冠心病、高脂血症和低高密度脂蛋白血症患者载脂蛋白Al基因的多态性

本实验用分析基因限制性内切酶片段长度多态性(Restriction fragment length olymorphisms,RFLPs)技术,检测到中国人载脂蛋白AI(Apolipoprotein AI。Apo AI)基因3′端存一PstI多态位点,并发现该多态位点与低高密度脂蛋白(HDL)血症及冠心病有较密切的关系。     

血脂康对高脂家兔、鹌鹑模型的降脂作用

 以３种动物模型研究了血脂康的降血脂作用。将２５％酪蛋白加入家兔基础饲料中，６０ｄ后血清ＴＣ从１．８１ｍｍｏｌ／Ｌ升至７．５１ｍｍｏｌ／Ｌ，则内源性高胆固醇血症模型建立；血脂康０．４，０．８ｇ·ｋｇ￣（－１）·ｄ￣（－１）治疗性给药３０ｄ后，有显著降低血清ＴＣ浓度和ＴＣ／ＨＤＬ－Ｃ比值（０．８ｇ．ｋｇ￣（－１）·ｄ￣（－１））的作用（Ｐ＜０．０５）。将０．５％胆固醇，１５％蛋黄粉，５％猪油加入家兔基础饲料中，可形成外源性高脂血症模型；同时预防性ｐｏ血脂康０．８９．ｋｇ￣（－１）·ｄ￣（－１）后，服药家兔血清ＴＣ、ＴＧ浓度和ＴＣ／ＨＤＬ－Ｃ比值明显降低（Ｐ＜０．０５），且有抑制主动脉粥样硬化斑块形成和脂质在肝脏沉积的作用。将１％胆固醇，１４％猪油，６％豆油加入鹌鹑基础饲料中，２周后可形成外源性高脂血症模型；同时预防性ｐｏ血脂康０．１，０．２，０．４ｇ．ｋｇ￣（－１）·ｄ￣（－１）后，可显著降低血清ＴＣ、ＴＧ（Ｐ＜０．０５或Ｐ＜０．０１）的浓度。此结果证实了血脂康在降血脂及预防动脉粥样硬化方面的药理作用。     

Influence of guar on serum lipids in patients with hyperlipidaemia

Summary The antihyperlipidaemic effect of a guar preparation which absorbs a particularly large amount of water has been examined in 13 patients with Type II hyperlipidaemia. A 30-day pre-treatment phase was followed by 60 days of treatment with 4 g guar dissolved in 200-ml liquid at each meal-time (total guar 12 g/day), and a 60-day post-treatment observation period. Routine other clinical blood tests were performed 30, 15 or 0 days before treatment, 15, 30 and 60 days after the start of treatment, and 30 and 60 days after its end.Total cholesterol fell by 0.85 mmol·l^–1, from a pre-treatment concentration of 7.4 mmol·l^–1 to a treatment value of 6.5 mmol·l^–1, and LDL-cholesterol fell by 0.64 mmol·l^–1, from 5.5 mmol·l^–1 to a treatment value of 4.8 mmol·l^–1. There was no significant change in triglyceride and VLDL concentrations during the study. A slight but significant fall in HDL-cholesterol was seen. The sole adverse effect was occasional intestinal discomfort.     

Effects of rosuvastatin on endothelial function in patients with familial combined hyperlipidaemia (FCH)

ABSTRACT

Objective: Although several studies have reported a positive effect of statins on endothelial vasoreactivity, most studies performed in subjects with type 2 diabetes mellitus report no effect at all. This lack of effect may be related to the existence of insulin resistance, or to insufficient lowering of atherogenic (apo)lipoproteins. Therefore, we tested in this study whether treatment of insulin resistant familial combined hyperlipidaemia (FCH) patients with a high dose (40?mg/day) of the potent rosuvastatin was able to improve endothelial function, without necessarily improving insulin sensitivity.

Research design and methods: In a double-blind randomised crossover study, 18 subjects with FCH (without evident cardiovascular disease, mean [standard deviation] age 54 [7] years) underwent a 4‐week run-in period after which they were randomised to treatment with placebo once daily for 12 weeks, followed by rosuvastatin 40?mg/day for 12 weeks or vice versa. Endothelial function was determined after 8 and 12 weeks of both treatment periods, respectively, by measurement of flow-mediated vasodilation (FMD) using high-resolution ultrasound and by measurement of vasodilator response to intrabrachial acetylcholine (Ach) by venous occlusion plethysmography (forearm blood flow [FBF]).

