Effect of dietary alpha‐ketoglutarate on blood lipid profile during hypercholesterolaemia in rats

Objective. The aim of the study was to determine the effect of α‐ketoglutarate on the blood lipid profile using a rat animal model with experimentally induced hypercholesterolaemia. Material and methods. The female and male (30/30) Wistar rats had ad libitum access to a diet containing cholesterol (1?%) and lard (10?%) throughout the entire experimental period (120 days). On day 60 of the study, both the females and the males were divided into three groups, the first receiving a mixture of drinking water adjusted to pH?4.6 using HCl (control), the other two (experimental groups) receiving a solution containing 0.01?M and 0.1?M α‐ketoglutarate (AKG) (pH adjusted to 4.6). Blood samples were taken on days 0, 30, 60 and 120. Results. The concentrations of total cholesterol, triglycerides, HDL and LDL, respectively, in the blood serum were estimated spectrophotometrically. During the entire experimental period the total cholesterol, triglycerides and LDL levels of the control rats increased, whereas that of HDL decreased. The serum concentrations of total cholesterol, LDL and triglycerides in both the experimental groups receiving AKG decreased (days 60 to 120) (p<0.05), while the HDL concentration tended to increase. The body gain in all groups receiving AKG was significantly lower than in the control group. Conclusions. These observations clearly prove that oral treatment with AKG can decrease the risk of hypercholesterolaemia developing and can lower the body weight. The relative concentrations of the plasma LDL and HDL changed to a more favourable ratio promoting good health.     

Relationship between adiponectin, glycemic control and blood lipids in diabetic type 2 postmenopausal women with and without complication of ischemic heart disease

BACKGROUND: Recently major adipocytokine, adiponectin, are thought to play important roles in the regulation of cardiovascular and metabolic homeostasis. We compared serum adiponectin concentrations and lipid profile in diabetic patients with and without complication of cardiovascular disease in postmenopausal women. METHODS: We included 120 female subjects between the age of 45 and 60 years. The subjects were divided into 3 groups and each group comprised of 40 subjects. First group comprised of normal healthy controls, second group diabetic type 2 patients with no history of ischemic heart disease (IHD) and the third group diabetic patients with IHD. Serum adiponectin concentrations, serum triglycerides, cholesterol, LDL cholesterol and HDL cholesterol concentrations were determined. RESULTS: Values of fasting and random blood glucose, serum triglycerides, cholesterol, LDL cholesterol were significantly increased (P<0.001) in diabetic patients with IHD as compared with normal control subjects except for serum adiponectin and HDL cholesterol concentrations, which were significantly decreased (P<0.001) in diabetic patients and diabetic patients with IHD group. When values of cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, fasting and random blood glucose and adiponectin were compared among diabetic and diabetic patients with IHD, it was observed that they were significantly increased (P<0.001) except for adiponectin, which was decreased significantly (P<0.001) and random blood glucose, LDL and HDL cholesterol in which no change was observed between the 2 groups. CONCLUSIONS: Serum adiponectin concentrations may be a predictor for development of cardiovascular disease in postmenopausal diabetic patients.     

High‐density lipoprotein from end‐stage renal disease patients exhibits superior cardioprotection and increase in sphingosine‐1‐phosphate

Background

Chronic kidney disease (CKD) exacerbates the risk of death due to cardiovascular disease (CVD). Modifications to blood lipid metabolism which manifest as increases in circulating triglycerides and reductions in high‐density lipoprotein (HDL) cholesterol are thought to contribute to increased risk. In CKD patients, higher HDL cholesterol levels were not associated with reduced mortality risk. Recent research has revealed numerous mechanisms by which HDL could favourably influence CVD risk. In this study, we compared plasma levels of sphingosine‐1‐phosphate (S1P), HDL‐associated S1P (HDL‐S1P) and HDL‐mediated protection against oxidative stress between CKD and control patients.

Methods

High‐density lipoprotein was individually isolated from 20 CKD patients and 20 controls. Plasma S1P, apolipoprotein M (apoM) concentrations, HDL‐S1P content and the capacity of HDL to protect cardiomyocytes against doxorubicin‐induced oxidative stress in vitro were measured.

