Relationship of cigarette smoking with blood pressure, serum lipids and lipoproteins in young Japanese women

1. The relationship of cigarette smoking with blood pressure and serum lipids and lipoproteins was studied in 1062 young Japanese women aged 20-39 years of age. 2. After adjusting for age, body mass index (BMI), alcohol intake and physical activity scores, the mean systolic and diastolic blood pressures (SBP and DBP, respectively) did not indicate dose-dependent relationships with cigarette smoking. The largest significant mean differences in SBP (3.5%; P < 0.001), DBP (6.2%; P < 0.018), high-density lipoprotein-cholesterol (HDL-C; 13.2%; P < 0.005), ratio of total cholesterol to HDL-C (13.9%; P < 0.022), triglycerides (TG; 24.1%; P < 0.001) and the logarithmic transformation of TG (log TG; 5.6%; P < 0.001) were found between non-smokers and smokers. 3. When age, BMI, alcohol intake and physical activity scores were included in the forward step-wise multiple regression analysis, there were negative relationships found for cigarette smoking and SBP and DBP and positive relationships for cigarette smoking and TG and log TG. 4. Although the results are somewhat variable, the present study shows that cigarette smoking is negatively associated with SBP and DBP and that there is an association between cigarette smoking and serum lipids and lipoproteins and that smoking has an unfavourable effect on these parameters in young Japanese women.     

Short- and long-term effects of lovastatin and pravastatin alone and in combination with cholestyramine on serum lipids,lipoproteins and apolipoproteins in primary hypercholesterolaemia

Summary The effects of the HMG CoA reductase inhibitors lovastatin and pravastatin on serum lipids, lipoproteins and apolipoproteins have been studied in 35 patients with primary hypercholesterolaemia.LDL cholesterol was lowered to the same extent by both agents compared on a mg basis of each drug per day. HDL cholesterol was increased by lovastatin but not by pravastatin. The reduction in serum triglycerides, VLDL triglycerides and VLDL cholesterol was more pronounced after lovastatin than pravastatin. After 1 year the effect of combined treatment with 40 mg pravastatin and 8 g cholestyramine on the reduction in LDL cholesterol (–39%) in 13 patients was comparable to that of 80 mg lovastatin plus 8 g cholestyramine (–40%) in 12 patients with identical baseline values.Differences were also found in the effects of the combination therapy with the two drugs on HDL cholesterol, serum triglycerides, VLDL triglycerides, VLDL cholesterol, and apolipoproteins.     

Fenofibrate and colestipol: Effects on serum and lipoprotein lipids and apolipoproteins in familial hypercholesterolaemia

Summary Effects on serum lipoproteins were studied in ten patients with familial hypercholesterolaemia (FH) during consecutive eight-week treatment periods with fenofibrate 0.3 g/day, fenofibrate plus colestipol, 15 g/day, and fenofibrate 0.25 g/day plus colestipol. VLDL, LDL, HDL, HDL₂, and HDL₃ were isolated by ultracentrifugation and precipitation. Lipids and apolipoproteins A–I and B were determined by enzymatic and immunonephelometric techniques, respectively. Administration of fenofibrate alone resulted in decreases in VLDL and LDL cholesterol (–48% and –18%) and in serum apolipoprotein B (–10%), but in increases in HDL, HDL₂, and HDL₃ (+25%, +26%, and +24%), and in serum apolipoprotein A–I (+6%). Addition of colestipol produced a further reduction in LDL cholesterol (–31%) and in serum apolipoprotein B (–19%). The effects were maintained with less fenofibrate. In FH, an acceptable therapy combines the favourable effects of sufficient lowering of LDL and of a rise in HDL.     

