碱提类肝素及其组分降血脂作用的比较

碱提类肝素及其组份1和组分2(简称 C、C_1和 C_2)对 Triton 性大鼠高胆固醇血症和高甘油三酯血症均有明显的抑制作用。各组分的降胆固醇作用均随剂量的增加而加强,作用强度依次为 C_2>C>C_1。     

Living-donor liver transplantation for homozygous familial hypercholesterolemia from a donor with heterozygous hypercholesterolemia

Familial hypercholesterolemia is a rare inherited disease with an incidence of approximately one per million. Severe hypercholesterolemia is observed from the time of birth onwards. It is associated with severe atherosclerosis in childhood, leading to death from myocardial infarction before the age of 20 years. Liver transplantation is the only effective treatment for this disease. We experienced the case of an infant aged 2 years 5 months who had homozygous familial hypercholesterolemia and who received a liver graft from his father, who had familial heterozygous hypercholesterolemia. The pre-operative plasma cholesterol level was >800 mg/dl. After liver transplantation, the recipient's cholesterol level decreased to 250 mg/dl after we administered the HMG-CoA reductase inhibitor. At present, 6 months after transplantation, the patient is doing well and free from a special diet. We can thus conclude that the combination therapy of liver transplantation from a donor with heterozygous familial hypercholesterolemia on cholesterol-lowering drugs is an effective therapy for a patient with the homozygous type of hypercholesterolemia.     

Carob pulp preparation rich in insoluble fibre lowers total and LDL cholesterol in hypercholesterolemic patients

Summary. Background: Recently, insoluble fibre from carob pulp has been found to affect blood lipids in animals in a similar manner as soluble dietary fibre. Aim of the study: To investigate whether a carob pulp preparation containing high amounts of insoluble fibre has a beneficial effect on serum cholesterol in humans. Methods: Volunteers (n = 58) with hypercholesterolemia were recruited to participate in a randomised, double- blind, placebo-controlled and parallel arm clinical study with a 6 week intervention phase. All participants consumed daily both, bread (two servings) and a fruitbar (one serving) either with (n = 29) or without (n = 29) a total amount of 15 g/d of a carob pulp preparation (carob fibre). Serum concentrations of total, LDL and HDL cholesterol and triglycerides were assessed at baseline and after week 4 and 6. Results: The consumption of carob fibre reduced LDL cholesterol by 10.5 ± 2.2% (p = 0.010). The LDL:HDL cholesterol ratio was marginally decreased by 7.9 ± 2.2 % in the carob fibre group compared to the placebo group (p = 0.058). Carob fibre consumption also lowered triglycerides in females by 11.3 ± 4.5% (p = 0.030). Lipid lowering effects were more pronounced in females than in males. Conclusion: Daily consumption of food products enriched with carob fibre shows beneficial effects on human blood lipid profile and may be effective in prevention and treatment of hypercholesterolemia.     

Naringin supplementation lowers plasma lipids and enhances erythrocyte antioxidant enzyme activities in hypercholesterolemic subjects

BACKGROUND AND AIMS: Preliminary studies have shown that naringin has a potent lipid-lowering effect and antioxidant capacity in high-cholesterol diet fed animals. Accordingly, the present study was conducted to investigate the effect of naringin on hypercholesterolemic subjects. METHODS: A hypercholesterolemic group (n=30) and healthy control group (n=30) were established based on the plasma cholesterol levels in the subjects, then all subjects received naringin (400mg/capsule/day) with regular meals for a period of 8 weeks. RESULTS: In the hypercholesterolemic subjects, naringin supplementation was found to lower the plasma total cholesterol by 14% and low-density lipoprotein cholesterol concentrations by 17%, while the plasma triglyceride and high-density lipoprotein cholesterol concentrations remained unaffected. The apolipoprotein B levels in the hypercholesterolemic subjects were significantly lowered after naringin treatment, yet no change was observed in the apolipoprotein A-1 levels. The erythrocyte superoxide dismutase and catalase activities in the hypercholesterolemic group were significantly increased, whereas the glutathione peroxidase activity and plasma TBARS levels were not different from the baseline measurements. Meanwhile, naringin supplementation had no affect on plasma lipids, apolipoproteins, and TBARS levels or antioxidant enzyme activities in the control group. CONCLUSIONS: Therefore, these data suggest that naringin may play an important role in lowering plasma cholesterol and regulating the antioxidant capacity in hypercholesterolemic subjects.     

Dyslipoproteinemia and Xanthomatosis

Abstract: The cutaneous markers associated with dyslipoproteinemia are reviewed in the context of the current view of lipid and lipoprotein metabolism. The utility of determining the plasma levels of lipoprotcins and certain apoproteins in children or adults with xanthomas or xanthelasma is discussed. We hope that early identification and appropriate treatment of such patients will reduce the morbidity and mortality from the two major complications of dyslipoproteinemia—atherosclerotic cardiovascular disease and pancreatitis.     