Results

Chronic kidney disease patients showed a typical profile with significant reductions in plasma HDL cholesterol and albumin and an increase in triglycerides and pro‐inflammatory cytokines (TNF‐alpha and IL‐6). Unexpectedly, HDL‐S1P content (P = .001) and HDL cardioprotective capacity (P = .034) were increased significantly in CKD patients. Linear regression analysis of which factors could influence HDL‐S1P content showed an independent, negative and positive association with plasma albumin and apoM levels, respectively.

Discussion

The novel and unexpected observation in this study is that uremic HDL is more effective than control HDL for protecting cardiomyocytes against oxidative stress. It is explained by its higher S1P content which we previously demonstrated to be the determinant of HDL‐mediated cardioprotective capacity. Interestingly, lower concentrations of albumin in CKD are associated with higher HDL‐S1P.     

Liver transplantation restores low serum levels of very low density and high density lipoproteins in end-stage primary biliary cirrhosis.

Amounts of serum lipids were determined in 10 women suffering from end-stage primary biliary cirrhosis (PBC) in order to evaluate the concentrations of and changes in very low density (VLDL), high density (HDL) lipoprotein cholesterol and apoprotein A-I before and after liver transplantation. The concentrations of some preoperative serum total lipids, especially HDL cholesterol and VLDL triglyceride, and apoprotein A-I, were significantly lower, but those of serum total triglycerides and cholestanol (a metabolite of cholesterol) were higher in the PBC patients than in 12 controls matched for age, sex, and body mass index. The relation between the serum concentrations of HDL cholesterol and cholestanol was markedly different before transplantation in the PBC group and in the control group. Liver transplantation was followed by a significant and rapid increase in serum apoprotein A-I and HDL cholesterol concentrations, which were affected by CMV and Klebsiella infections and acute rejections and immunosuppressive treatments. As a result the patients serum values did not quite return to normal during the three month follow up. The concentrations of serum VLDL cholesterol, triglycerides and cholestanol returned to normal during the follow up, and the changes in cholestanol were inversely related to the increases in amounts of HDL cholesterol. Thus, the restoration of low HDL concentrations after liver transplantation suggests that the liver plays a key role in HDL metabolism and indicates that concentrations of serum HDL cholesterol may be useful in monitoring the recovery of liver function.     

Serum high density lipoprotein cholesterol in diabetes mellitus: An analysis of factors which influence its concentration

The study assesses whether diabetes has an effect on serum high density lipoprotein (HDL) cholesterol concentration independent of other factors known to influence serum HDL cholesterol concentration. Concentrations of serum HDL cholesterol, serum cholesterol, serum M particles and blood sugar, and the proportion of haemoglobin in the form of HbA₁ were measured in a diabetic and a non-diabetic population. Relative body weight, alcohol and cigarette consumption, age, a clinical estimate of diabetic control and duration of diabetes were also recorded. The diabetic patients were divided into those in whom insulin treatment was clinically indicated and those in whom it was not.Serum HDL cholesterol concentration was significantly higher in diabetic men treated with insulin than in normal men and also higher in diabetic women treated with insulin than in normal women. In the diabetic men and women not treated with insulin, serum HDL cholesterol concentration was not significantly different from normal. There were differences between the diabetic and non-diabetic populations in terms of factors known to influence serum HDL cholesterol and also in the degree of correlation between these and the serum HDL cholesterol. Multivariate analysis revealed that in both male and female diabetic patients treated with insulin, diabetes was a highly significant influence on serum HDL cholesterol concentration, but in the non-insulin-treated diabetic patients the influence was absent in women and only marginal in men. The proportion of HbA₁ influenced serum HDL cholesterol concentration negatively in insulin-treated diabetes but not in diabetes treated without insulin.     