Effects of simvastatin and fenofibrate on serum lipoproteins and apolipoproteins in primary hypercholesterolaemia

Summary Sixteen patients with primary hypercholesterolaemia received double-blind either fenofibrate (n=8; 200 mg bid) or the HMG-CoA reductase inhibitor simvastatin (n=8; 20 mg qid or 40 mg qid if LDL-cholesterol did not fall below 3.6 mmol·l^–1 after 4 weeks of treatment).Simvastatin reduced total cholesterol from 9.7 to 7.0 mmol·l^–1 after 10 weeks (–28%), and fenofibrate reduced it from 9.2 to 7.7 mmol·l^–1 (–15%). The decrease was less during fenofibrate than during simvastatin treatment (time × drug:p=0.02).Serum LDL-cholesterol fell from 8.3 to 5.3 mmol·l^–1 (–36%) during simvastatin and from 7.2 to 6.0 mmol·l^–1 (–16%) during fenofibrate administration. Again, the effect of simvastatin was more pronounced than that of fenofibrate (time × drug:p=0.03).HDL-cholesterol increased significantly from 1.1 to 1.2 mmol·l^–1 (+13%) during fenofibrate administration and it did not change significantly during simvastatin.Serum triglycerides fell from 1.3 to 1.1 mmol·l^–1 (–16%) during simvastatin, and even more significantly from 2.2 to 1.1 mmol·l^–1 (–51%) during fenofibrate (time × drug:p=0.002).Apolipoprotein B fell on simvastatin from 1.9 to 1.4 g·l^–1 (–24%) and from 1.8 to 1.4 g·l^–1 (–22%) during fenofibrate.Both drugs were well tolerated and had no significant adverse effects.Simvastatin lowered total and LDL-cholesterol concentrations more than fenofibrate, while the latter had more effect on triglycerides, suggesting specific indications for the two drugs in the treatment of hyperlipoproteinaemias.     

酚噻嗪类药物对精神分裂症患者血清载脂蛋白、脂蛋白含量的影响

目的:探讨长时间(1月-25年)接受酚噻嗪类药物治疗后的精神分裂症患者引起血脂代谢紊乱的危险因素及其临床意义。方法:采用酶法、免疫透射比浊法检测了120例慢性精神分裂症患者、50例血管性痴呆患者和100例健康体检者血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(ApoAl)、载脂蛋白B(ApoB)的水平.结果:精神分裂症、血管性痴呆患者血ApoAI,HDL-C,ApoAI/ApoB含量明显低于健康对照组(P<0.01),ApoB、TG水平分别显著高于健康对照组(P<0.01),其中阴性症状组和血管性痴呆组TG含量明显高于阳性症状组(P<0.01),而三组病人TC的水平与正常对照组相比差异无显著性(P>0.05)。结论:长时间服用酚噻嗪类药物治疗后的慢性精神分裂症患者存在着血脂代谢紊乱,应在治疗精神分裂症的同时服用降脂、降粘、扩血管等药物,以预防和降低诱发心、脑血管病的危险因素,并达到延缓和推迟患者智能障碍以及痴呆的发展。     

The influence of transdermal oestradiol replacement therapy and medroxyprogesterone acetate on serum lipids and lipoproteins

Aims The objective of this study was to examine the effects of continuous transdermal oestradiol with or without sequential oral medroxyprogesterone acetate on serum lipids and lipoproteins in menopausal women.
Methods Sixty-two healthy menopausal women, attending at two menopause clinics in Western India, were recruited for this study over a period of 1 year. Group 1 included 38 hysterectomised women being treated with continuous transdermal oestradiol only (50  μg daily). Group 2 included 24 menopausal women with an intact uterus being treated with transdermal oestradiol (50  μg daily) and medroxyprogesterone acetate (10  mg daily for the first 12 days of each calendar month). Women maintained on 50  μg oestradiol throughout 6 months (group 1: n =22; group 2: n =16) were reviewed for changes in serum lipids and lipoproteins at the end of 6 months (group 1), and between days 8 and 12 of the seventh month (combined phase of treatment) (group 2).
Results In group 1, there was a small reduction in the concentrations of total cholesterol (−5.5%, P =0.04) and a small but not significant reduction in LDL-cholesterol (−5.7%, P =0.16). In group 2, there were no significant changes in total cholesterol (−4.2%, P =0.43) and LDL-cholesterol (−3.9%, P =0.57). HDL-cholesterol levels did not change significantly with unopposed transdermal oestradiol (+3.0%, P =0.53), or with additional sequential medroxyprogesterone acetate (−3.8%, P =0.32). Serum triglyceride concentrations decreased significantly in both the groups (−13.9%, P =0.01, and −13.4%, P =0.008, respectively). Serum lipid changes did not differ between the groups.
Conclusions Transdermal oestrogen therapy appears to be of particular benefit for women with hypertriglyceridaemia. There were no significant adverse effects of medroxyprogesterone acetate on serum lipids and lipoproteins.     

