The Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk

(1) Background: Cardiometabolic disease, including insulin resistance, hyperlipidemia, and hypertension, are major contributors to adverse health outcomes. Fasting has gained interest as a nonpharmacological therapeutic adjunct for these disorders. (2) Methods: We conducted a prospective, single-center study on the effects of prolonged water-only fasting followed by an exclusively whole-plant-food refeeding diet on accepted measures of cardiovascular risk and metabolic health. Participants were recruited from patients who had voluntarily elected to complete a water-only fast in order to improve their overall health according to an established protocol at an independent, residential medical center. Median fasting and refeed lengths were 17 and 8 days, respectively. The primary endpoint was to describe the mean glucose tolerance as indicated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores at baseline, end-of-fast (EOF), and end-of-refeed (EOR) visits. Secondary endpoints were to describe the mean weight, body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid panel, and high-sensitivity C-reactive protein (hsCRP) at the same time points. (3) Results: The study enrolled 48 overweight/obese non-diabetic participants, of which 26 completed the full study protocol. At the EOF visit, the median SBP, AC, low-density lipoprotein (LDL), and hsCRP were decreased and triglycerides (TG) and HOMA-IR scores were increased. Conclusion: Prolonged water-only fasting and whole-plant-food refeeding holds potential as a clinical therapy for cardiometabolic disease but increased TG and HOMA-IR values after refeeding necessitate further inquiry.     

降脂合剂联合非诺贝特等治疗高脂血症80例临床观察

目的 观察降脂合剂联合非诺贝特等治疗高脂血症的临床效果.方法 将158例高脂血症患者随机分为治疗组和对照组,治疗组80例以降脂合剂联合非诺贝特等治疗,对照组78例单纯以非诺贝特等治疗,治疗12周后测量两组患者血清总胆固醇(TC)、低密度脂蛋白( LDL-C)、高密度脂蛋白(HDL-C)、血清甘油三酯(TG)水平以及血液...     

Type 1 diabetic children have abnormal lipid profiles during pubertal years

Aim/Hypothesis: To study the prevalence of hypercholesterolemia, hypertriglyceridemia and the relationship between metabolic control, pubertal status and plasma lipoprotein levels in children with diabetes mellitus.
Subjects and methods: A cross‐sectional study was conducted on 126 subjects with type I diabetes followed at our institution. There were 57 boys and 69 girls (mean age: 13.4±3.4 yr; mean duration of diabetes: 7.3±2.1 yr), on whom fasting lipoprotein levels and pubertal status were determined. Mean glycated hemoglobin (HbA1c) of the preceeding year was used in the analysis. Cholesterol (CT) and triglyceride (TG) levels were transformed into standard deviations (SD) using age dependent normal values.
Results: 1) CT levels of DM children (mean level: +0.9±1.2 SD) are higher for both sexes and at each age. Sixteen percent of the cases had CT level ≥2 SD. Within the range of the HbA1c observed (9.1±1.2%), CT levels are not correlated with the degree of metabolic control. In contrast to non‐diabetic children, CT levels of the diabetic children did not vary throughout pubertal stages. CT levels correlated highly with apolipoprotein B (r=0.79; p<0.00001 and r²=82%, in univariate and multivariate analysis, respectively. 2) Plasma TG levels are comparable in the diabetic children (mean level: ?0.11±0.9 SD) and non‐diabetic children. Only 5% of the diabetic children have a TG level ≥2 SD. The TG levels are significantly, but weakly, positively correlated with duration of diabetes and the degree of metabolic control (r²=12% and 16%, respectively, p<0.0001 for both).
Conclusions: Plasma CT levels of type I diabetic children are increased in comparison to non‐diabetic children and do not follow the usual decreasing pattern during puberty.     