Prognostic evaluation of primary non-small cell lung carcinoma patients using biological fluid variables. A systematic review

There is growing experimental evidence to suggest the role of oxidatively modified low‐density lipoprotein (LDL) in the initiation and progression of atherosclerosis. The oxidation of lipoprotein moiety causes modification of positively charged lysine residues and results in negative net charge of lipoprotein particles. Objective: To measure the amount of circulating electronegatively charged LDL particles (LDL–) in plasma of patients with angiographically documented coronary artery disease (CAD). Methods: Thirty patients were assigned to the study group (CAD+) and 10 patients to the control group (Ctrl). LDL– was quantitated in homogeneous LDL fractions obtained by ultracentrifugation, using ion exchange high performance liquid chromatography. Plasma lipids were measured using enzymatic kits. Results: The CAD+ group had significantly higher levels of LDL– in the whole LDL fraction (7.66±1.92 vs. 5.14±0.84%, p=0.0003). Moreover the CAD+ group had significantly higher levels of total cholesterol (255.4±35.1 vs. 210.4±22.4?mg/dL), LDL cholesterol (154.5±26.9 vs. 122.4±21.1?mg/dL) and significantly lower levels of high‐density lipoprotein (HDL) cholesterol (40.4±9.4 vs. 51.0±11.5?mg/dL). LDL– remained significantly higher in the CAD+ group after adjustment for total cholesterol, LDL cholesterol and HDL cholesterol (6.3 vs. 5.14% at p=0.0095). There is a trend towards a positive correlation between LDL– levels and LDL cholesterol in the control group (Spearman R=0.55 at p=0.098). Conclusions: Electronegatively charged LDL appears to be an additional hallmark of coronary artery disease, independently of established lipid risk factors. The trend towards a positive correlation between LDL cholesterol concentration and the level of LDL– in the control group may reflect the susceptibility of LDL cholesterol to autoxidation, Moreover, this may indicate other oxidative mechanisms in coronary artery disease. Nonetheless, further studies assessing the prognostic value of electronegatively charged LDLs are necessary.     

Ciprofibrate treatment decreases non-high density lipoprotein cholesterol and triglycerides and increases high density lipoprotein cholesterol in patients with Frederickson type IV dyslipidemia phenotype

OBJECTIVE: The combination of hypertriglyceridemia and low high density lipoprotein (HDL) cholesterol is one of the most common lipid abnormalities. Thus, the aim of this study was to determine the effects of ciprofibrate on lipid profile in patients with Frederickson's type IV dyslipidemia phenotype. RESEARCH DESIGN AND METHODS: Seventy-five patients with type IV dyslipidemia were assigned at random to 1 of 2 therapeutic options: group A (control), American Heart Association (AHA) Step II diet and physical activity; and group B, AHA diet, physical activity, and ciprofibrate 100 mg daily for 8 weeks. The lipid profile of all patients was determined at baseline and after therapeutic intervention. RESULTS: Patients in group B (treated with ciprofibrate) compared with group A (control) had significantly higher reductions in total cholesterol (downward arrow 14.2% vs. downward arrow 4.8%; P < 0.02), triglycerides (downward arrow 38.0% vs. downward arrow 21.6%; P < 0.007), very low density lipoprotein cholesterol (downward arrow 38.0% vs. downward arrow 21.6%; P < 0.007), non-HDL cholesterol (downward arrow 20.5% vs. downward arrow 7.1%; P < 0.007), and total cholesterol/high density cholesterol ratio (downward arrow 25.6% vs. downward arrow 9.4%; P < 0.01). The ciprofibrate group had a significantly higher increase in HDL cholesterol levels compared with the other group (upward arrow 25.0% vs. upward arrow 9.6%, P < 0.02). CONCLUSIONS: Ciprofibrate treatment effectively reduced triglyceride-rich particles and non-HDL cholesterol, and significantly increased HDL cholesterol, proving its effectiveness in patients with low HDL cholesterol and type IV Frederickson's hyperlipidemia.     

SCREENING AND TREATMENT FOR HYPERUPIDAEMIA IN NON-INSULIN-DEPENDENT DIABETES: A PROSPECTIVE ASSESSMENT OF 350 PATIENTS

SUMMARY This report presents experiences in screening 350 non-insulin-dependent diabetics for hypercholesterolemia and results of 1 year's treatment. Mean serum total cholesterol was 6.4 mmol/l at screening; 46 patients whose initial total serum cholesterol was above 7.0 mmol/l attended for detailed assessment and treatment. Mean total cholesterol concentrations fell between screening and review (7.8 vs 7.1 mmol/l, P<0.01). Levels fell below 7.0 mmol/l in 13 patients with diet alone. After excluding patients with secondary dyslipidaemia (including poor diabetic control), 10 patients received lipid-lowering drug treatment. Total cholesterol and triglyceride concentrations fell significantly and the HDL/non- HDL cholesterol ratio improved on treatment. Screening diabetic patients identifies a small group of hyperlipidaemic patients, whose lipoprotein profiles improve with drug treatment. Many of those screened, however, do not ultimately require drug treatment using a cut-off of 7.0 mmol/l.     

