Differential effects of exercise on serum lipid and lipoprotein levels seen with changes in body weight. A meta-analysis

Ninety-five studies conducted between September 1955 and October 1983 measuring changes in human serum lipid and lipoprotein levels in response to exercise training were analyzed using meta-analysis. Change in body weight during exercise training may confound observed serum lipid and lipoprotein level changes; thus, data from these studies were partitioned into those where subjects gained body weight, maintained body weight, or lost body weight. Results showed differential changes in cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol, and cholesterol/high-density lipoprotein-cholesterol levels in the three body-weight categories. Where body weight did not change, cholesterol and LDL-C levels decreased significantly (7.3 mg/dL and 3.3 mg/dL, respectively). Where body weight decreased, cholesterol and LDL-C levels also decreased significantly (13.2 mg/dL and 11.1 mg/dL, respectively). However, with body-weight increase, cholesterol and LDL-C levels increased by 2.9 mg/dL and 3.0 mg/dL, respectively. These results suggest that reductions in cholesterol and LDL-C levels were greatest when exercise training was combined with body-weight losses.     

Genetic heterogeneity of autosomal dominant hypercholesterolemia in Mexico

BACKGROUND: Familial hypercholesterolemia (FH) and familial defective apolipoprotein B-100 (FDB) are relatively common lipid disorders caused by mutations of the low-density lipoprotein receptor (LDLR) and apolipoprotein B (apoB) genes, respectively. A third locus on chromosome 1p34.1-p32 was recently linked to FH and the responsible gene has been identified [protein convertase subtilisin/kexin type 9 (PCSK9)]. METHODS: We assessed the contribution of the LDLR, apoB, and PCSK9 genes as cause of FH in Mexico. Forty six unrelated probands, as well as 68 affected and 60 healthy relatives, were included. RESULTS: All index cases were diagnosed as having heterozygous autosomal dominant FH. Seventeen of the 46 index cases had LDLR gene mutations, four of which were novel (Fs92ter108, C268R, Q718X, and Fs736ter743); and only one patient had an apoB mutation (R3500Q). We sequenced the PCSK9 gene in the remainder of the 28 probands with no identified LDLR or APOB gene defects; however, no PCSK9 mutations were found, including one large kindred with positive linkage to the 1p34.1-32 locus (multipoint LOD score of 3.3) and two small pedigrees. Linkage was excluded from these three loci in at least four kindreds suggesting that other yet uncharacterized genes are involved. CONCLUSIONS: Our results underline substantial genetic heterogeneity for FH in the Mexican population.     

Case report on an infant presenting with hypoglycemia,and milky serum

A 4-month-old male baby who presented in a moribund condition with seizures was found to have hepatomegaly, hypoglycemia and milky serum. Serum triglycerides were markedly elevated (3 168 mg/dL) with cholesterol being 257 mg/dL and high density lipoprotein levels were low (19 mg/dL). The possibility of glycogen storage disease type I was considered in the diagnosis. Infants with glycogen storage disease type I may present like sepsis. The association of hepatomegaly, hypoglycemia and abnormal lipid profile stated above should alert the physician to consider glycogen storage disease type I in the diagnosis.     

辛伐他汀对老年冠心病患者血脂和脂质比值的调节作用

目的观察辛伐他汀对老年冠心病患者的血脂和脂质比值的调节作用。方法选择老年冠心病合并原发性高脂血症患者106例,予辛伐他汀20 mg/d,治疗、随访12个月。随访中如患者血清总胆固醇(TC)≤3.6 mmol/L(140 mg/dL)和低密度脂蛋白胆固醇(LDL-C)≤1.8 mmol/L(70 mg/dL),辛伐他汀减为10 mg/d。结果104例患者治疗12个月后,TC、LDL-C、三酰甘油(TG)和载脂蛋白B(ApoB)分别下降38%、45%、20%和25%,P均<0.001。高密度脂蛋白胆固醇(HDL-C)和载脂蛋白A1(ApoA1)分别升高7%和10%(P<0.05)。TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA1比值分别下降为3.30、1.71和0.62,P均<0.001。治疗6个月和12个月时,分别有87.3%和95.2%的患者血脂达标,服用辛伐他汀10 mg/d。结论辛伐他汀对老年冠心病患者的血脂和脂质比值的调节作用显著,安全性良好。     

Lipid levels among African and Middle-Eastern Bedouin populations.