辛伐他汀对脂代谢异常患者两种调脂方法的临床研究

目的观察辛伐他汀低剂量维持治疗和停止辛伐他汀治疗后血脂水平的变化,心、脑血管事件及与药物相关的不良反应。方法对高脂血症患者给予辛伐他汀治疗,血脂正常后部分患者继续给予低剂量维持治疗,部分患者选择了停止服用他汀类药物,在血脂正常后2、4、6个月分别观察两组的血脂水平、缺血性心血管事件和与他汀类药物有关的不良反应。结果辛伐他汀低剂量维持治疗能持续有效地降低血清总胆固醇、低密度脂蛋白胆固醇,使甘油三酯维持在正常范围内,随着治疗时间的延长,高密度脂蛋白胆固醇进一步升高。经辛伐他汀治疗后半年内,其防止心、脑血管事件的作用仍然存在。低剂量维持治疗未出现与他汀类药物有关的不良反应。停止辛伐他汀治疗后血脂水平出现反弹。结论辛伐他汀低剂量维持治疗,患者耐受性好,疗效确切,能保持血脂水平持续达标。     

大豆低聚糖和低聚肽对高脂血症大鼠血管活性物质和血液流变学的影响

目的探讨大豆低聚糖(SOS)和大豆低聚肽(SOP)对高脂血症大鼠血管活性物质和血液流变学的影响。方法60只健康成年SD大鼠随机分为5组:分别饲喂正常饲料(正常对照组,NCG),高脂饲料(高血脂模型组,HCG),高脂饲料 2%SOS(SOS组)、高脂饲料 3%SOP(SOP组)、高脂饲料 2%SOS 3%SOP(SOSP组)8周,测定大鼠血脂、血管活性物质PG I2、TXA2、NO和血液流变学指标。结果各实验组均能显著降低高脂血症大鼠血清TC、TG、LDL-C,升高HDL-C,改善血脂水平。同时升高PG I2、NO,降低TXA2和TXA2/PG I2比值,还能降低血黏度和红细胞压积,并以复合干预组效果最佳。结论SOS和SOP具有良好的调节血脂、影响血管活性物质生成和改善血液流变学的作用,以联合使用效果最为显著。     

The Effects of High Dose Pravastatin and Low Dose Pravastatin and Ezetimibe Combination Therapy on Lipid,Glucose Metabolism and Inflammation

Objective Coronary artery disease (CAD) is presently the major cause of mortality and morbidity. Anti-hyperlipidemic treatment is one of the main treatment steps in the management of CAD. Statins are the cornerstones in this treatment. Ezetimibe can be reliably used, when statins prove ineffective in treatment, or to reduce their side effects. In the present study we examined the effects of high-dose pravastatin (40 mg) and low-dose pravastatin (10 mg) + ezetimibe (10 mg) combination therapy on lipid and glucose mechanism, as well as inflammation. Methods This study registered 100 cases. Of the cases, 50 [57.1 ± 11.1 years (24 (48%) females and 26 (52%) males)] were administered 40 mg/day pravastatin (group 1) and 50 [53.2 ± 12.2 years (27 (54%) females and 23 (46%) males)] were administered 10 mg pravastatin + 10 mg ezetimibe (group 2). Results In group 1, total cholesterol fell from 231.1 ± 83.5 mg/dl to 211.3 ± 37.2 mg/dl (p = 0.03), triglyceride from 243.5 ± 96.8 mg/dl to 190.9 ± 55.2 mg/dl (p = 0.003), and LDL cholesterol from 165.7 ± 29.7 mg/dl to 133.4 ± 26.6 mg/dl (p = 0.02). In group 2, total cholesterol dropped from 250.9 ± 51.8 mg/dl to 187.9 ± 34.9 mg/dl (p = 0.001), triglyceride from 270.3 ± 158.9 mg/dl to 154.6 ± 60.7 mg/dl (p = 0.001), and LDL cholesterol from 158.1 ± 47.5 mg/dl to 116.9 ± 26.4 mg/dl (p = 0.001). Insulin resistance decreased from 4.05 ± 2.31 to 3.16 ± 1.90 (p = 0.07) in group 1 and from 2.96 ± 1.50 to 2.05 ± 0.55 (p = 0.009) in group 2. High sensitive C-reactive protein fell from 6.69 ± 6.11 mg/l to 3.02 ± 1.70 mg/l (p = 0.01) in group 1 and from 6.36 ± 2.06 mg/l to 2.68 ± 1.69 mg/l (p = 0.001) in group 2. Conclusion Both therapy regimes are effective. However, we found that low-dose pravastatin and ezetimibe combination therapy is more effective than high-dose pravastatin therapy on lipid metabolism, glucose metabolism and inflammation.     

