Long term efficacy of simvastatin in renal transplant recipients treated with cyclosporine or tacrolimus

BACKGROUND: Hyperlipidemia is frequently developed following renal transplantation and results in worsening of the patient's prognosis. METHODS: In this study, 14 patients who had hypercholesterolemia [total cholesterol (TC) >200 mg/dL] and hypertriglyceridemia [triglyceride (TG) >150 mg/dL] 1 month after renal transplantation (post-transplantation), seven patients each under the treatment with immunosuppressant, either cyclosporine or tacrolimus started simvastatin treatment of 5-10 mg/d and continued the treatment for 4 yr. The effect of simvastatin treatment was assessed by comparison in serum lipid levels (TC, TG, cholesterol in lipoprotein fractions, and apolipoproteins) and the lipid metabolism related enzyme activities for post-transplantation, after 6-month and 4-yr simvastatin treatment. RESULTS: Simvastatin treatment of 4 yr significantly decreased the elevated levels of serum TC from 234.5 +/- 30.8 to 186.3 +/- 20.5 mg/dL (p < 0.001), low density lipoprotein cholesterol (LDL-C) from 116.7 +/- 22.5 to 82.7 +/- 16.6 mg/dL (p < 0.05) and TG from 200.3 +/- 109.2 to 97.0 +/- 45.2 mg/dL (p < 0.001). In addition, there were significant decreases in elevated serum very-low-density lipoprotein cholesterol (VLDL-C) from 47.8 +/- 18.4 to 28.6 +/- 9.5 mg/dL (p < 0.001) and LDL2 cholesterol (LDL2-C) from 20.8 +/- 8.2 to 5.7 +/- 1.8 mg/dL (p < 0.001). CONCLUSION: The results indicate that 4-yr treatment of simvastatin improves profiles of the atherogenic lipids in renal transplant patients with immunosuppressant caused hypercholesterolemia and hypertriglyceridemia treated either cyclosporine or tacrolimus in similar manner.     

Metabolic consequences of atypical antipsychotic drugs

Atypical antipsychotic drugs have become the treatment of choice for psychotic disorders. However, these medications, though certainly superior in many respects to the more traditional medications, have been shown to have a number of untoward consequences. Understanding of the metabolic consequences of these medications is essential for the psychiatrist. The possible development of diabetes, weight gain, and hypertriglyceridemia in patients taking atypical antipsychotics makes it imperative that the prescribing physician regularly monitor patients on these agents. One possible monitoring scheme is outlined and recommendations for treatment are discussed.     

Effect of micronized fenofibrate on vascular endothelial function in patients with hypertriglyceridemia

Objective To investigate the effect of micronized fenofibrate on vascular endothelial function in patients with hypertriglyceridemia. Methods Using high-resolution ultrasound, we measured flow- and nitroglycerin-induced dilatation of the brachial artery in 30 patients with hypertriglyceridemia before and after treatment with micronized fenofibrate at a dose of 200 mg once daily for 4 weeks. Simultaneously, both serum lipid and plasma endothelin (ET) levels were determined.Results After micronized fenofibrate therapy, serum triglyceride (TG) levels decreased significantly (P&lt;0.05). Plasma ET levels also decreased markedly ［(82.66±15.46） μg/L vs. （106.22±19.16） μg/L, P&lt;0.001］. Flow-induced vasodilatation was much improved (11.0%±9.0% vs 2.7%±2.0%, P&lt;0.01). However, no significant changes in vasodilatation occurred in response to nitroglycerin (16.2%±6.0% vs 15.0%±5.0%, P&gt;0.05) in patients with hypertriglyceridemia. Conclusions Micronized fenofibrate can improve impaired endothelium-dependent vasodilatation in patients with hypertriglyceridemia. Improving endothelial function may also be the mechanism responsible for the beneficial effects of micronized fenofibrate.     

The origin of Hypertriglyceridemia in streptozotocin diabetic rats

Summary The effect of diet on the origin of hypertriglyceridemia seen in experimental diabetes was studied in streptozotocin diabetic rats after insulin treatment for one month and two days after insulin withdrawal. The data indicate that both exogenous and endogenous types of hypertriglyceridemia were present in insulin treated streptozotocin diabetes but that the exogenous component predominated during the period of insulin treatment and was independent of the amount of dietary fat. After insulin withdrawal there was a rise in serum triglyceride which was mainly reflected in the endogenous component. The data imply that dietary sucrose or protein might have contributed to this endogenous hypertriglyceridemia.Presented in part at the Southern Section, American Federation for Clinical Research, New Orleans, Louisiana, January 1971.     