BACKGROUND: Previous studies observed higher high-density lipoprotein (HDL) levels and lower triglycerides levels among people of African ancestry. The goal of this study was to characterize lipid levels in Bedouins of African vs. Middle-Eastern ethnicity. MATERIAL/METHODS: A cross-sectional study was conducted in a Bedouin primary care clinic in southern Israel, with 4470 listed individuals over the age of 21, of whom 402 (9%) were of African origin. A stratified random sample was included in the analysis. Associations between ethnicity, age, gender and lipid levels were assessed. Multiple linear regression and logistic regression models were used for multivariate analysis. RESULTS: The study included 261 African Bedouins and 406 Middle-Eastern Bedouins. (median age: 37 years, 58.6% females). The average total cholesterol and low-density lipoprotein (LDL) levels were 10 mg/dl lower among African Bedouins as compared to Middle-Eastern Bedouins (total cholesterol: 168.6 vs. 179.6 mg/dl, p<0.001; LDL: 99.5 vs. 109.0 mg/dl, respectively, p<0.001). Average triglycerides levels were 36 mg/dl lower among African Bedouins as compared to Middle-Eastern Bedouins (102.8 vs. 138.9 mg/dl, respectively, p<0.001). Average HDL levels were 3 mg/dl higher among African Bedouins as compared to Middle-Eastern Bedouins (48.3 vs. 44.6 mg/dl, respectively, p<0.001). CONCLUSIONS: A lower prevalence of dyslipidemia was found in African Bedouins, as compared with Middle-Eastern Bedouins.     

Hyperlipidemia in childhood idiopathic nephrotic syndrome during initial remission and relapse

The objective of this study was to correlate hyperlipidemia during initial remission of nephrotic child with relapse. This observational prospective study was carried out among 26 children, between 1 to 8 years age with first attack idiopathic nephrotic syndrome, who was seen at Paediatric Nephrology Department of BSMMU and Paediatric Nephrology Department, NIKDU, from December'2005 to August'2006 and were followed-up for at least 6 months after initial attack. Twenty two age and sex matched hospitalized children, suffering from non-renal diseases, were enrolled as controls. Fasting blood samples for lipid profile were taken at the time of diagnosis of both cases and controls and also during remission of cases only. These patients were divided into two groups based on serum lipid profile during remission. Group-I consisted 16 patients who had normal lipid profile during remission and Group-II consisted 10 patients who had abnormal lipid profile during remission. Both Groups I & II had higher mean levels of serum cholesterol, LDL, TG and Lp(a) than those of controls during initial diagnosis. Between two groups on remission, Group-II patients showed higher mean serum cholesterol (332.9±105.19 mg/dL vs. 183.13±16.89 mg/dL; p<0.001), serum LDL (252±101.67 mg/dL vs. 119.19±21.33mg/dL; p<0.001), and serum TG (182.8±73.83 mg/dL vs. 93.31±20.95 mg/dL; p<0.001). Five patients out of 10 patients of Group-II (19% of total case) developed subsequent relapse within 6 months follow-up. Among the relapsers, mean cholesterol (334±46 vs. 232±34 mg/dL; p<0.05) was significantly higher than that of non-relapsers of Group-II patients. On the other hand, no patient of Group-I developed relapse within 6 months follow-up. It may be concluded from this study that hyperlipidemia in general at remission, specifically serum total cholesterol, may be regarded as predictor of relapse in childhood idiopathic nephrotic syndrome.     

One year experience in the treatment of familial hypercholesterolaemia with simvastatin.

