids and lipoproteins in Japanese men. METHODS: Study subjects were 4587 male self-defense officials aged 48-56 years who had a preretirement health examination at one of the three hospitals of the Self-Defense Forces from October 1986 to December 1992. A self-administered questionnaire ascertained lifestyle characteristics including consumption of a limited number of foods and beverages by all of the men. Serum concentrations of total cholesterol (TC), triglycerides (TG), and high density lipoprotein (HDL) cholesterol were measured, and low density lipoprotein (LDL) cholesterol levels were calculated from the values of TC, TG, and HDL cholesterol. RESULTS: While the consumption of brewed coffee was unrelated to any parameter of serum lipids and lipoproteins, instant coffee consumption showed a highly significant positive association with serum LDL cholesterol levels and an inverse association with serum TG levels. After adjustment for body mass index, smoking, alcohol use, green tea consumption, rank, and hospital, for each cup of instant coffee per day, LDL cholesterol levels were 0.82 mg/dl (95% confidence interval (CI) 0.29-1.35) higher, and TG levels in a natural log-scale were 0.014 mg/dl (95% CI 0.006-0.022) lower. There was also a tendency for a positive association between instant coffee intake and serum TC levels (trend p = 0.09). HDL cholesterol levels were unrelated to instant coffee consumption. These associations did not change after additional adjustment for selected foods and beverages associated with serum lipids and lipoproteins. CONCLUSIONS: The findings suggest that instant coffee, not brewed coffee, may be associated with raised levels of serum LDL cholesterol and decreased levels of serum TG.     

Krill oil supplementation lowers serum triglycerides without increasing low-density lipoprotein cholesterol in adults with borderline high or high triglyceride levels

The aim of the study was to explore the effects of 12 weeks daily krill oil supplementation on fasting serum triglyceride (TG) and lipoprotein particle levels in subjects whose habitual fish intake is low and who have borderline high or high fasting serum TG levels (150–499 mg/dL). We hypothesized that Krill oil lowers serum TG levels in subjects with borderline high or high fasting TG levels. To test our hypothesis 300 male and female subjects were included in a double-blind, randomized, multi-center, placebo-controlled study with five treatment groups: placebo (olive oil) or 0.5, 1, 2, or 4 g/day of krill oil. Serum lipids were measured after an overnight fast at baseline, 6 and 12 weeks. Due to a high intra-individual variability in TG levels, data from all subjects in the four krill oil groups were pooled to increase statistical power, and a general time- and dose-independent one-way analysis of variance was performed to assess efficacy. Relative to subjects in the placebo group, those administered krill oil had a statistically significant calculated reduction in serum TG levels of 10.2%. Moreover, LDL-C levels were not increased in the krill oil groups relative to the placebo group. The outcome of the pooled analysis suggests that krill oil is effective in reducing a cardiovascular risk factor. However, owing to the individual fluctuations of TG concentrations measured, a study with more individual measurements per treatment group is needed to increase the confidence of these findings.     

Soy isoflavones lower serum total and LDL cholesterol in humans: a meta-analysis of 11 randomized controlled trials

BACKGROUND: Clinical trials have reported the cholesterol-lowering effects of soy protein intake, but the components responsible are not known. OBJECTIVE: This meta-analysis was primarily conducted to evaluate the precise effects of soy isoflavones on lipid profiles. The effects of soy protein that contains enriched and depleted isoflavones were also examined. DESIGN: PUBMED was searched for English-language reports of randomized controlled trials published from 1990 to 2006 that described the effects of soy protein intake in humans. Eleven studies were selected for the meta-analysis. RESULTS: Soy isoflavones significantly decreased serum total cholesterol by 0.10 mmol/L (3.9 mg/dL or 1.77%; P = 0.02) and LDL cholesterol by 0.13 mmol/L (5.0 mg/dL or 3.58%; P < 0.0001); no significant changes in HDL cholesterol and triacylglycerol were found. Isoflavone-depleted soy protein significantly decreased LDL cholesterol by 0.10 mmol/L (3.9 mg/dL or 2.77%; P = 0.03). Soy protein that contained enriched isoflavones significantly decreased LDL cholesterol by 0.18 mmol/L (7.0 mg/dL or 4.98%; P < 0.0001) and significantly increased HDL cholesterol by 0.04 mmol/L (1.6 mg/dL or 3.00%; P = 0.05). The reductions in LDL cholesterol were larger in the hypercholesterolemic subcategory than in the normocholesterolemic subcategory, but no significant linear correlations were observed between reductions and the starting values. No significant linear correlations were found between reductions in LDL cholesterol and soy protein ingestion or isoflavone intakes. CONCLUSIONS: Soy isoflavones significantly reduced serum total and LDL cholesterol but did not change HDL cholesterol and triacylglycerol. Soy protein that contained enriched or depleted isoflavones also significantly improved lipid profiles. Reductions in LDL cholesterol were larger in hypercholesterolemic than in normocholesterolemic subjects.     