子癎前期患者血脂代谢异常变化及其对围产儿预后的影响

目的：探讨子痫前期患者血脂、脂蛋白和载脂蛋白的水平异常变化与病情严重程度及围产儿预后的关系。方法：分别采用酶法及免疫比浊法测定34例轻度、32例重度子痫前期患者及30例正常孕妇（正常组）妊娠晚期的血脂水平，腹部彩超测S／D值，分析比较3组血脂水平的特点及其水平的异常改变对围产儿结局的影响。结果：（1）重度子痢前期组三酰甘油（TG）及胆固醇（TC）以及低密度脂蛋白（LDL—C）较正常组升高（P〈0．05）；并且LDL—C随病情加重增高明显。（2）轻度和重度子痫前期组高密度脂蛋白（HDL—C）明显低于正常组（P〈0．05，P〈0．01）。（3）轻度和重度子痫前期组的载脂蛋白B水平高于正常组（P〈0．05，P〈0．01），载脂蛋白A水平在各组之间差异无统计学意义。（4）重度子痫前期组的S／D值、早产率、新生儿窒息率较正常组增高（P〈0．05），新生儿体质量低于轻度组及正常组（均P〈0．05），且与LDL—C水平呈负相关。结论：脂代谢异常与子痫前期的发病具有一定的相关性，孕期定期监测血脂水平对预测该病的发生及改善围产预后具有重要临床意义。     

The roles of apolipoproteins B and E in lipid transport and atherosclerosis

The metabolism of various lipoproteins is largely regulated by the protein constituents, the apolipoproteins. Although approximately a dozen apolipoproteins have been identified, apolipoproteins B and E (apoB, apoE) appear to play the major role in the receptormediated clearance of lipoproteins by the liver and other tissues, thereby directly influencing plasma lipid levels. In man, apoB is synthesized by both the intestine (apoB-48) and the liver (apoB-100), but it is the hepatogenic peptide that is the sole constituent of plasma low-density lipoproteins (LDL) recognized by the LDL receptor in liver and other tissues. ApoB-100 is found in normal and atherosclerotic aorta and taken up by aortic endothelium in vivo, providing further evidence that LDL is the source of arterial foam cell lipids. Evidence is provided suggesting that the clinical measurement of plasma apoB-100 provides a better index than LDL for determining coronary heart disease risk. ApoE, on the other hand, is clearly the most important binding ligand for the hepatic removal of a variety of lipoproteins. Numerous studies suggest that apoE directs peripheral cell cholesterol to the liver for excretion from the body (reverse cholesterol transport). Human apoE can be separated into three major isoforms, which differ in primary structure. Patients with the genetic disorder type III hyperlipoproteinemia have severe atherosclerosis due to an excess of one apoE isoform that does not bind normally to hepatic receptors. Other alterations of apoE can change its conformation and hence its ability to be recognized. Future directions in the treatment of dyslipidemias should include the discovery of pharmacologic agents that facilitate lipoprotein clearance by altering apoE conformation or recognition of apoB-containing lipoproteins. The control of apoB and apoE synthesis should also provide insights for drug discovery in light of the undisputed roles of these proteins in lipid transport and atherosclerosis.     

Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers

A growing number of laboratory studies have shown that acute bouts of aerobic exercise favorably impact affect and cravings among smokers. However, randomized trials have generally shown exercise to have no favorable effect on smoking cessation or withdrawal symptoms during quit attempts. The purpose of the present study was to explore this apparent contradiction by assessing acute changes in affect and cravings immediately prior to and following each exercise and contact control session during an eight-week smoking cessation trial. Sixty previously low-active, healthy, female smokers were randomized to an eight-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either three sessions/week of moderate intensity aerobic exercise or contact control. Findings revealed a favorable impact of exercise on acute changes in positive activated affect (i.e., energy), negative deactivated affect (i.e., tiredness), and cigarette cravings relative to contact control. However, effects dissipated from session to session. Results suggest that aerobic exercise has potential as a smoking cessation treatment, but that it must be engaged in frequently and consistently over time in order to derive benefits. Thus, it is not surprising that previous randomized controlled trials-in which adherence to exercise programs has generally been poor-have been unsuccessful in showing effects of aerobic exercise on smoking cessation outcomes.     

Atenolol and metoprolol: Comparison of effects on blood pressure and serum lipoproteins,and side effects

Summary Several -blockers increase VLDL-TG and decrease HDL-cholesterol concentrations. The underlying mechanism ist not yet clear. Some studies have suggested that the effect is less pronounced during treatment with selective -blockers. The effects of 2 such drugs, metoprolol 200 mg/day and atenolol 50 mg/day, have been compared in 50 hypertensive patients (WHO Stage I–II), mean age 47 years. Serum lipoproteins were determined in 20 patients before treatment and after treatment with either drug for 3 months. Both drugs were equally effective in reducing blood pressure. After atenolol the initial VLDL-cholesterol concentration of 1.04 mmol/l had not changed, but it rose to 1.29 mmol/l after metoprolol (p<0.05). The HDL-cholesterol concentration 1.42 mmol/l did not fall during atenolol treatment, but during metoprolol there was a small reduction to 1.31 mmol/l (p<0.05). Hyperlipoproteinaemia is common in hypertensive patients, 40% of the present group had hypertriglyceridaemia and 25% had hypercholesterolaemia. Thus, atenolol 50 mg was found not to affect lipoproteins, whereas metoprolol 200 mg increased the VLDL concentration in 75% of the patients.     

Effects of coffee on plasma lipids, lipoproteins and apolipoproteins

The acute effects of coffee, cigarette smoking and alcohol on serum lipids, lipoproteins and thromboxane B2 production by platelets were studied in nine healthy volunteers who were non-drinkers of coffee and alcohol and non-smokers. They received, in a single administration, coffee (containing 200 mg of caffeine), alcohol (0.50 ml/kg body wt), or smoked two cigarettes. No differences were observed between baseline and 15, 60 and 80 min values for plasma cholesterol, triglycerides, HDL cholesterol, plasma apolipoproteins A-I and B and thromboxane B2 production. Chronic coffee consumption also did not affect either plasma lipoprotein profile or the interaction of low density lipoproteins with cellular receptors in a group of healthy individuals. These results suggest that coffee itself does not affect acutely the plasma lipoprotein profile in healthy man. This was also true in heavy coffee drinkers.     

Effect of carnosine treatment on oxidative stress in serum, apoB-containing lipoproteins fraction and erythrocytes of aged rats

One of the mechanisms underlying the aging process is proposed to be oxidative damage by free radicals. Carnosine (β-alanyl-L-histidine) is a dipeptide with antioxidant properties. In this study, we investigated the effect of carnosine supplementation on oxidative stress in serum, apoB-containing lipoproteins (LDL + VLDL) and erythrocytes of young and aged rats. At the initiation of the study, young and aged rats were 5 and 22 months old, respectively. Carnosine (250 mg/kg, daily, i.p.) was administered for 1 month to young and aged rats. We found that serum malondialdehyde (MDA) and diene conjugate (DC) levels and endogenous DC and copper-induced MDA levels in the LDL+ VLDL fraction increased in aged rats, but there was no change in plasma antioxidant activity. Endogenous DC and H(2)O(2)-induced MDA levels were also higher, but glutathione (GSH) levels were lower in erythrocytes of aged rats. Administration of carnosine for 1 month to aged rats resulted in decreased levels of MDA and DC in serum, the LDL + VLDL fraction and erythrocytes and increased levels of GSH in erythrocytes. Our findings indicate that in vivo carnosine treatment may be useful for the decrease in aged-induced oxidative stress in serum, the LDL + VLDL fraction and erythrocytes.     