Effect of rosuvastatin monotherapy or in combination with fenofibrate or ω-3 fatty acids on lipoprotein subfraction profile in patients with mixed dyslipidaemia and metabolic syndrome

Background: Raised triglycerides (TG), decreased high‐density lipoprotein cholesterol (HDL‐C) levels and a predominance of small dense low density lipoproteins (sdLDL) are characteristics of the metabolic syndrome (MetS). Objective: To compare the effect of high‐dose rosuvastatin monotherapy with moderate dosing combined with fenofibrate or ω‐3 fatty acids on the lipoprotein subfraction profile in patients with mixed dyslipidaemia and MetS. Methods: We previously randomised patients with low‐density lipoprotein cholesterol (LDL‐C) > 160 and TG > 200 mg/dl to rosuvastatin monotherapy 40 mg/day (R group, n = 30) or rosuvastatin 10 mg/day combined with fenofibrate 200 mg/day (RF group, n = 30) or ω‐3 fatty acids 2 g/day (Rω group, n = 30). In the present study, only patients with MetS were included (24, 23 and 24 in the R, RF and Rω groups respectively). At baseline and after 12 weeks of treatment, the lipoprotein subfraction profile was determined by polyacrylamide 3% gel electrophoresis. Results: The mean LDL size was significantly increased in all groups. This change was more prominent with RF than with other treatments in parallel with its greater hypotriglyceridemic capacity (p < 0.05 compared with R and Rω). A decrease in insulin resistance by RF was also noted. Only RF significantly raised HDL‐C levels (by 7.7%, p < 0.05) by increasing the cholesterol of small HDL particles. The cholesterol of larger HDL subclasses was significantly increased by R and Rω. Conclusions: All regimens increased mean LDL size; RF was the most effective. A differential effect of treatments was noted on the HDL subfraction profile.     

Correlation of serum lipids with diabetes control in sulfonylurea-treated diabetic patients

The relationships between fasting blood glucose, glycosylated hemoglobin A1, and several lipid parameters were studied in 67 non-insulin-dependent diabetic patients (19 men, 48 women) being treated with tolbutamide, chlorpropamide, or glibenclamide. All patients were over 60 yr of age with a mean age of 76.4 +/- 6.7 yr (+/- SD). There were positive associations between fasting blood glucose and serum cholesterol, LDL cholesterol, and serum triglycerides. A strong association between total cholesterol and triglycerides was also evident. Diabetes control and HDL cholesterol did not correlate with each other. A weak inverse correlation existed between fasting blood glucose and the HDL cholesterol/total cholesterol ratio. HDL cholesterol concentrations were low in the diet- and drug-treated diabetic patients. No deleterious sulfonylurea effects on cholesterol, LDL cholesterol, and triglyceride concentrations or HDL cholesterol/total cholesterol ratio were noted.     

Associations between change in C-reactive protein and serum lipids during statin treatment

Hypolipidaemic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (statin) treatment reduces cardiovascular risk and is also associated with the reduction of C-reactive protein (CRP) concentrations. However, there is scant data concerning the relationship between CRP and lipid changes during statin treatment. We studied 60 hypercholesterolaemic coronary patients who participated in the Treat to Target (3T) study comparing atorvastatin and simvastatin. Serum lipids and CRP (with a sensitive method) were measured before treatment at baseline and after 12 months of statin treatment. Low-density lipoprotein (LDL) cholesterol was substantially decreased and high-density lipoprotein (HDL) cholesterol increased during statin treatment. CRP decreased significantly (sign test P = 0.03) during treatment, and the changes of CRP were significantly associated with changes in HDL cholesterol (r = ?0.45; P < 0.001) and apolipoprotein A1 (r = ?0.40; P < 0.001) but not with changes in LDL cholesterol or triglycerides. The change in HDL cholesterol explained 20% of the change in CRP during statin treatment. The results are in line with previous suggestions that HDL has anti-inflammatory properties.     