The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients.

OBJECTIVE: To examine the effect of zinc sulfate supplementation on the concentrations of serum zinc and serum cholesterol in hemodialysis (HD) patients. SETTING: Outpatient dialysis center in a large metropolitan city. DESIGN: Randomized, double-blind, before-after trial. PATIENTS: Twenty-eight maintenance HD patients were selected. Twenty (15 women and 5 men) completed the study. Subjects were identified for inclusion in the study by the following criteria: HD treatment for a minimum of 6 months, no signs of gastrointestinal disorders, and no record of hospitalizations for reasons other than vascular access complications within the last 3 months. INTERVENTIONS: Patients were given a daily supplement of 7.7 micromol zinc sulfate (50 mg elemental zinc) or a cornstarch placebo capsule for 90 days. Patients completed 2-day food records, at day 0 and day 90 of the study, which included 1 dialysis day and 1 nondialysis day. MAIN OUTCOME MEASURE: Fasting, predialysis serum samples were collected on days 0, 40, and 90 to determine serum zinc and total cholesterol (TCHOL) concentrations. Dietary parameters, including zinc, protein, and energy intake, were also analyzed on days 0 and 90. RESULTS: Initial concentrations of serum zinc indicated subjects were below the normal range for serum zinc standards (12 micromol/L [80 microg/dL]). After supplementation, subjects in the zinc-supplemented group showed significant increases in serum zinc concentrations from 0.79 microg/mL at day 0 to 0.96 microg/mL at day 90. Serum TCHOL concentrations were initially low among subjects in the control (2.914 +/- 0.158 mmol/L [112.7 +/- 6.1 mg/dL]) and zinc-supplemented (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) groups. Serum TCHOL concentrations in the control group increased slightly throughout the study period but did not reach statistical significance. A progressive increase in serum TCHOL concentration was observed in the zinc-supplemented group from the beginning (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) to the end (4.445 +/- 0.478 mmol/L [171.9 +/- 18.5 mg/dL]) of the study (r =.63, P <.05). Mean serum high-density lipoprotein (HDL) cholesterol concentrations for the zinc-supplemented group were 0.959 mmol/L +/- 0.11 (37.1 mg/dL +/- 4.3), 0.825 mmol/L +/- 0.08 (31.9 mg/dL +/- 3.2), and 0.908 mmol/L +/- 0.10 (35.1 mg/dL +/- 3.9) from the beginning to the end of the experimental period. The mean serum HDL cholesterol concentrations for the control group were 0.760 mmol/L +/- 0.075 (29.4 mg/dL +/- 2.9), 0.760 +/- 0.08 (29.4 mg/dL +/- 3.0), and 0.799 mmol/L +/- 0.13 (30.9 mg/dL +/- 4.9) from the beginning to the end of the experimental period. A progressive increase in low-density lipoprotein (LDL) cholesterol concentration was observed for the zinc-supplemented group throughout the study. Mean LDL cholesterol concentrations for the zinc-supplemented group were 2.19 mmol/L +/- 0.39 (85 mg/dL +/- 15.0), 3.30 mmol/L +/- 0.36 (127.8 mg/dL +/- 14.1), and 3.53 mmol/L +/- 0.53 (136.7 mg/dL +/- 20.6) from the beginning to the end of the study period. When serum zinc concentration was correlated with serum LDL cholesterol concentration, a significant correlation was found (r =.62, P <.03) for the zinc-supplemented group and no significant difference was found for the control group. No significant differences in LDL cholesterol concentrations were found within the control group from the beginning to the end of the study. Dietary intake of zinc, cholesterol, total fat, and saturated fat remained constant and did not statistically influence serum values. Reported energy intake increased significantly in the zinc-supplemented group from 5,799 kJ/24 h (1,385 kcal/d) at day 0 to 7,042 kJ/24 h (1,682 kcal/d) at day 90. CONCLUSION: Zinc supplementation is an effective means of improving serum levels of zinc and cholesterol in the HD patient.     