Patients with heterozygous familial hypercholesterolaemia (FH) have a substantially increased risk of atherosclerosis due to very high plasma levels of cholesterol. Recent evidence has shown that coronary heart disease in these patients may regress with lipid-lowering therapy. In this study the efficacy and safety of simvastatin, an inhibitor of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A, was investigated in 30 patients with FH over a period of one year. Substantial reductions in the plasma concentrations of total cholesterol (-28%), low-density lipoprotein (LDL) cholesterol (-32%), intermediate-density lipoprotein (IDL) cholesterol and apolipoprotein (apo) B (-33%) were achieved with 20 mg/day of simvastatin; there were no significant changes in triglycerides high-density lipoprotein cholesterol or apo A. In contrast to previous studies, 40 mg/day of simvastatin did not result in a further statistically significant fall in LDL cholesterol, IDL cholesterol or apo B in the group as a whole. The drug was well tolerated and no adverse clinical or laboratory events were recorded. In particular, no ophthalmological, hepatic or renal disorders were observed and there were no sleep disturbances. We conclude that simvastatin is an efficacious and safe drug to treat patients with heterozygous FH and that rarely will the dose need to be increased above 20 mg/day.     

2代3人同患家族性高胆固醇血症及其低密度脂蛋白受体基因突变分析

目的　调查姐妹二人同患家族性高胆固醇血症的家系并进行系谱分析。方法　根据患者及其家系的血缘关系绘制家系图谱,分析临床症状和血脂检查资料。结果　先证者女性,17岁,血清胆固醇浓度为18.89 mmol/L,3岁时即有臀部黄色瘤, 17岁时首次发生前壁心肌梗死,其姐血清胆固醇浓度为15.23 mmol/L,全身多处黄脂瘤。初步诊断先证者为纯合子型,其姐为杂合型。检查患儿4代29人,根据血脂和临床表现确诊2例杂子型家族性高胆固醇血症患者,系谱分析该家系遗传方式符合常染色体显性遗传规律。结论　初步证实一个纯合子型家族性高胆固醇血症系谱。     

Association of body mass index and abdominal adiposity with atherogenic lipid profile in Nigerians with type 2 diabetes and/or hypertension

Background:

We explored the relationship between anthropometric indices (obesity and abdominal adiposity) and the presence of an atherogenic lipid profile in Nigerians with major cardiovascular risk factors (type 2 diabetes mellitus-T2DM, hypertension-HBP, and concomitant disease).

Materials and Methods:

Using a prospective design, 278 patients with T2DM, HBP, or concomitant disease, attending out-patient diabetes and hypertension clinics at a tertiary institution in Nigeria were evaluated. All patients were cholesterol-lowering oral medication naοve. Demographic and clinical data and anthropometric measurements were documented. Fasting lipid profiles were measured in all cases. The cut-off points for defining dyslipidaemia were: Elevated total cholesterol (TC) (mg/dL) ≥200, elevated low-density lipoprotein cholestrol (LDL-C) (mg/dL) ≥100, low high-density lipoprotein cholesterol (HDL-C) (mg/dL) <40 for men and <50 for women, and high triglycerides (TG) (mg/dL) ≥150 mg/dL.

Results:

We found a significantly higher mean BMI (kg/m²) in the HBP group (30.5 ± 6.0) compared to T2DM (28.1 ± 5.9) and concomitant HBP and T2DM groups (29.4 ± 5.2) (ANOVA; P = 0.02). The most frequent dyslipidaemia was elevated LDL-C in 92 (96.8%) HBP, 73 (85.9%) T2DM and 79 (80.6%) concomitant disease. The frequency of low HDL-C was highest in T2DM (68.2%) compared to the other 2 groups (P = 0.03).

Conclusions:

Only TG levels were found to relate with any anthropometric index (waist circumference (WC) in this case) in Nigerians with major cardiovascular risk factors in this study. Routine anthropometric indices do not appear to be reliable surrogates for atherogenicity measured by abnormalities in TC, LDL-C and HDL-C.     

Analysis of low-density lipoprotein receptor gene mutations in a Chinese patient with clinically homozygous familial hypercholesterolemia

Objective To screen the point mutation of the low-density lipoprotein receptor （LDL-R） gene in Chinese familial hypercholesterolemia (FH) patients, characterize the relationship between the genotype and the phenotype and discuss the molecular pathological mechanism of FH. Methods A patient with clinical phenotype of homozygous FH and her parents were investigated for mutations in the promoter and all eighteen exons of the LDL-R gene. Screening was carried out using Touch-down PCR and direct DNA sequencing; multiple alignment analysis by DNASIS 2.5 was used to find base alteration, and the LDL-R gene mutation database was searched to identify the alteration. In addition, the apolipoprotein B gene (apo B) was screened for known mutations (R3500Q) that cause familial defective apo B100 (FDB) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results Two new heterozygous mutations in exons 4 and 9 of the LDL-R gene were identified in the proband (C122Y and T383I) as well as her parents. Both of the mutations have not been published in the LDL-R gene mutation database. No mutation of apo B100 (R3500Q) was observed. Conclusion Two new mutations (C112Y and T383I) were found in the LDL-R gene, which may result in FH and may be particularly pathogenetic genotypes in Chinese people.     