Smoking and plasma lipoproteins in man: effects on low density lipoprotein cholesterol levels and high density lipoprotein subfraction distribution

Abstract. In a survey of a healthy population (n = 197), LDL cholesterol, plasma triglycerides and VLDL triglycerides were found to be substantially increased and plasma HDL cholesterol decreased in smokers. The lipid-associated atherogenic risk in smokers as assessed by the LDL/HDL ratio was significantly higher [2.89 (SD 1.18, n= 63)] than in non-smokers [2.38 (SD 0.98, n= 86) P < 0.01]. The lower HDL level found in smokers was explained by a lower HDL-2 subfraction as determined by analytical ultracentrifugation. HDL 2b, 2a and 3a, measured by gradient gel electrophoresis, were all lower in the smokers but this was only significant for HDL 2a. Smoking had no effect on Lp(a) levels. HDL cholesterol and HDL-2 were strongly negatively correlated whereas LDL cholesterol and LDL/HDL ratio were strongly positively correlated with the plasma triglyceride concentration. There was a small but significant reduction in plasma CETP activity [non-smokers 49%t/μl (SD 17, n= 90), smokers 43%t/μl (SD 17, n= 66) P < 0.05] but CETP activity was not correlated with any measure of HDL in this population. Smoking was found to be an important independent contributor to the variation in plasma triglyceride, HDL, HDL-2 and LDL/HDL ratio. After correcting for sex, age, BMI, alcohol consumption, oral contraceptive use and plasma triglycerides smoking was still found to be significantly associated with HDL and the LDL/HDL ratio. Upon adjustment for covariant factors the mean differences between smokers and non-smokers for HDL cholesterol, HDL-2 and LDL/HDL were 0.15 mM, 16 mg dl-¹ and 0.39 respectively. There appeared to be important sex differences in the influence of smoking on plasma lipoproteins. In women the main impact of smoking was on triglyceride levels and they in turn affected LDL and HDL. In contrast, in men, smoking had little impact on triglycerides and affected HDL more directly. We conclude that smoking cigarettes has an important effect on plasma lipoprotein metabolism through multiple mechanisms.     

Remnant-like particle cholesterol, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients

OBJECTIVE: The aim of the study was to investigate the relationships between remnant-like particle (RLP) cholesterol, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients. RESEARCH DESIGN AND METHODS: A total of 86 nonobese Japanese type 2 diabetic patients (72 men and 14 women, aged 40-83 years, BMI 20.1-26.6 kg/m2) were studied. BMI, HbA1c levels, and fasting concentrations of plasma glucose, serum lipids (RLP cholesterol, total cholesterol, HDL cholesterol, and triglycerides), and serum insulin were measured. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). The subjects were divided into two groups according to the value of HOMA-IR. Values >2.5 were indicative of the insulin-resistant state, and values <2.5 were indicative of the insulin-sensitive state. RESULTS: The insulin-resistant group had significantly higher RLP cholesterol and triglyceride levels and lower HDL cholesterol levels compared with the insulin-sensitive group. Univariate regression analysis showed that insulin resistance was positively correlated with BMI (r = 0.254, P = 0.019), HbA1c levels (r = 0.278, P = 0.011), RLP cholesterol levels (r = 0.315, P = 0.004), and triglyceride levels (r = 0.332, P = 0.002) and was negatively correlated with HDL cholesterol levels (r = -0.301, P = 0.006) in our diabetic patients. Multiple regression analysis showed that insulin resistance was independently associated with serum triglyceride levels, which explained 13.5% of the variability of insulin resistance in our nonobese Japanese type 2 diabetic patients. CONCLUSIONS: These results indicate that 1) nonobese Japanese type 2 diabetic patients with insulin resistance are characterized by high RLP cholesterol and triglyceride levels, and low HDL cholesterol levels; and 2) the level of serum triglycerides is an independent predictor of insulin resistance in these patients.     