Effects of prazosin and alphamethyldopa on blood lipids and lipoproteins in hypertensive patients

Summary The effects of prazosin and alphamethyldopa on blood lipids and lipoproteins were assessed in 20 patients with mild or moderate arterial hypertension. Parameters measured included serum cholesterol (CHO), triglycerides (TG), high density lipoprotein-cholesterol (HDL-CHO), insulin (I), glucose (G), and non-esterified fatty acids (NEFA). Prazosin — 4 mg/day for 6 weeks in hydrochlorothiazide-treated patients lowered blood pressure by 18.6/17.2 (systolic/diastolic pressure) mmHg. There was a significant decrease in CHO (–5.8%), in I (–16.5%), and in NEFA (–3.0%), and a significant increase in HDL-CHO (+15.5%). Alphamethyldopa 250–750 mg/day for 6 weeks in hydrochlorothiazide-treated patients lowered blood pressure by 18.8/14.6 (systolic/diastolic pressure) mmHg, accompanied by a non-significant decrease in CHO and TG, and significant increases in HDL-CHO (+10.3%), G (+8.5%) and NEFA (+6.4%). Thus, prazosin appears to have a more beneficial effect on blood lipids and lipoproteins than alphamethyldopa.     

Effect of simvastatin on plasma lipids,apolipoproteins and lipoprotein particles in patients with primary hypercholesterolaemia

Summary The effect of treatment with simvastatin, a new HMG-CoA reductase inhibitor, has been investigated in 27 patients with primary hypercholesterolaemia.It produced a significant decrease of cholesterol and phospholipids in plasma, LDL and apolipoprotein B-containing lipoproteins. Plasma apolipoproteins B, C-III and E were also significantly lowered. The concentration of lipoprotein particles recognized by monoclonal antibodies (BL₃, BL₅ and BL₇), associated with atherosclerotic disease, was also lowered by the treatment.Lipoproteins LpA-II:A-I were not changed, while LpA-I, which has been suggested to be the protective fraction of the apo A-I-containing lipoproteins, was slightly and inconsistently increased.     

大豆异黄酮对大鼠血脂的影响及其体内外抗氧化作用研究

目的：观察大豆异黄酮（SI）对高脂饮食大鼠血脂、血液及肝脏丙二醛（MDA）、超氧化物岐化酶（SOD）及肝脏脂肪病变的影响,以及其主要成分之一金雀异黄素对过氧化氢损伤的ECV304内皮细胞有无保护作用。方法：根据血清总胆固醇（TC）水平,50只雄性Wistar大鼠分为5组：正常对照、高脂饮食对照组和3个SI治疗组。3个SI治疗组分别每日灌胃给予SI30、60、120mg/kg,对照组则给予相应的溶媒,持续9周。治疗第2、4、9周末,测定血清TC、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）。治疗结束时,测定红细胞和肝匀浆SOD活力,血清和肝匀浆MDA含量,并观察肝脏病理变化。以MTT法观察与不同浓度的金雀异黄素体外孵育一定时间后的ECV304内皮细胞对抗过氧化氢氧化损伤的能力。结果：SI30、60、120mg/kg无改善血清TC、LDL、TG、HDL的作用,肝脏病理结果也与血脂结果相似。但是与高脂饮食对照组相比,大鼠红细胞及肝脏的SOD活力明显升高,而血清及肝脏MDA含量也有一定程度降低（P〈0.01,P〈0.05）。对于过氧化氢引起ECV304细胞损伤,金雀异黄素25、50、100μmol/L有剂量依赖性保护作用。结论：大豆异黄酮不能改善高脂饮食大鼠的血脂,不能抑制其肝脏脂肪病变。但其有一定体内外抗氧化作用。     

Effect of neomycin sulphate alone and in combination with d-thyroxine on serum lipoproteins in hypercholesterolaemic subjects