大剂量辛伐他汀短期治疗对急性冠脉综合征患者血浆高敏C 反应蛋白水平的影响

目的研究大剂量(40?mg/d)和常规剂量(20?mg/d)辛伐他汀治疗急性冠脉综合征(ACS)2周后,对患者血浆高敏C反应蛋白(hs CRP)水平的影响。方法选取ACS患者86例,随机分为常规剂量组(n=43,辛伐他汀20?mg/d)和大剂量组(n=43,辛伐他汀40?mg/d),测定治疗前和治疗1、2周后患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL C)、高密度脂蛋白胆固醇(HDL C)、甘油三酯(TG)和hs CRP水平。结果治疗2周后,常规剂量组和大剂量组TG和HDL C变化不明显,TC和LDL C均下降(P＜0.05),大剂量组下降更为明显;hs CRP水平亦呈下降趋势,大剂量组下降更为明显(P＜0.01)。相关性分析显示,治疗后血浆hs CRP浓度的变化与同期血脂(TC、LDL C、HDL C、TG)水平的变化无显著相关性。结论短期大剂量辛伐他汀治疗可以使血脂和hs CRP水平显著下降, 减少炎症反应,稳定动脉粥样硬化斑块。     

Inverse association between plasma cholesterol and gallstone disease.

BACKGROUND: The association between gallstone disease (gallstones or cholecystectomy) and plasma lipids was evaluated in 2,089 subjects who attended a private health care facility in Mexico City from August 1991 to August 1992. METHODS: All participants provided data on their sociodemographic status, non-insulin-dependent diabetes mellitus diagnoses, alcohol consumption, and smoking habits; women also gave data regarding their obstetric-gynecologic histories. Ultrasounds of the liver and biliary tract were performed. Cholesterol levels, high-density lipoproteins cholesterol, and triglyceride plasma concentration were determined. RESULTS: This study shows a strong inverse association between gallstone disease and plasma cholesterol concentration, with OR = 0.61 (95% CI = 0.42-0.89) in the category of 181-239 mg/dL, and OR = 0.49 (95% CI = 0.32-0.77) in the group of 240 mg/dL or more, when compared to 180 mg/dL or less, after adjusting for the following risk factors: gender, age, and body mass index. CONCLUSIONS: These results suggest an increment in the catabolic pool of cholesterol, reflected in lower levels of plasma cholesterol in subjects with gallstone disease.     

Lipid profile of a French-Canadian population: 1. Association of plasma lipid and lipoprotein levels with age, relative body weight and education

Plasma lipid and lipoprotein levels were determined in a randomly selected population of 1169 French-Canadian men in the Quebec City area. The mean levels of total plasma cholesterol and triglycerides were 224.0 and 166.5 mg/dL respectively. The mean level of low-density lipoprotein cholesterol was higher and the mean level of high-density lipoprotein (HDL) cholesterol lower than those reported in a recent study in English-Canadian men. The mean HDL₂ and HDL₃ levels were lower than those reported in American men. Stratification of plasma triglyceride levels for all age groups showed that mean HDL₂ levels decreased rapidly with moderate rises in triglyceride levels. Less than 9% of the variation in lipid or lipoprotein levels was related to age or relative body weight. Education had no significant effect on the levels.     