Short-term effects of glucosyl hesperidin and hesperetin on blood pressure and vascular endothelial function in spontaneously hypertensive rats

Glucosyl hesperidin (G-hesperidin) is a water-soluble derivative of hesperidin. In the present study, the short-term effects of G-hesperidin and hesperetin, a putative metabolite of G-hesperidin, in spontaneously hypertensive rats (SHR) and in normotensive Wistar-Kyoto rats (WKY) were investigated. Single oral administration of G-hesperidin (10 to 50 mg/kg) induced a dose-dependent reduction in systolic blood pressure (SBP) in SHR, but had no effects in WKY. Intraperitoneal injection of hesperetin (50 mg/kg) into SHR also caused a significant reduction in SBP. The depressor effect was significantly inhibited by a nitric oxide synthase inhibitor, N(G)-nitro-L-arginine methyl ester. Moreover, hesperetin (10(-5) M) enhanced endothelium-dependent relaxation induced by acetylcholine, but had no effect on endothelium-independent relaxation induced by sodium nitroprusside in isolated aortas from SHR. These data suggest that the hypotensive effect of hesperetin in SHR is associated with nitric oxide-mediated vasodilation. Therefore, this effect may be involved in the mechanisms by which G-hesperidin lowers blood pressure in hypertension.     

The cholesterol-lowering effect of coconut flakes in humans with moderately raised serum cholesterol

This study investigated the effect of coconut flakes on serum cholesterol levels of humans with moderately raised serum cholesterol in 21 subjects. The serum total cholesterol of subjects differed and ranged from 259 to 283 mg/dL. The study was conducted in a double-blind randomized crossover design on a 14-week period, consisting of four 2-week experimental periods, with each experimental period separated by a 2-week washout period. The test foods were as follows: corn flakes as the control food, oat bran flakes as the reference food, and corn flakes with 15% and 25% dietary fiber from coconut flakes (made from coconut flour production). Results showed a significant percent reduction in serum total and low-density lipoprotein (LDL) cholesterol (in mg/dL) for all test foods, except for corn flakes, as follows: oat bran flakes, 8.4 +/- 1.4 and 8.8 +/- 6.0, respectively; 15% coconut flakes, 6.9 +/- 1.1 and 11.0 +/- 4.0, respectively; and 25% coconut flakes, 10.8 +/- 1.3 and 9.2 +/- 5.4, respectively. Serum triglycerides were significantly reduced for all test foods: corn flakes, 14.5 +/- 6.3%; oat bran flakes, 22.7 +/- 2.9%; 15% coconut flakes, 19.3 +/- 5.7%; and 25% coconut flakes, 21.8 +/- 6.0%. Only 60% of the subjects were considered for serum triglycerides reduction (serum triglycerides >170 mg/dL). In conclusion, both 15% and 25% coconut flakes reduced serum total and LDL cholesterol and serum triglycerides of humans with moderately raised serum cholesterol levels. Coconut flour is a good source of both soluble and insoluble dietary fiber, and both types of fiber may have significant role in the reduction of the above lipid biomarker. To our knowledge, this is the first study conducted to show a relationship between dietary fiber from a coconut by-product and a lipid biomarker. Results from this study serves as a good basis in the development of coconut flakes/flour as a functional food, justifying the increased production of coconut and coconut by-products.     

Fasting increases serum total cholesterol, LDL cholesterol and apolipoprotein B in healthy, nonobese humans.

Voluntary fasting is practiced by many humans in an attempt to lose body weight. Conflicting results have been published on the effects of food deprivation on serum lipids. To study the effect of acute starvation on serum lipids, 10 nonobese (93-124% of ideal body weight), healthy adults (6 men, 4 women, 21-38 y old) fasted (no energy) for 7 d. Fasting increased total serum cholesterol from 4.90 +/- 0.23 to 6.73 +/- 0.41 mmol/L (37.3 +/- 5.0%; P < 0.0001) and LDL cholesterol from 2.95 +/- 0.21 to 4.90 +/- 0.36 mmol/L (66.1 +/- 6. 6%; P < 0.0001). Serum apolipoprotein B (apo B) increased from 0.84 +/- 0.06 to 1.37 +/- 0.11 g/L (65.0 +/- 9.2%; P < 0.0001). The increases in serum cholesterol, LDL and apo B were associated with weight loss. Fasting did not affect serum concentrations of triacylglycerol and HDL cholesterol. Serum concentrations of insulin-like growth factor-I (IGF-I) decreased from 246 +/- 29 (prefast) to 87 +/- 10 microg/L after 1 wk of fasting (P < 0.0001). We conclude that, in nonobese subjects, fasting is accompanied by increases in serum cholesterol, LDL and apo B concentrations, whereas IGF-I levels are decreased.     