Beta-blockers, diuretics and physical fitness as determinants of serum lipids in myocardial infarction patients

Serum lipid levels were followed in myocardial infarction patients for one year after the infarction and related to their drug use and physical performance. Serum triglyceride concentrations were significantly elevated in patients using diuretics or diuretics and beta-blockers together both 3 and 12 months after the infarction when compared to patients not having drugs. The beta-blockers alone did not change triglycerides. No differences were found in total cholesterol concentration between any of the drug groups. The HDL cholesterol levels were significantly lower in all the drug groups 12 months after the infarction in comparison with the group using no drugs, but 3 months after the infarction these differences were not present. Total work in the exercise stress test correlated negatively with serum triglycerides and total cholesterol and positively with HDL/total cholesterol ratio in the group using no drugs 12 months after the infarction. In beta-blocker users, total work correlated negatively with triglyceride and total cholesterol concentrations. In all drug groups no correlation between total work and HDL/total cholesterol ratio could be found. These data suggest that despite differences in the physical working capacity between the groups, the drugs themselves are major determinants of differences in serum lipids.     

Pioglitazone reduces atherogenic dense LDL particles in nondiabetic patients with arterial hypertension: a double-blind,placebo-controlled study

OBJECTIVE: The oral antidiabetic agent pioglitazone improves insulin sensitivity and glycemic control and appears to lower atherogenic dense LDL in type 2 diabetes. Insulin resistance may occur frequently in nondiabetic patients with hypertension. This study is the first to report the effect of pioglitazone on LDL subfractions in normolipidemic, nondiabetic patients with arterial hypertension. RESEARCH DESIGN AND METHODS: We performed a monocentric, double-blind, randomized, parallel-group comparison of 45 mg pioglitazone (n = 26) and a placebo (n = 28), each given once daily for 16 weeks. Fifty-four moderately hypertensive patients (LDL cholesterol, 2.8 +/- 0.8 mmol/l; HDL cholesterol, 1.1 +/- 0.3 mmol/l; triglycerides, 1.4 mmol/l (median; range 0.5-7.1) were studied at baseline and on treatment. RESULTS: At baseline, dense LDLs were elevated (apolipoprotein [apo]B in LDL-5 plus LDL-6 >250 mg/l) in 63% of all patients. Sixteen weeks of treatment with pioglitazone did not significantly change triglycerides, total, LDL, and HDL cholesterol. However, pioglitazone reduced dense LDLs by 22% (P = 0.024). The mean diameter of LDL particles increased from 19.83 +/- 0.30 to 20.13 +/- 0.33 nm (P < 0.001 vs. placebo), whereas the mean LDL density decreased from 1.0384 +/- 0.0024 to 1.0371 +/- 0.0024 kg/l (P = 0.005 vs. placebo). The effect of pioglitazone on LDL size and density was independent of fasting triglycerides and HDL cholesterol at baseline and of changes in fasting triglycerides and HDL cholesterol. CONCLUSIONS: The prevalence of atherogenic dense LDL in nondiabetic, hypertensive patients is similar to patients with type 2 diabetes. Pioglitazone significantly reduces dense LDL independent from fasting triglycerides and HDL cholesterol. The antiatherogenic potential of pioglitazone may thus be greater than that expected from its effects on triglycerides, LDL, and HDL cholesterol alone.     

Is there a relationship between plasma phenylalanine and cholesterol in phenylketonuric patients under dietary treatment?

OBJECTIVES: To study the lipid profile in a group of treated phenylketonuric patients (PKU; n = 61) compared with a group of inborn error of intermediary metabolism patients (IEM; n = 22), a group of hyperphenylalaninemic children (HPA; n = 37), and a control group without dietary restriction (n = 41). DESIGN AND METHODS: Phenylalanine was analyzed by ion exchange chromatography and triglycerides, cholesterol and HDL were determined by standard procedures with the Cobas Integra analyzer. RESULTS: Serum total cholesterol concentrations were significantly lower in PKU patients compared with IEM patients (whose cholesterol daily intake was similar to those of PKU patients), HPA children and the control group. A negative correlation was observed between cholesterol and phenylalanine concentrations in the PKU patients. CONCLUSIONS: Our findings support the hypothesis of a relationship between high plasma phenylalanine levels and an inhibition of cholesterogenesis, although the low cholesterol intake of the special diets may also decrease serum cholesterol values.     