Risk factors for cardiovascular disease in a healthy young population: Family matters

BackgroundIndia faces an epidemic of cardiovascular disease (CVD). This study sought the effect of family history of CVD and/or its risk factors (CVD-risk) on the presence of risk factors for CVD, in a healthy young college population.MethodsBlood pressure (BP), heart rate (HR), anthropometric variables, fasting blood sugar and lipid fractions were measured in two hundred healthy individuals (163 men and 37 women), aged 17–22 years. Data were analysed to elicit effect of CVD-risk on measured parameters.ResultsAll but one subject, had family history of a CVD-risk. Men with family history of coronary heart disease had higher diastolic BP (79.24 ± 7.7 vs 75.99 ± 7.49 mmHg, p = 0.007) and triglycerides (118.66 ± 57.98 vs 85.82 ± 50.89 mg/dL, p < 0.0001) compared with those without similar family history. Men with family history of hypertension (HTN) had higher diastolic BP (78.75 ± 7.15 vs 75.84 ± 8.37 mmHg, p = 0.019) and low-density lipoprotein (86.24 ± 25.38 vs 78.21 ± 17.93 mg/dL, p = 0.019), as well as lower high-density lipoprotein (50.27 ± 8.4 vs 53.96 ± 10.38 mg/dL, p = 0.019). Women with family history of diabetes mellitus had lower high-density lipoproteins (49.89 ± 8.05 vs 59.53 ± 11.44, p = 0.006). Family history of dyslipidaemia was associated with significantly higher triglycerides (146.14 ± 46.19 vs 98.44 ± 56.19 mg/dL, p = 0.002) in men and in subjects across sex. HDL was contrarily higher, in women with family history of cerebrovascular accident/HTN and men with family history of coronary heart disease/HTN. The proportion of pre-HTN, overweight/obese, impaired fasting glucose and borderline high triglycerides was 88.3%, 36.8%, 11% and 38.7% in men and 64.9%, 37.8%, 18.9% and 48.7% in female subjects.ConclusionYoung adults with a family history of CVD-risk already have an incomplete/atypical CVD risk profile.     

高血压患者胆红素与血脂综合指数的变化

目的:探讨胆红素与血脂综合指数的变化状况对冠心病的诊断价值.方法:对67例高血压组和72例冠脉正常组血清总胆红素(TB)、直接胆红素(DB)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)指标进行测试,分析组间胆红素、血脂、血脂综合指数和胆红素与血脂综合指数的差别.结果:高血压组血清总胆红素明显低于冠脉正常组(P<0.05);高血压组胆红素与血脂综合指数结合指标明显高于冠脉正常组(P<0.01).结论:胆红素与血脂综合指数是具有临床使用价值的预测指标.     

Investigation of 4-hydroxynonenal-delved Epitopes on Apolipoprotein B in Human Serum

Ｉｎｖｅｓｔｉｇａｔｉｏｎｏｆ４┐ｈｙｄｒｏｘｙｎｏｎｅｎａｌ┐ｄｅｌｖｅｄＥｐｉｔｏｐｅｓｏｎＡｐｏｌｉｐｏｐｒｏｔｅｉｎＢｉｎＨｕｍａｎＳｅｒｕｍ①ＣｈｅｎＱｉ（陈琪）ＣｈｅｎＢｉｎｇｙｉｎｇ（陈丙莺）＊ＣｈｅｎＸｉｕｙｉｎｇ（陈秀英）ＷａｎｇＮ...     

Hypertriglyceridemia: a case report from diagnostic laboratory,Barasat, West Bengal,India

Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis, even in the absence of hypercholesterolemia. This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat. He was nonsmoker, non-alcoholic, had a reasonable diet with abundant fruits and vegetables, and was on regular exercise. He was not taking any lipid lowering medications. He hailed from Barasat, and was employed in Government sector in Barasat and policeman by profession. His father died at the age of 57 years in a heart attack; but his mother is healthy and now almost 62 years of age, and he has two brothers one elder and another younger to him, both are healthy. His blood pressure was normal, his body-mass index was 27, and his waist circumference was 96 cm and hip circumference was 103. His waist/hip ratio was 0.932. The Biochemical analyses were as follows- Fasting Glucose: 186 mg/dL, Total Cholesterol: 90 mg/dL, Triglycerides: 372 mg/dL, High-density cholesterol: 3.80 mg/dL, Low-density cholesterol: 2.90 mg/dL, VLDL: 83.20 mg/dL, Cholesterol/HDL-C ratio: 23.6:1, LDL-C/HDL-C: 0.07:1. This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males, suggesting that this group is at an increased risk of developing CAD leading to young infarcts. Combination lifestyle therapies i.e., enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.     