Utilization of Small Dense Low-Density Lipoprotein Cholesterol Testing in Korean Patients Visiting Local Clinics and Hospitals

Small dense low-density cholesterol (sdLDL) has been the focus of studies due to its potential as an independent risk factor for atherosclerotic cardiovascular diseases. We aimed to investigate the utilization of sdLDL testing by LDL particle size analysis and the prevalence of an sdLDL predominant phenotype in Korean adult patients by visiting local clinics and hospitals. Among 9222 Korean adults (4577 men and 4645 women) with a median age of 62.8 years (interquartile range, IQR 54.5 to 71.8 years) undergoing lipid profile testing using LDL particle size analysis, the prevalence of hypercholesterolemia (total cholesterol ≥ 240 mg/dL), hypo HDL cholesterolemia (<40 mg/dL), and hyper LDL cholesterolemia (≥160 mg/dL) was 7.8%, 12.9%, and 0.5%, respectively. The overall prevalence of the sdLDL predominant non-A phenotype of LDL was 46.8% of study subjects. Approximately 32.8% of the study subjects possessed lipid test results that did not exhibit increased risk except for sdLDL (only the sdLDL predominant non-A phenotype as a risk factor). In Korea, sdLDL testing was utilized in patients whose LDL cholesterol level was not increased. Future studies to clarify the clinical significance of this test in the Korean population are needed.     

Standardized capsule of Camellia sinensis lowers cardiovascular risk factors in a randomized, double-blind, placebo-controlled study

OBJECTIVE: Previous studies examining the effect of tea drinking on cardiovascular health have produced mixed results due to their observational nature and qualitatively and quantitatively imprecise definitions of active tea components. The objective of this study was to determine if a standardized and defined decaffeinated green tea (Camellia sinensis) product lowers blood pressure, serum lipids, oxidative stress, and markers of chronic inflammation. METHODS: A randomized, double-blind, placebo-controlled, parallel study on 111 healthy adult volunteers 21-70 y old was performed. We administered a standardized capsule of Camellia sinensis compounds (CSC) twice a day. Before and after 3 wk, blood pressure, serum lipids, serum amyloid-alpha (a marker of chronic inflammation), and serum malondialdehyde (a marker of oxidative stress) were measured. RESULTS: After 3 wk, CSC lowered systolic and diastolic blood pressures by 5 and 4 mmHg, respectively. After 3 mo, systolic blood pressure remained significantly lower. CSC lowered serum amyloid-alpha by 42% and lowered malondialdehyde by 11.9%. In men, there were 10- and 9-mg/dL reductions in total and low-density lipoprotein (LDL) cholesterol, respectively. In all subjects with a baseline LDL cholesterol level >99 mg/dL, there was 9 mg/dL lowering of total and LDL cholesterol. Adverse effects were mild and few and not different from placebo. CONCLUSION: CSC was effective for decreasing, in as quickly as 3 wk, blood pressure, LDL cholesterol, oxidative stress, and a marker of chronic inflammation, all independent cardiovascular risk factors.     

Effect of soy protein varying in isoflavone content on serum lipids in healthy young men

BACKGROUND: Previous research supports a role for soy protein in reducing serum lipids; however, few studies involved healthy male subjects or focused on soy isoflavones (or did both). OBJECTIVE: The objective was to ascertain the effects of soy protein varying in isoflavone content on serum lipids in healthy young men. DESIGN: Thirty-five males (x +/- SD age: 27.9 +/- 5.7 y) consumed milk protein isolate (MPI), low-isoflavone soy protein isolate (low-iso SPI; 1.64 +/- 0.19 mg aglycone isoflavones/d), and high-isoflavone SPI (high-iso SPI; 61.7 +/- 7.4 mg aglycone isoflavones/d) for 57 d each, separated by 4-wk washout periods, in a randomized crossover design. Blood samples were collected at the beginning and end of each treatment period, and total, LDL, and HDL cholesterol; triacylglycerols; apolipoprotein (apo) B; apo A-I; and C-reactive protein (CRP) were measured in serum. Twenty-four-hour urine samples were collected for 3 consecutive days at the end of each treatment period and analyzed for isoflavones. RESULTS: Urinary isoflavones were significantly greater with consumption of the high-iso SPI than with that of the low-iso SPI or MPI. The differences between the 3 treatments with respect to individual serum lipids were not significant, but the ratios of total to HDL cholesterol, LDL to HDL cholesterol, and apo B to apo A-I were significantly lower with both SPI treatments than with MPI treatment. CONCLUSION: Soy protein, regardless of isoflavone content, modulates serum lipid ratios in a direction beneficial for cardiovascular disease risk in healthy young men.     