Summary Treatment with neomycin sulphate 1.5 g/d for 8 weeks significantly lowered total serum cholesterol by an average of 19% in 15 out of 19 patients with primary hypercholesterolaemia and LDL-cholesterol by 21%, without significantly changing the corresponding triglyceride and HDL-cholesterol concentrations. Combined treatment with neomycin sulphate 1.5 g/d and d-thyroxine 6 mg/d for 8 weeks lowered total serum cholesterol in the same patients by an average of 30%, LDL-cholesterol by 27% and serum triglycerides by 18%, without significantly changing the HDL-cholesterol concentration. Continued treatment of 10 patients with neomycin sulphate 1.5 g/d for up to 13 months did not further change the reduced serum cholesterol level. 10 of 19 patients complained of side effects after 4–8 weeks of treatment with neomycin: 8 of recurrent diarrhoea, abdominal pain or poor appetite, and 4 of acute attacks of vertigo with nystagmus. All side effects were reversed a few days after stopping the neomycin treatment. No additional serious side effects due to d-thyroxine were observed. These serious side effects of neomycin sulphate limit its use to selected high risk patients with hypercholesterolaemia, who have failed to respond successfully to other LDL-cholesterollowering drugs. They stress the necessity for frequent monitoring for the side effects described.     

Simvastatin and bezafibrate: Effects on serum lipoproteins and lecithin: Cholesterol acyltransferase activity in familial hypercholesterolaemia

Summary Sixteen subjects with familial hypercholesterolaemia were randomly assigned to treatment with simvastatin 20–40 mg/day (an inhibitor of 3-hydroxy-3-methylglutaryl CoA reductase) or with bezafibrate 600 mg/day (a clofibrate analogue) for 12 weeks.Both drugs produced significant reductions in serum and LDL cholesterol; mean percentage fall –30.5% and –38.1% (simvastatin) and –17.8% and –20.6% (bezafibrate), respectively. Both drugs also caused a decrease in VLDL cholesterol, while only bezafibrate decreased the serum and VLDL triglyceride levels and increased HDL cholesterol and serum apolipoprotein A-I and A-II levels. Serum apolipoprotein B fell by 33.3% (simvastatin) and 15.7% (bezafibrate). Simvastatin and bezafibrate produced significant increases in the mean fractional esterification rate of LCAT, by +124,1% and +20.6%, respectively.Thus simvastatin was clearly more effective than bezafibrate in lowering LDL by enhancing its turnover, but bezafibrate had specific effects on VLDL and HDL that might be favourable in combined treatment regimens.     

Effect of pindolol on changes in serum lipids induced by hydrochlorthiazide

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

Long-term effects of guar gum and microcrystalline cellulose on glycaemic control and serum lipids in Type 2 diabetes

Summary The effects of guar gum (GG) and microcrystalline cellulose (MC) on metabolic control and serum lipids were compared in a double-blind, cross-over trial in 18 poorly controlled Type 2 diabetic patients. There were two 12 week treatment periods separated by a 4 week wash-out period.A significant reduction in fasting BG was found after 6 weeks treatment with GG, but the initial level was regained after further 6 weeks, at the end of the treatment period. No statistically significant change in fasting BG was observed with MC. Serum cholesterol was lowered by 10% during GG treatment. Microcrystalline cellulose had no effect on serum lipids.The results suggest, that during 12 weeks supplementation with guar gum, the improvement in glycemic control was not sustained, but that it might reduce the risk of macrovascular disease in diabetic patients.     

Effects of bisoprolol on blood pressure,serum lipids and HDL-cholesterol in essential hypertension

Summary Fifty patients with essential hypertension WHO Grades I–II have been treated for 3 months with bisoprolol, a new selective betablocker, in doses up to 40 mg once daily. Forty-three patients reached the preset target diastolic blood pressure of 90 mmHg on a mean daily dose of 16.8 mg bisoprolol. There was no effect on serum lipids and HDL-cholesterol during the study. The side-effects were mild and were those usually associated with beta-blocking therapy.