Dyslipidemia in young Japanese children: its relation to familial hypercholesterolemiaand familial combined hyperlipidemia

BACKGROUND: Most cases of dyslipidemia found in adults are non-familial. However, in children, especially young children, dyslipidemias other than familial hypercholesterolemia (FH) have not yet been characterized. METHODS: From April 1990 to March 1999, 56 181 children were screened, and 1380 showed abnormal levels of apolipoprotein B (more than 2.5 standard deviations above the mean). Among these, 1198 were re-examined and further characterized by measuring lipids and apolipoproteins, and by their familial histories. RESULTS: Seventy-seven percent of the children (928 of 1198) recalled were diagnosed as being dyslipidemic. Ninety-one children were FH, 423 were type IIa, 128 were type IIb, 98 were type IV, and 188 were hypoalphalipoproteinemia. The presumed incidence of FH was 0.19%, IIa 0.87%, IIb 0.26%, IV 0.20%, and hypoalphalipoproteinemia 0.39%, taking into account the percentage of subjects who refused recall. At regular follow-ups, in many children with type IIb, the phenotypic expression changes from type IIb to IIa or IV. Thus, lipid and apolipoprotein levels were determined in 77 family members in 34 families of children with type IIb. Forty-five family members were dyslipidemic (type IIa 18, type IIb 11, type IV 16). As a result, 27 children (79%) with type IIb met the criteria for familial combined hyperlipidemia. CONCLUSIONS: Children with dyslipidemia had more family or genetic background than adults. Unexpectedly, children with type IIb were mostly familial combined hyperlipidemia. Thus, setting appropriate eating patterns during childhood might be important for normalizing risk factors for atherosclerotic coronary heart disease, especially in children with FH or type IIb.     

Effect of statins on platelet function in patients with hyperlipidemia

Introduction

It is generally assumed that cholesterol reduction by statins is the predominant therapeutic result underlying their beneficial effects in cardiovascular disease. However, the action of statins may be partially independent of their effects on plasma cholesterol levels, as they combine lipid lowering with positive effects on hemorheological conditions and endothelial function. We evaluated the impact of statin treatment on platelet adhesion to fibrinogen (spontaneous and ADP-activated), along with ADP, collagen or ristocetin-induced aggregation in type II hyperlipidemic patients.

Material and methods

The study group included 70 persons: 50 patients affected by type II hyperlipidemia without concomitant diseases and 20 healthy volunteers. The effects of 8-week statin treatment (atorvastatin 10 mg/day, simvastatin 20 mg/day, or pravastatin 20 mg/day) on platelet activation were evaluated.

Results

Regardless of the type of statin, a significant decrease in ADP-induced platelet aggregation was observed: for atorvastatin 50.6 ±12.8% vs. 41.1 ±15.8% (p < 0.05), for simvastatin 57.2 ±18.0% vs. 44.7 ±22.1% (p = 0.05), and for pravastatin 55.8 ±19.5% vs. 38.8 ±23.3% (p < 0.05). There was no significant effect of statins on collagen or ristocetin-induced platelet aggregation and adhesion.

Conclusions

Therapy with statins beneficially modifies ADP-induced platelet aggregation in patients with hyperlipidemia and does not affect spontaneous or ADP-induced platelet adhesion to fibrinogen and platelet aggregation induced by collagen or ristocetin.     

高脂血症对钛种植体骨结合影响的研究进展

高脂血症是常见的全身代谢性疾病,中老年人多见,发病率较高。高脂血症是种植治疗的风险因素之一,可引起种植体骨结合不良,从而影响种植义齿的临床疗效。本文针对高脂血症对钛种植体骨结合影响的研究进展作一综述。