Influence of portocaval anastomosis on lipid parameters in patients with alcoholic cirrhosis

The effect of portocaval shunt operation on lipid metabolism was investigated in 10 patients with alcoholic cirrhosis. Portocaval shunt operation resulted in a significant decrease of concentration of total serum cholesterol, total serum triglycerides, LDL cholesterol, VLDL cholesterol, VLDL triglycerides, and LCAT activity. The concentrations of free cholesterol, esterified cholesterol, phospholipids, LDL triglycerides, HDL cholesterol, and HDL triglycerides were unaffected.     

茶色素对高脂血症的疗效观察

目的探讨茶色素调节血脂紊乱的作用。方法治疗组：２４８例血脂紊乱者；对照组：５５例的血总胆固醇、甘油三酯、高密度脂蛋白胆固醇正常，４１例的血清脂蛋白（ａ）＜３０ｍｇ／ｄｌ，二组均每次口服茶色素１２．５ｍｇ，每日３次。结果治疗一个月后，治疗组血清总胆固醇平均下降１２％（Ｐ＜０．０００１），甘油三脂下降２０％Ｐ＜０．０００１），高密度脂蛋白胆固醇上升２２％（Ｐ＜０．０００１）。对照组总胆固醇与甘油三酯亦明显下降（Ｐ值分别＜０．０１与０．０５），高密度脂蛋白胆固醇与脂蛋白（ａ）无变化，未见明显副作用。结论茶色素为调节血脂紊乱的较好药物，在心＊协作单位：北京阜外心血管医院、北京解放军总医院、北京医科大学第三医院、北京医科大学人民医院、上海市高血压病研究所、江西医学院心血管病研究所、江西医学院二附院心内科、江西萍乡市人民医院脑血管病的防治中可能起重要作用。     

Lowered levels of serum albumin and HDL‐cholesterol in children with a recent mild infection

BACKGROUND. Infections are associated with atherogenic changes in serum.

AIM. To elucidate effects of recent infections on risk factors for coronary heart disease in children.

SUBJECTS AND METHODS. In 1983 and again 3 years later, 2458 individuals aged 9, 12, 15, 18 and 21 years were investigated. In 1986, 106 subjects had symptoms of infection during the past 2 weeks before their follow‐up visit. Their serum albumin and lipid concentrations were compared to those in 1983 when these individuals probably were healthy. An age‐ and sex‐matched healthy control group from the cohort 1986 was chosen for comparison. For cholesterol age, sex and body mass index specific Z‐scores in addition to actual values were used in statistical comparisons.

RESULTS. Serum albumin was 42?g/L in subjects with positive history of infection and 46?g/L in healthy controls (P<0.0001). HDL‐cholesterol and the ratio of HDL‐ to total cholesterol were lower with increasing evidence of infection. Elevated serum C‐reactive protein (CRP) or orosomucoid grouped the subjects with high and low serum HDL‐cholesterol concentrations better than history of infection alone.

CONCLUSION. A mild infection lowers serum HDL‐cholesterol and serum albumin concentrations, which both favour atherogenesis.     

老年抑郁症认知功能与血清同型半胱氨酸及血脂水平的相关性

目的 研究老年抑郁症患者血清同型半胱氨酸(Hcy)、血脂水平与认知功能之间的关系。方法 选取60例老年抑郁患者为研究组,以60例健康志愿者为对照组,测定两组血清Hcy、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL C)、低密度脂蛋白胆固醇(LDL C)水平。用汉密尔顿抑郁量表（HAMD）评定病情严重程度,蒙特利尔认知评估量表(MoCA)评估患者的认知功能。结果 与对照组比较,研究组MoCA评分明显低于对照组（P＜0.05）,血清Hcy明显高于对照组（P＜0.05）,血清HDL C水平明显低于对照组（P＜0.05）。相关分析显示,研究组认知功能损害程度与病情严重程度呈正相关（r=0.327,P＜0.01）,认知功能评估中注意与集中、记忆、执行功能评分与血清Hcy水平呈负相关（r=-0.402,P=0.01）,其中执行功能评分与HDL C水平成正相关（r=0.562,P=0.008）。结论 老年抑郁症患者的认知功能损害与血清高水平Hcy和低水平HDL C水平有关,血清高水平Hcy和低水平HDL C可能是老年抑郁症患者的危险因素。