Detection and treatment of hypercholesterolemia in a biethnic community, 1979–1985

Although hypercholesterolemia has been recognized as a risk factor for coronary heart disease (CHD) for decades, only in recent years have clinical trials definitively shown the efficacy of lowering serum cholesterol to prevent the occurrence or worsening of CHD. In 1985, an NIH consensus conference published guidelines for the diagnosis and treatment of hypercholesterolemia. Prior to 1985, physicians and lay people alike were not yet convinced of the necessity to know one’s cholesterol level, nor did they know what levels should be treated. In a community-based survey of cardiovascular risk factors, known as the San Antonio Heart Study, in which 1,932 Mexican-Americans (MAs) and 1,133 non-Hispanic whites (NHWs) were examined between 1979 and 1985, the authors found that only 36/501 MAs (7%) and 54/312 NHWs (17%) in the moderate- or high-risk categories were aware that their cholesterols were high. Of the total number aware, including those whose cholesterol levels were in the low-risk range, only 23/97 MAs (24%) and 29/108 NHWs (27%) were receiving dietary or drug treatment. Of those being treated, only 9/23 MAs (39%) and 12/29 NHWs (41%) were effectively controlled. Mexican-Americans were less likely to be aware of their hypercholesterolemia than non-Hispanic whites, but both ethnic groups had low levels of treatment. Received from the Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Supported by Grant HL-24799 from the National Heart, Lung, and Blood Institute. Dr. Pugh’s salary was supported by Grant HL-07466 from the same institute.     

The effect of portacaval shunt on hepatic lipoprotein metabolism in familial hypercholesterolemia

The hyperlipidemia observed in familial hypercholesterolemia can be reduced by portacaval anastomosis. We report the effects of a portacaval shunt on hepatic morphology and biosynthetic pathways crucial to hepatic cholesterol homeostasis in homozygous receptor-negative familial hypercholesterolemia. Portacaval anastomosis was associated with a dramatic change in hepatocyte morphology, 28% reduction in plasma low-density lipoprotein concentration, and a decrease in hepatic total and free cholesterol content by 27 and 75%, respectively. Furthermore, the rate-limiting enzyme in cholesterol biosynthesis, 3-hydroxy-3-methylglutaryl coenzyme A reductase was decreased by 56%. Finally, the reduced binding of low-density lipoproteins to hepatic membranes preoperatively was increased following the portacaval shunt. These combined results indicate that the changes in circulating lipoprotein concentrations observed after portacaval shunt are due to alterations in the metabolic consequences of the defective recognition of low-density lipoproteins by the liver of familial hypercholesterolemic subjects.     

Identification of a second "French Canadian" LDL receptor gene deletion and development of a rapid method to detect both deletions

Hobbs et al. (N. Engl. J. Med. 317: 734-737, 1987) reported a large deletion of approximately 10 kilobases in the 5' portion of the human low-density lipoprotein (LDL) receptor gene. This deletion affects about 60% of familial hypercholesterolemia (FH) heterozygotes in the French Canadian population. We have developed a rapid, convenient method for the detection of the deletion using double digestion with the restriction enzymes XbaI and EcoRV, or triple digestion with XbaI, EcoRV and XmnI, and a 650 bp cDNA probe, radio-labeled using a random oligonucleotide primer technique. Eighty French Canadian FH heterozygotes were screened for the presence of the deletion. Forty-seven (59%) of them were found to carry the 10 kb deletion. Using the same method, we also identified a new mutation which was found in four of the 80 (5%) FH patients. This mutation has been found to be a 5 kb deletion removing exons 2 and 3 of the LDL receptor gene, which correspond to the first two repeats of the LDL receptor binding domain. Cosegregation of the 5 kb deletion and the FH phenotype was observed in one family. Possible structure-function relationship is discussed.     

老年高血压患者血管内皮依赖性舒张功能探讨

目的　探讨老年高血压患者的内皮依赖性舒张功能及其影响因素。方法　用高分辨 2D和多谱勒超声测定 6 0例老年高血压患者及 6 0例正常血压的老年对照组的肱动脉。在袖带加压开放4.5min后 ,血流增加引起的肱动脉扩张反应的增量结果。结果　老年高血压组血流介导的血管扩张百分率 ( 5 .18± 3 .40 )明显低于对照组 ( 8.0 5± 5 .0 6 ,P <0 .0 5 ) ,两组硝酸甘油介导的血管扩张率无统计学差别。单因素分析发现除高血压外 ,血清总胆固醇水平、冠心病史、吸烟史是内皮依赖性舒张功能的影响因素。结论　老年高血压患者的血管内皮依赖性舒张功能比对照组明显降低 ,除高血压外 ,冠心病及其危险因素可能是其损害因素之一     

高胆固醇血症对兔胆管括约肌细胞内Ca2+转运的影响

目的观察高胆固醇(cholesterol, Ch)血症对兔胆管括约肌(sphincter of Oddi, SO)细胞内Ca2+转运的影响, 以探讨SO功能紊乱的机制. 方法高Ch饲养兔8 wk(实验组), 制作高Ch血症模型, 与对照组SO细胞分别进行原代培养. Fluo-3/AM负载, 用激光共聚焦显微镜对照观测静息状态及3.6 mmol*L-1 MgSO4作用下SO胞内Ca2+浓度变化特征. 结果与对照组相比较, 静息状态下, 实验组SO细胞内Ca2+荧光强度明显增高[(21.07±0.82) vs (13.56±1.22), P＜0.05]; 3.6 mmol*L-1 MgSO4持续作用下, 实验组细胞内Ca2+荧光强度下降速率减慢[(0.87±0.14)*s-1 vs (1.38±0.22)*s-1, P＜0.05],下降幅度减少[(23.59±1.22)% vs (50.77±2.56)%, P＜0.05],下降后的最低值仍明显高于对照组最低值[(16.81±0.05) vs (6.40±0.16), P＜0.05], 恢复速率明显减慢[(0.01±0.00)*s-1 vs (0.41±0.04)*s-1, P＜0.05]. 结论高胆固醇血症兔SO细胞Ca2+ 跨膜转运障碍, [Ca2+]i呈超载状态,导致胞内钙滞留. 提示高Ch可影响细胞膜钙通道活性、胞内钙库释放和摄取Ca2+过程.