血清氧化性修饰载脂蛋白B的新法测定

４羟基壬烯醛（ＨＮＥ）是脂质过氧化反应的一个重要产物。本文报告用酶联免疫法检测人血清载脂蛋白Ｂ（ａｐｏＢ）上的ＨＮＥ抗原决定簇的表达水平。发现男性的平均水平（１５６．５ｍｇ／Ｌ，ｎ＝１５７）高于女性（１４７．６ｍｇ／Ｌ，ｎ＝１０６），在７０岁以前还随年龄而增高。ａｐｏＢ上ＨＮＥ抗原决定簇的表达与血清铁蛋白含量呈正相关，还与血清总胆固醇、甘油三酯以及低密度脂蛋白胆固醇水平呈正相关，与高密度脂蛋白胆固醇水平呈负相关。提示本法可作为检测血清脂质过氧化反应的一个有用指标。     

Safety and efficacy after switch to a saquinavir-containing antiretroviral regimen in protease inhibitor pretreated HIV-positive patients

Objective

The RAINBOW survey is a multinational observational study assessing the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r), using the 500 mg film-coated SQV formulation, in routine clinical practice. This analysis presents data from the German subgroup of protease inhibitor (PI)-pretreated, but SQV-naïve patients.

Methods

Multicenter, prospective, open-label, 48 week cohort study. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 48. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 48.

Results

A total of 426 patients were included in the analysis. The proportion of patients with HIV RNA levels < 50 copies/mL at week 48 was 60.3% (compared with 31.7% at switch to SQV/r) (intent-to-treat, last observation carried forward analysis). After 48 weeks, median CD4 count increased by +61 cells/mm³ from baseline (p < 0.01) and 60.3% of patients achieved HIV-1 RNA < 50 copies/mL. Median changes in fasting triglyceride levels (stratified according to baseline level) at week 48 were: +14 mg/dL (IQR -8; 57) for patients with baseline triglyceride < 200 mg/dL; -50 mg/dL (IQR -139; 0) for baseline triglyceride 200-750 mg/dL, and -656 mg/dL (IQR 1024; 0) for baseline triglyceride > 750 mg/dL (p < 0.01 for all). Median changes in fasting total cholesterol (TC) levels (stratified according to baseline) were +16 mg/dL (IQR -3; 43) for patients with baseline TC < 200 mg/dL (p < 0.01), -3 mg/dL (IQR -25; 25) for baseline TC 200-300 mg/dL (p = 0.4), and -47 mg/dL (IQR -87; -4) for baseline TC > 300 mg/dL (p < 0.01). No significant changes in liver enzymes or bilirubin were observed. SQV treatment was discontinued in 22% of patients, 6% due to side effects.

Conclusions

These data confirm the efficacy and tolerability of SQV/r in PI-experienced, SQV-naïve patients treated in a real-life clinical setting. Of particular relevance are the improvements in triglycerides and TC levels observed in patients with baseline grade III-IV elevations.     

EFFECTS OF SIMVASTAIN COMBINED WITH OMEGA-3 FATTY ACIDS ON HIGH SENSITIVE C-REACTIVE PROTEIN,LIPIDEMIA,AND FIBRINOLYSIS IN PATIENTS WITH MIXED DYSLIPIDEMIA

Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein (HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipidemia.Methods A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (＜ 100 mg/dL) or close to the goal (＜ 130 mg/dL), while triglyceride (TG) ≥ 200 mg/dL and ＜ 500 mg/dL, was combined with omega-3fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, highdensity lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein Al (apoAl), apolipoprotein B (apoB),plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients.Results (1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 ± 2.77mg/L (38.5%), 94.0± 65.4 mg/dL (31.1%), 13.3 ± 22.3 mg/dL (6.3%), 0.78 ± 1.60 respectively in the omega-3 fatty acids group (P ＜ 0.01, ＜ 0.001, ＜ 0.05, ＜ 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P= 0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r = 0.51and 0.45, P=0.021 and 0.047 respectively).Conclusion In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia's therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.