膳食脂肪对高血压人群血脂水平的影响

目的 探讨改善膳食脂肪摄入情况对血脂的影响。方法 对营养健康教育前后高血压患者的膳食脂肪摄入情况及血脂水平进行测定分析。结果 基线调查表明人群膳食脂肪及胆固醇摄入量过高,脂肪供能比占总热能的30％以上;血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL－L）水平偏高。相关分析表明,体质指数（BMI）和饱和脂肪酸（SFA）与血清TC、TG、LDL－C呈正相关;高密度脂蛋白（HDL－C）／TC与BMI、SFA呈负相关,而与单不饱和脂肪酸（MUFA）呈正相关。进行社区营养干预后,干预组脂肪供能比小于总热能的30％,与对照组相比及自身干预前后比较差异均有显著性,胆固醇摄入量有下降趋势;干预组人群血脂TC、LDL－C水平显著降低。结论 研究结果提示减少膳食脂肪和胆固醇摄入量,适当增加单不饱和脂肪酸摄入对高血压人群降低血脂水平,控制血压是有效的。     

Evaluation of efficacy and safety of fixed dose lovastatin and niacin(ER) combination in asian Indian dyslipidemic patients: a multicentric study

Asian Indian dyslipidemia is characterized by: borderline high low-density lipoprotein (LDL) cholesterol and apolipoprotein (apo) B; high triglycerides, low high-density lipoprotein (HDL) cholesterol and apoA1; and high lipoprotein(a) (lp[a]). We performed a controlled multicentric trial in India to evaluate the efficacy and safety of a fixed dose combination of lovastatin and niacin extended release (niacin(ER)) formulation in patients with moderate to severe dyslipidemia. Consecutive subjects that satisfied the selection criteria, agreed to an informed consent, and with no baseline presence of liver/renal disease or heart failure were enrolled in the study. After a 4-week run-in period there were 142 patients with LDL levels > or = 130 mg/dL. Eleven patients were excluded because of uncontrolled hyperglycemia and 131 patients were recruited. After baseline evaluation of clinical and biochemical parameters all subjects were administered lovastatin (20 mg) and niacin(ER) (500 mg) combination once daily. Dose escalation was done on basis of lipid parameters at 8 weeks and in 11 patients increased to lovastatin (20 mg) and niacin(ER) (1000 mg). An intention-to-treat analysis was performed and data was analyzed using nonparametric Wilcoxon signed rank test. Thirteen patients (10%) were lost to follow-up and 4 (3%) withdrew because of dermatological adverse effects: flushing, pruritus, and rash. The mean values of various lipid parameters (mg/dL) at baseline, and at weeks 4, 12, and 24 respectively were: total cholesterol 233.9 +/- 27, 206.3 +/- 27, 189.8 +/- 31, and 174.9 +/- 27 mg/dL; LDL cholesterol 153.4 +/- 22, 127.3 +/- 21, 109.2 +/- 27, and 95.1 +/- 23 mg/dL; triglycerides 171.1 +/- 72, 159.5 +/- 75, 149.2 +/- 45, and 135.2 +/- 40 mg/dL; HDL cholesterol 45.6 +/- 7, 48.9 +/- 7, 51.6 +/- 9, and 53.9 +/- 10 mg/dL; lp(a) 48.5 +/- 26, 40.1 +/- 21, 35.4 +/- 21, and 26.9 +/- 19 mg/dL; and apoA1/apoB ratio 0.96 +/- 0.7, 1.04 +/- 0.4, 1.17 +/- 0.5, and 1.45 +/- 0.5 (p < 0.01). The percentage of decline in various lipids at 4, 12, and 24 weeks was: total cholesterol 11.8%, 18.8%, and 25.2%; LDL cholesterol 17.0%, 28.8%, and 38.0%; triglyceride 6.8%, 12.8%, and 21.0%; lp(a) 17.5%, 26.9%, and 44.5% respectively (p < 0.01). HDL cholesterol and apoA1/apoB increased by 7.2%, 13.1%, and 18.2%; and 7.9%, 21.9%, and 51.6% respectively (p < 0.01). Target LDL levels (< 100 mg/dL in subjects with manifest coronary heart disease or diabetes; < 130 mg/dL in subjects with > 2 risk factors) were achieved in 92 (80.7%) patients. No significant changes were observed in systolic or diastolic blood pressure, blood creatinine, transaminases, or creatine kinase. A fixed dose combination of lovastatin and niacin(ER) significantly improved cholesterol lipoprotein lipids as well as lp(a) and apoA1/apoB levels in Asian Indian dyslipidemic patients. Satisfactory safety and tolerability profile in this population was also demonstrated.     