Results: Plasma levels of lipids, (apo)lipoproteins and high-sensitivity C‐reactive protein (hsCRP) improved significantly after rosuvastatin therapy compared to placebo. However, rosuvastatin had no effect on homeostasis model assessment (HOMA)-indices or on vasodilator responses to intra-brachial acetylcholine-infusion (FBF-ratio increased from a mean of 1.28 [SD: 0.46] to 5.82 [3.44] after rosuvastatin and from 1.33 [0.67] to 5.99 [3.89] after placebo, p = 0.35). Endothelium-dependent FMD was also unchanged (1.6% [3.1%] vs. 3.2% [3.5]%, p = 0.56 rosuvastatin vs. placebo, respectively).

Conclusion: In patients with FCH, a 12‐week treatment of rosuvastatin 40?mg/day did not improve endothelial function (either in large conduit vessels or in resistance vessels), despite significant improvements in plasma lipids, (apo)lipoproteins. and low-grade inflammation.     

Prevalences of and risk factors for biliary stones and gallbladder polyps in a large Chinese population

Objectives

This study aimed to identify the prevalences of and risk factors associated with the development of gallbladder stones and polyps in a large Chinese population.

Methods

Prevalences of and risk factors for biliary stones and gallbladder polyps were retrospectively investigated among subjects who underwent a general check-up at the Health Screening Centres of Peking Union Medical College Hospital and Beijing Charity Hospital between January 2007 and June 2010.

Results

A total of 60 064 people were enrolled in the study. Overall prevalences of biliary stones and gallbladder polyps were 4.2% (n = 2527) and 6.9% (n = 4119), respectively. Risk factors associated with increased odds ratios (ORs) for the development of biliary stones were female gender (OR = 1.51), age ≥50 years (OR = 2.09), history of hypertension (OR = 1.37), thickened gallbladder wall (cholecystitis) (OR = 1.98), fasting blood glucose ≥6.10 mmol/l (OR = 1.27), body mass index ≥25 kg/m² (OR = 1.25), systolic blood pressure ≥140 mmHg (OR = 1.31) and diastolic blood pressure ≥90 mmHg (OR = 1.44). Factors associated with gallbladder polyps were female gender (OR = 0.66), thickened gallbladder wall (OR = 2.09), negativity for hepatitis B surface antigen (HBsAg) and positivity for hepatitis B core antibody (anti-HBc) (OR = 2.61), and positivity for both HBsAg and anti-HBc (OR = 3.21).

Conclusions

Prevalences of biliary stones and gallbladder polyps among Chinese people are similar to those reported for other populations. Biliary stones appear to be associated with female gender, age, obesity, blood glucose, blood pressure and cholecystitis. Male gender, hepatitis B virus infection and cholecystitis were strong risk factors for the formation of gallbladder polyps.     

Association between periodontitis and hyperlipidaemia: A systematic review and meta-analysis

To date, it has been reported that periodontitis (PD) may be associated with hyperlipidaemia in clinical practice. However, data on this issue are inconsistent and controversial. The purpose of this meta-analysis was to identify the association between PD and hyperlipidaemia. Here, 21 case-control and eight cross-sectional studies on PD and hyperlipidaemia were included in the random-effects meta-analysis, involving 2060 patients with PD and 2776 healthy controls (HC). Meta-analysis showed that serum triglyceride (TG) and total cholesterol (TC) levels in the PD group were significantly higher than those in the HC group [TG, weighted mean difference (WMD) = 19.4 mg/dL, 95% confidence interval (CI) 13.3–25.5 mg/dL, P = .000; TC, WMD = 15.4 mg/dL, 95%CI 10.2–20.6 mg/dL, P = .000]. Subgroup analysis stratified by study design validated that PD was associated with higher serum TG and TC levels. In addition, compared with the HC group, serum low-density lipoprotein (LDL) in patients with PD showed a markedly higher level (WMD = 11.7 mg/dL, 95% CI 8.3–15.0 mg/dL, P = .000), whereas serum high-density lipoprotein (HDL) in PD group exhibited a significantly lower level (WMD = −4.5 mg/dL, 95%CI −6.4 – −2.7 mg/dL, P = .000). Finally, no significant publication bias was observed and sensitivity analysis also confirmed the stability of our meta-analyses. In conclusion, the accumulated evidence suggests that PD is indeed associated with hyperlipidaemia in humans. More interventions for lowering lipids or increasing HDL may benefit the patients with PD, which need be further investigated in prospective clinical trials.     

Mulberry leaves and their potential effects against cardiometabolic risks: a review of chemical compositions,biological properties and clinical efficacy

Context: Cardiometabolic risks are regarded as the crucial factors associated with type 2 diabetes (T2DM) and cardiovascular diseases (CVD). Regarding an increased attention to medicinal plants in the current healthcare system, the effects of mulberry (Morus spp., Moraceae) leaves on cardiometabolic risks have been consecutively considered in scientific research.

Objective: The present review compiles and summarizes the chemical compositions, biological properties and clinical efficacy of mulberry leaves that are related to the amelioration of cardiometabolic risks.