A VLP-based vaccine targeting ANGPTL3 lowers plasma triglycerides in mice

Elevated triglycerides (TGs) are an important risk factor for the development of coronary heart disease (CHD) and in acute pancreatitis. Angiopoietin-like proteins 3 (ANGPTL3) and 4 (ANGPTL4) are critical regulators of TG metabolism that function by inhibiting the activity of lipoprotein lipase (LPL), which is responsible for hydrolyzing triglycerides in lipoproteins into free fatty acids. Interestingly, individuals with loss-of-function mutations in ANGPTL3 and ANGPTL4 have low plasma TG levels, have a reduced risk of CHD, and are otherwise healthy. Consequently, interventions targeting ANGPTL3 and ANGPTL4 have emerged as promising new approaches for reducing elevated TGs. Here, we developed virus-like particle (VLP) based vaccines that target the LPL binding domains of ANGPTL3 and ANGPTL4. ANGPTL3 VLPs and ANGPTL4 VLPs are highly immunogenic in mice and vaccination with ANGPTL3 VLPs, but not ANGPTL4 VLPs, was associated with reduced steady state levels of TGs. Immunization with ANGPTL3 VLPs rapidly cleared circulating TG levels following an oil gavage challenge and enhanced plasma LPL activity. These data indicate that targeting ANGPTL3 by active vaccination is a potential alternative to other ANGPTL3-inhibiting therapies.     

Hyperlipidemia after allogeneic stem cell transplantation: prevalence, risk factors, and impact on prognosis

Hyperlipidemia is one of the late complications after allogeneic stem cell transplantation (SCT). Although intrahepatic cholestasis caused by chronic graft‐versus‐host disease (GVHD) or calcineurin inhibitors has been considered as possible etiologies, its prevalence, risk factors, and impact on prognosis have not been investigated well. We performed a retrospective analysis of 194 patients who underwent allogeneic SCT between 1995 and 2008 in our institute and survived more than 100 d after SCT. Overall, 83 (42.8%) and 99 (50.8%) patients developed hypercholesterolemia (≥240 mg/dL) and hypertriglyceridemia (≥200 mg/dL), respectively. In multivariate analysis, the development of chronic GVHD (hazard ratio [HR] 2.04, p < 0.05) and steroid use (HR 2.24, p < 0.01) were independently associated with hypercholesterolemia, while administration of calcineurin inhibitors was not. As for the prognostic impact, multivariate analysis showed that the patients with hypercholesterolemia had a tendency of lower rate of relapse (HR: 0.44, p = 0.07). There was no difference in non‐relapse mortality or overall survival between the groups. In conclusion, the development of hypercholesterolemia is regarded as one of the symptoms accompanied with chronic GVHD and might indicate a better control of the primary disease.     

严重高三酰甘油血症对小鼠生育及其后代糖脂代谢的影响

目的 严重高三酰甘油血症（hypertriglyceridemia,HTG）伴发于妊娠可能诱发急性胰腺炎,不良妊娠结局明显增高,但关于HTG对后代的远期影响如糖脂代谢的影响未见报道.本研究旨在探讨载脂蛋白CIII（apolipoprotein CIII,Apo CIII）转基因严重HTG的雌性小鼠对后代糖脂代谢的影响.方法应用Apo CIII转基因的严重HTG雌性及正常雌性小鼠分别与正常雄性小鼠交配,观察严重HTG雌性小鼠生育能力,并得到3组后代：母系为转基因的正常（maternal control,MC）和转基因后代（maternal transgenic,MT）及正常对照组（normal control,NC）.比较了上述3组小鼠出生体质量及生长速度、血浆三酰甘油（triglycerides,TG）、总胆固醇 （total cholesterol,TC）、糖代谢的差异.结果 Apo CIII转基因导致的严重HTG对雌性小鼠生育能力无影响,Apo CIII转基因的雌性小鼠所生育后代小鼠出生体质量及生长速度均与对照组差异常无统计学意义,MT组小鼠血浆TG及TC浓度于出生14及28 d均较MC及NC组显著升高（P〈0.01）,并出现轻度糖耐量受损,空腹胰岛素（fasting insulin,FINS）水平及稳态模型评估胰岛素抵抗指数（homeostasis model assessment-insulin resistant index,HOMA-IR）也较其他2组增高（P〈0.05）.结论Apo CIII转基因严重HTG的雌性小鼠可正常妊娠、分娩及哺乳.严重HTG的Apo CIII转基因小鼠可以通过母系遗传而导致转基因后代发生糖耐量受损,高胰岛素血症及胰岛素抵抗指数增高.     

脂蛋白脂酶基因多态性与高甘油三酯血症的关系

为了解脂蛋白脂酶基因多态性与高甘油三酯血症的关系，比较了９５名正常人和５８名高甘油三酯血症患者脂蛋白脂酶ＰｖｕⅡ、ＨｉｎｄⅢ等位基因Ｐ＋、Ｐ－及Ｈ＋、Ｈ－的频率，结果显示，高甘油酯血症的患者Ｐ＋等位基因明显高于对照组。提示脂蛋白脂酶ＰｖｕⅡ的Ｐ＋等位基因可能在高甘油三酯的发病中起一定的作用     

中学教师健康体检结果分析

目的:通过对2573名中学教师体检资料分析,了解其健康状况.方法:将中学教师2年1次的体检指标如腰围、体重指数(BMI)、血压、血脂、尿酸、血糖、脂肪肝等结果进行比较.结果:中学教师体检指标存在性别和年龄差异,高血压、高甘油三酯血症、高尿酸血症均有逐年上升趋势(P<0.01).结论:加强中学教师健康教育,减少心脑血管疾...