Non-alcoholic fatty liver syndrome: a hepatic consequence of common metabolic diseases

BACKGROUND AND AIMS: The association of liver steatosis with a number of common metabolic conditions has been suggested. The aim of the present study was to evaluate the clinical features of subjects with different severities of steatosis. METHODS: The present study was performed in 282 consecutive patients with 'bright liver' at ultrasonography and in 58 subjects without steatosis. They had no history of alcohol abuse and negative tests for the presence of hepatitis B and C virus. Patients underwent clinical examination, anthropometry, laboratory tests and routine liver ultrasonography. Steatosis was graded as absent, mild, moderate and severe. RESULTS: A progressive increase in the prevalence of obesity (P < 0.001), type 2 diabetes (P < 0.001), alanine aminotransferase (ALT) elevation (P < 0.001) and hypertriglyceridemia (P < 0.001), and a decrease of hypercholesterolemia (P < 0.05) was observed from the control group to the groups with mild, moderate and severe steatosis. More than half the subjects with liver steatosis had insulin resistance metabolic syndrome. Obesity, diabetes and hypertriglyceridemia were more common by 5.3-fold, 4.0-fold, and 6.7-fold, respectively, in subjects with severe steatosis, as compared to controls. Prevalence of obesity, diabetes and hyperlipidemia was significantly higher in subjects with fatty liver and ALT elevation. CONCLUSION: Fatty liver can be considered as the hepatic consequence of common metabolic diseases.     

Long-term patency (9½ years) and atherosclerosis of a polytetrafluoroethylene (Gortex®) coronary artery bypass graft

The patency of a polytetrafluoroethylene (Gortex®) graft 9½ years after coronary artery bypass graft surgery (CABG) is demonstrated. While this material is not commonly used as a conduit because of limited success in the past, this case demonstrates that, given the right circumstances, longterm patency is possible. Since available conduits for CABG are quite often limited, viable alternatives may be lifesaving and require further evaluation. In addition to mechanical considerations such as size, length, and material, anticoagulation and strict management of hyperlipidemia may be critical.     

Increase of inflammatory state in overweight adults with combined hyperlipidemia

BACKGROUND AND AIM: Elevated levels of acute phase reactants are found in patients with cardiovascular disease. It is suggested that adipose tissue is a determinant of a low level of inflammatory state in overweight persons. The aim of the study was to determine, whether combined hyperlipidemia, which is an important factor of atherosclerosis, has influence on the inflammatory response in overweight adults. METHODS AND RESULTS: Levels of soluble cell adhesion molecules sICAM-1, sE-selectin and sP-selectin, PAI-1 Ag (by Elisa test), orosomucoid (ORM) and transferrin (TRF) (by microturbidimetry) and fibrinogen (FBG) according to Clauss were examined in peripheral blood of overweight adults (n 33, body mass index 27.1 +/- 1.8 kg/m2) with combined hyperlipidemia and in equal numbers of age, sex and BMI matched non-hyperlipidemic group. Overweight adults with combined hyperlipidemia had significantly higher plasma levels of sICAM-1 (376.5 +/- 107.4 ng/mL vs 239.3 +/- 60.4 ng/mL; p < 0.001), sE-selectin (70.4 +/- 20.2 ng/mL vs 48.5 +/- 25.6 ng/mL; p = 0.005), sP-selectin (228.2 +/- 88.6 ng/mL vs 123.1 +/- 45.3 ng/mL; p < 0.001) and positive acute phase proteins ORM (0.82 +/- 0.16 g/L vs 0.64 +/- 0.20 g/L; p = 0.005), FBG (3.42 +/- 0.54 g/L vs 2.74 +/- 0.57 g/L; p = 0.037) and PAI-1 Ag (97.9 +/- 40.6 ng/mL vs 56.4 +/- 25.6 ng/mL; p < 0.05), and a decrease of negative acute phase protein TRF (2.14 +/- 0.40 g/L vs 2.77 +/- 0.45 g/L; p < 0.001) compared to the results in overweight non-hyperlipidemic controls. CONCLUSIONS: It is suggested that overweight adults have an increase of inflammatory response dependent on hyperlipidemia. It was apparent from the elevation of sE--selectin, sP--selectin and sICAM-1 and from an increase of systemic inflammatory response according to the increase of "positive" acute phase proteins (APRs) and the decrease of "negative" APR protein levels in these patients.     