Methods: Published English literature from the PubMed, Science Direct and Google Scholar databases was searched by using ‘mulberry leaves’ ‘Morus spp.’, ‘hyperglycemia’, ‘hyperlipidemia’, ‘obesity’, ‘hypertension’, ‘oxidative stress’, ‘atherosclerosis’ and ‘cardiovascular diseases’ as the keywords. The relevant articles published over the past two decades were identified and reviewed.

Results: Mulberry leaves contain numerous chemical constituents. 1-Deoxynojirimycin (DNJ), phenolics and flavonoids are the prominent functional compounds. Preclinical and clinical studies showed that mulberry leaves possessed various beneficial effects against cardiometabolic risks, including antihyperglycaemic, antihyperlipidaemic, antiobesity, antihypertensive, antioxidative, anti-inflammatory, anti-atherosclerotic and cardioprotective effects.

Conclusions: Mulberry leaves could be a promising therapeutic option for modulating cardiometabolic risks. However, further investigations should be performed to substantiate the potential of mulberry leaves in practical uses.     

The role of lipids in the pathogenesis of glomerulosclerosis in the rat following subtotal nephrectomy

Abstract. Similarities between atherosclerosis and glomerulosclerosis suggest that hyperlipidaemia may contribute to glomerular injury. Dietary supplementation with 4% cholesterol +1% cholic acid was administered to rats 4 weeks after 1 1/3 nephrectomy and continued for 7 weeks. There was a significant increase in serum cholesterol (peak= 11.52 ±1.09 mmol 1^-1 vs. 4.73 ± 0.31 on control diet, < 0.001) and triglyceride concentrations (peak = 2.31 ± 0.27 mmol 1^-1 vs. 1.41 ±0.29, <0.05) and a marked increase in βmigrating lipoproteins. The severity of hypercholester-olaemia was significantly correlated with proteinuria (control diet: r = 0.600, cholesterol diet: r = 0.672, < 0.0001) as was hypertriglyceridaemia (control diet: r = 0.544, cholesterol diet: r = 0.678, <0.0001). The percentage of glomeruli containing lipid deposits was increased from 21% to 60% (<0.05). The kidney total cholesterol content was increased from 29.2 ±0.8 to 47.7 ± 3.3 μmols g^-1 dry weight (<0.0001), with esterified cholesterol increasing from 7.5 ± 0.4% to 14.5 ± 2.1% of total (<0.01). Serum cholesterol concentration was significantly correlated with both glomerular lipid deposition ( r _s= 0.7195, <0.0001) and tissue total cholesterol content ( r _s= 0.6053, <0.001). Lipid vacuolation was prominent in the paramesangium and within mesangial cells. Despite these changes hypertension, uraemia, proteinuria and glomerulosclerosis were not significantly increased on the cholesterol diet. Cholesterol deposition in the glomeruli occurs secondary to hyperlipidaemia in rats following subtotal nephrectomy but over 7 weeks no exacerbation of glomerulosclerosis is detectable.     

Birth weight and the insulin resistance syndrome: association of low birth weight with truncal obesity and raised plasminogen activator inhibitor-1 but not with abdominal obesity or plasma lipid disturbances

Abstract Aims/hypothesis. To distinguish the physiological disturbances related to birth weight from the cluster of disturbances called the insulin resistance syndrome.?Methods. Men participating in a population-based study in Uppsala, Sweden, with recordings of birth weight, were metabolically characterised at age 50 (n = 1268) and re-investigated at age 70 (n = 734). Blood pressure, BMI, glucose and insulin concentrations are associated with birth weight in this cohort.?Results. Birth weight was inversely associated (p < 0.03) with subscapular:triceps skinfold ratio (truncal fat), plasminogen activator inhibitor-1 (PAI-1) activity, specific insulin and proinsulin-like molecules when adjusted for BMI. Birth weight was not related (p > 0.10) with waist circumference, serum triglycerides or HDL cholesterol. The insulin resistance syndrome was defined as the combination of hypertension, insulin resistance and dyslipidaemia. The prevalence of this syndrome at age 50 and 70 was inversely related to birth weight with odds ratio 0.66 and 0.71, respectively, per kg increase in birth weight. When the syndrome was defined to include truncal obesity or raised plasminogen activator inhibitor-1 instead of dyslipidaemia, the corresponding odds ratios were 0.51 and 0.66, respectively.?Conclusions/interpretation. Low birth weight predicts high blood pressure, insulin resistance, truncal obesity and high plasminogen activator inhibitor-1 activity but not the abdominal obesity or dyslipidaemia present in the insulin resistance syndrome. The cluster of disturbances associated with low birth weight is a subset of the disturbances that are clustered in the general population as the insulin resistance syndrome. This subset of physiological disturbances is possibly linked by a specific pathway. [Diabetologia (2000) 43: 54–60] Received: 14 May 1999 and in revised form: 15 July 1999