Lipid responses in mildly hypertriglyceridemic men and women to consumption of docosahexaenoic acid-enriched eggs

This randomized, double-blind, controlled clinical trial assessed lipid responses in mildly hyper-triglyceridemic men and women to consumption of docosahexaenoic acid (DHA)-enriched eggs or ordinary chicken eggs. The study included 153 subjects aged 21-80 years, with serum triglyceride concentrations between 140 and 450 mg/dL, inclusive, and serum total cholesterol concentrations < 300 mg/dL. Subjects were randomly assigned to receive either DHA-enriched (147 mg DHA/egg) or ordinary eggs (20 mg DHA/egg), added to their usual diets for six weeks (10 eggs/week). Both treatments significantly lowered triglycerides and increased high-density lipoprotein (HDL) cholesterol levels from baseline; however, these changes were not significantly different between treatments. Low-density lipoprotein (LDL) cholesterol concentrations increased significantly in subjects who consumed DHA-enriched eggs (p = 0.047 vs. control). This increase was significantly higher than that observed with ordinary eggs. However, there was no significant increase in cholesterol carried by small, dense LDL particles, as determined by nuclear magnetic resonance analysis. Results of exploratory analyses suggest favorable effects of the DHA-enriched eggs over ordinary eggs on triglyceride and HDL cholesterol levels in subjects with body mass index > or = 30 kg/m2; the DHA treatment produced a larger reduction in serum triglyceride concentration vs. ordinary eggs (-12.3 vs. 2.1%; p = 0.027), and there was a greater increase for HDL cholesterol in the DHA-enriched vs. ordinary egg group (5.0 vs. 1.1%; p = 0.040).     

Are post-treatment low-density lipoprotein subclass pattern analyses potentially misleading?

Background  

Some patients administered cholesterol-lowering therapies may experience an increase in the proportion of small LDL particles, which may be misinterpreted as a worsening of atherosclerotic coronary heart disease risk. This study assessed the lipid effects of adding ezetimibe to atorvastatin or doubling the atorvastatin dose on low-density lipoprotein cholesterol (LDL-C) levels (and the cholesterol content of LDL subclasses), LDL particle number (approximated by apolipoprotein B), and LDL particle size. This was a multicenter, double-blind, randomized, parallel-group study of hypercholesterolemic, high atherosclerotic coronary heart disease risk patients. After stabilization of atorvastatin 40 mg, 579 patients with LDL-C >70 mg/dL were randomized to 6 weeks of ezetimibe + atorvastatin 40 mg or atorvastatin 80 mg. Efficacy parameters included changes from baseline in LDL-C, apolipoprotein B, non-high-density lipoprotein cholesterol (non-HDL-C), and lipoprotein subclasses (Vertical Auto Profile II) and pattern for the overall population, as well as patient subgroups with baseline triglyceride levels <150 mg/dL or ≥150 mg/dL.     

Solubilization of phytosterols in diacylglycerol versus triacylglycerol improves the serum cholesterol-lowering effect.