微粒化力平脂治疗原发性高脂血症疗效的初步观察

22例原发性高脂血症患者服用微粒化力平脂200mg，每晚一次，共8周，并随机设立空白对照11例。结果显示：治疗8周后，患者血清甘油三酯明显降低（P＜0．001），显效率为86．4％，高密度脂蛋白胆固醇明显升高（P＜0．01），纤维蛋白原明显降低（P＜0．01），而血清总胆固醇降低未达到统计学意义。结论：微粒化力平脂特别适用于IV型高脂血症患者并对纤维蛋白原升高者有益。     

降脂通脉胶囊联合藻酸双酯钠治疗高脂血症的临床研究

目的探讨降脂通脉胶囊联合藻酸双酯钠片治疗高脂血症的临床疗效。方法选择2018年3月-2019年3月在陕西省荣誉军人康复医院治疗的高脂血症患者86例,根据用药的差别分为对照组(43例)和治疗组(43例)。对照组口服藻酸双酯钠片,50mg/次,3次/d;治疗组在对照组基础上口服降脂通脉胶囊,2.0g/次,3次/d。两组患者经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、胆固醇(TC)、嗜酸性粒细胞阳离子蛋白(ECP)、摄食抑制因子-1(NSF-1)、硫氧还蛋白相互作用蛋白(TXNIP)、肿瘤坏死因子-α(TFN-α)、白细胞介素-1β(IL-1β)、脂联素(ADP)、超氧化物歧化酶(SOD)、丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px)水平。结果治疗后,对照组临床有效率为81.40%,显著低于治疗组的97.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者TC、TG、LDL-C、ECP、IL-1β、TFN-α、TXNIP、NSF-1和MDA水平均显著降低(P<0.05),而HDL-C、ADP、SOD和GSH-Px水平均显著升高(P<0.05),且治疗组患者这些指标明显好于对照组(P<0.05)。结论降脂通脉胶囊联合藻酸双酯钠片治疗高脂血症可有效降低血脂指标,促进机体细胞因子和氧化应激指标的改善,具有一定的临床推广应用价值。     

自噬对高胆固醇饮食大鼠下颌骨结构改变的影响研究

目的    探讨自噬对高胆固醇饮食大鼠下颌骨结构改变的影响及辛伐他汀的治疗效果。方法　将30只SD大鼠随机分为正常饮食组（NC组）10只、高胆固醇组20只;喂养24周后,高胆固醇组再随机分成两组,每组10只,一组继续喂养高胆固醇饲料（HC组）,另一组在高胆固醇饲料中加入5 mg/kg辛伐他汀（HC+SIM组）。喂养32周后,取大鼠空腹血进行生化检测;处死大鼠后对下颌骨进行骨组织形态分析;实时荧光定量PCR（qRT-PCR）及免疫组织化学染色检测各组自噬相关基因Lc3及p62的mRNA和蛋白表达水平。结果　（1）3组总胆固醇和低密度脂蛋白水平总的比较,差异均有统计学意义（F值分别为21.539、16.596,均P < 0.05）;其中NC组和HC+SIM组总胆固醇和低密度脂蛋白水平均低于HC组（均P < 0.05）,而NC组和HC+SIM组组间比较,差异无统计学意义（P > 0.05）。（2）与NC组比较,HC组大鼠骨体积分数、骨小梁厚度、骨小梁数目明显下降,而骨小梁间隔增加,Lc3及p62 mRNA表达水平明显升高,差异均有统计学意义（均P < 0.05）;与HC组比较,HC+SIM组骨体积分数、骨小梁厚度、骨小梁数目均明显升高,骨小梁间隔减小,p62 mRNA和蛋白表达水平明显下降,差异均有统计学意义（均P < 0.05）;而NC组和HC+SIM组这些指标组间比较,差异均无统计学意义（均P > 0.05）。结论    自噬可能参与调控高胆固醇饮食大鼠下颌骨结构的改变,辛伐他汀能够改善高胆固醇饮食导致的大鼠下颌骨微结构的破坏     