OBJECTIVE: This study was performed to investigate the difference in the serum-cholesterol- and triglyceride-lowering activities between phytosterols dissolved in diacylglycerol (PS/DG) and dispersed in triacylglycerol (PS/TG). The effects of the solvent on the concentrations of serum beta-sitosterol and campesterol were examined. DESIGN: The study had a randomised crossover design. SUBJECTS: Twelve healthy normocholesterolemic or moderately hypercholesterolemic men aged 29-50 y participated in this study. INTERVENTIONS: For 2 weeks before the test period (designated as the control period), all subjects consumed control mayonnaise (PS free) daily with supper and were randomly assigned to two groups for the 2 week test period; one group was given mayonnaise containing PS (500 mg/day) dissolved in DG (10 g/day), and the other mayonnaise containing PS (500 mg/day) dispersed in TG (10 g/day). After a wash out period consuming control PS-free mayonnaise for 4 weeks, the groups were reversed for 2 weeks. RESULTS: PS/TG feeding had no effect on the serum cholesterol level. In contrast, PS/DG feeding significantly reduced the total and LDL cholesterol levels from the initial value of 5.57 to 5.31 mmol/l (4.7%; P<0.05) and from 3.69 to 3.39 mmol/l (7.6%; P<0.05), respectively. Moreover, the degree of total cholesterol reduction induced by PS/DG feeding in the test period was significantly greater than that induced by PS/TG feeding (P<0.05). In addition, the serum beta-sitosterol and campesterol concentrations did not change during the PS/TG or PS/DG feeding periods. CONCLUSIONS: Dissolution of PS in DG had a better serum cholesterol lowering effect than dissolution in TG. SPONSORSHIP: Kao Corporation.     

Effect of apolipoprotein E polymorphism on the serum lipid and insulin response to whole grain consumption in coronary artery disease patients

Whether apo E polymorphism influenced serum lipids and insulin response to the isocalorical replacement of refined rice with whole grains was investigated in coronary artery disease (CAD) men with a low-fat diet. CAD men (n=110) were switched from their basal diet (61% carbohydrate and 19% fat) to isoenergetic diet containing 70g whole grain powder (220kcal), as a carbohydrate source of breakfast for 16 weeks. Apo E2 group (n=11) showed higher baseline serum triglyceride than apo E3 group (n=82). Baseline serum concentrations of total and LDL cholesterol and apo B were highest in apo E4 group (n=16), intermediate in apo E3 and lowest in apo E2. Apo E3 groups showed significantly decreases of triglyceride, total and LDL cholesterol and apo B by 12%, 5%, 8% and 8% after 16 weeks, respectively. In apo E4 group, similar decrease of LDL cholesterol and apo B was observed. HDL cholesterol significantly increased by 8% and 15% in apo E3 and E4 groups, respectively. Apo E3 group showed about 9% decrease in fasting insulin and glucose. Apo E genotype modified the serum lipids and insulin response to the isocalorical replacement of refined rice with whole grains in CAD men with a low-fat diet; apo E2 subjects were non-responders, while apo E3 subjects were favorable responders.     

Effect of a soy protein diet on serum lipids of renal transplant patients

ObjectiveThe aim of the present study was to evaluate the effect of a soy-protein diet on plasma lipid levels of renal transplant recipients with moderate hypercholesterolemia.DesignDietary intervention case-control observational study.SettingRenal transplantation outpatient clinic.PatientsFifteen stable patients who had renal transplantation (serum creatinine < 2 mg/dL) with moderate hypercholesterolemia (low-density lipoprotein [LDL] cholesterol > 140 mg/dL).InterventionAfter a baseline dietary interview, dietary counseling was given individually with the goal of substituting 25 g of animal protein with 25 g of soy protein for a 5-week period, using commercially available soy foods, according to each patient’s own preference.Main outcome measuresBefore and after the soy-diet period, plasma lipid profiles including total, LDL, and high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein A1 and B were determined. Protein catabolic rate was assumed as a measure of dietary protein intake.ResultsTwo patients dropped out. After the soy diet, total cholesterol (254 ± 22 to 231 ± 31 mg/dL, P < .05) and LDL cholesterol (165 ± 20 versus 143 ± 20 mg/dL, P < .01) decreased significantly. No significant changes were observed regarding HDL cholesterol and triglycerides. Dietary protein intake did not differ at baseline (73.2 ± 22.9 g/day) and during the soy diet (72.6 ± 15.6 g/day), when the reported actual soy protein intake resulted 26 ± 8 g/day.ConclusionsThis study shows that soy proteins given as part of the daily protein intake have beneficial effects on serum LDL cholesterol levels of renal transplant recipients with moderate hypercholesterolemia. Soy proteins could be of use in the nutritional management of renal transplant recipients.