洛伐他汀对实验性家兔动脉粥样硬化形成及其相关癌基因表达作用的研究

本研究观察了洛伐他汀（ｌｏｖａｓｔａｔｉｎ，商品名：美降之）对高胆固醇饲喂的家兔动脉粥样硬化（ＡＳ）形成及其相关癌基因表达的影响。结果显示，洛伐他汀治疗组（Ｌ组）血脂水平、ＡＳ斑块面积与主动脉内膜面积的百分比、平均最大斑块厚度和平均最大斑块与中膜比值，均较动脉粥样硬化对照组（ＣＡＳ组）低（Ｐ＜０．０１）。ＣＡＳ组原癌基因Ｖ－ｓｉｓ、Ｃ－ｆｏｓ、Ｈ－ｒａｓ表达量分别是Ｌ组的２．４倍（Ｐ＜０．０１）、１．４倍、１．４倍（Ｐ＜０．０５）。提示洛伐他汀具有抗ＡＳ作用，其机制可能与降低血脂，抑制癌基因表达有关。     

氨氯地平联合阿托伐他汀对高血压合并高血脂症患者的疗效

目的:探究氨氯地平联合阿托伐他汀在治疗高血压合并高血脂症中的临床疗效.方法:门诊治疗的高血压合并高血脂症患者200例,随机均分为观察组和对照组,观察组患者采用氨氯地平联合阿托伐他汀治疗,对照组患者采用氨氯地平进行治疗;观察两组患者治疗前后血压变化,比较治疗效果;同时比较两组患者治疗前后的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)及胆固醇(TC),丙氨酸氨基转移酶(ALT)、血肌酐、血钾(K+)及血尿酸水平.结果:治疗后,观察组总有效率优于对照组,不良反应明显低于对照组(P＜0.05),收缩压和舒张压较治疗前明显下降,观察组改善更明显(P＜0.05);观察组患者LDL-C、TG及TC水平较治疗前下降,而HDL-C升高,这些血脂成分改变优于对照组(P＜0.05);观察组治疗后,血肌酐和血尿酸水平下降明显(P＜0.05),与无变化的对照组间比较,差异有统计学意义(P＜0.05).结论:氨氯地平联合阿托伐他汀对高血压合并高血脂症患者的治疗效果优于单独使用氨氯地平.     

Antiobesity,hypolipidemic, antioxidant and hepatoprotective effects of Achyranthes aspera seed saponins in high cholesterol fed albino rats

Introduction

Numerous herbal medicines have been recommended for the treatment of different diseases. Achyranthes aspera, Linn. (Family: Amaranthaceae), popularly known as Charchitta or Pitpapra, is commonly used by traditional healers for the treatment of fever, malaria, dysentery, asthma, arterial hypertension, pneumonia, and diabetes. The root extract is well reputed for its insect molting hormonal activity. This investigation was conducted to evaluate the effects of saponins from Achyranthes aspera seeds on the serum lipid profile of albino rats fed a high cholesterol diet.

Material and methods

Hypolipidemic, antioxidant and hepatoprotective activities of these saponins were tested as described previously. To determine the mechanism underlying the observed effects, serum antioxidant status was assessed according to ABTS (2,2’-azino-bis-3-ethylbenzo-thiazoline-6-sulfonic acid), superoxide dismutase and ferric ion reducing antioxidant power (FRAP) assays in saponin-treated hyperlipidemic animals. Liver enzyme levels were determined to reveal any possible hepatotoxicity.

Results

Four-week oral administration of A. aspera seed saponins produced a significant (p < 0.05) decrease of total cholesterol, total triglycerides and LDL-C and a significant increase of HDL-C level in hyperlipidemic rats. Treatment with A. aspera seed saponins also showed a significant (p < 0.01) improvement of serum antioxidant status in tested animals. No significant hepatotoxicity was produced by such treatment as the serum liver enzyme activity remained unaltered.

Conclusions

Saponins from A. aspera seeds possess antihyperlipidemic and antioxidant properties which might lead to improvement of serum lipid profile and blood antioxidant status. Our findings support the folkloric use of this indigenous plant in the treatment of hyperlipidemia. However, its exact mechanism of action remains to be elucidated.