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Biomedical subjects

G Schlierf

Publications and source records attributed to G Schlierf.

At least 109 records · Page 6Linked to original sources

Effects of estrogens and progestogens on lipid metabolism.

Because the incidence of venous thromboembolism, coronary heart disease, and stroke is increased in users of oral contraceptives (OCs), the possible causal metabolic side effects of OCs have been widely investigated. In this article we present epidemiologic data associated with OC use. Total plasma triglycerides and cholesterol levels were elevated in OC users while high-density lipoprotein cholesterol levels were lowered. Another section discusses some hormone-dependent physiologic and pathophysiologic aspects of lipid metabolism. Finally, we report on the isolated influence of estrogens and progestogens and their interrelation, including some recent findings about the effects of different progestogens on lipoproteins.

Adolescent↗

"Low dose" colestipol in children, adolescents and young adults with familial hypercholesterolemia.

The effect of colestipol on plasma lipids and lipoproteins was studied in children, adolescents and young adults with familial hypercholesterolemia. O.125 g or 0.25 g/kg body weight were given in randomized sequence for period of 4 weeks. Total cholesterol was lowered by 13 and 18% with the smaller and larger dose , respectively, and LDL cholesterol lowered by 15% with the smaller and 12% with the larger dose. HDL cholesterol rose by 18 an 32%. LDL composition before and during the study was abnormal due to a markedly reduced triglyceride content. "Low-dose" colestipol is less effective lowering total plasma and LDL cholesterol than conventional doses but may, due to very few side effects, by advantageously used in cases of familial hypercholesterolemia when plasma cholesterol levels after dietary management are only 15-20% above normal.

Adolescent↗

Treatment of familial hypercholesterolemia with a combination of bezafibrate and guar.

The effect of guar (15.6 g/day), a dietary fibre, and simultaneous administration of bezafibrate (600 mg/day) during dietetic treatment on the plasma lipoproteins and apolipoproteins was investigated in 12 patients with familial hypercholesterolemia (corresponding to the HLP type IIa pattern). Either bezafibrate alone or bezafibrate in combination with guar was administered in a cross-over study for 3 months. Guar led to an additional lowering of the total cholesterol in the plasma by 7% (P less than or equal to 0.05) associated with a fall of the low density lipoprotein cholesterol (LDL-cholesterol (LDL-cholesterol) by 13% (P less than or equal to 0.01) without any changes in the very low density lipoprotein (VLDL) and high density lipoprotein (HDL) cholesterols. In parallel with the decrease in LDL-cholesterol, the apoprotein B also was diminished by 20% (P less than or equal to 0.05). The plasma triglyceride level and the triglyceride distribution within the individual lipoprotein fractions were not altered in any consistent manner by the addition of guar. Neither the fasting plasma glucose level nor the body weight were affected. The side-effects due to guar treatment consisted of slight nausea, meteorism and constipation, but this did not in any of the cases lead to early termination of the study. These results demonstrate that guar exerts its cholesterol-lowering effect in addition to that of bezafibrate.

Adult↗

The prognostic significance of hypocholesterolemia in hospitalized patients.

Hypocholesterolemia (less than 120 mg/dl) was found in 200 out of 3,700 patients admitted consecutively to a University Department of Internal Medicine. In 91, hypocholesterolemia as defined above could be confirmed in a second serum sample on the following day. Mortality during hospitalization in this group was 32%. When diagnoses were grouped into 5 categories, prognosis was particularly poor in heart (36%) and liver disease (31%) and in malignancies (33%), while patients with malabsorption syndromes had a considerably better prognosis (10% mortality). Hypocholesterolemia was associated with a low cholesterol/phospholipid ratio and may be among the first signs of further deterioration of disease.

Adult↗

Diet and high density lipoproteins.

The acute and subacute effects of different diets on serum high density lipoprotein (HDL) cholesterol concentration and/or HDL composition are described. In obese normolipemic, hypercholesterolemic (type II) and hypertriglyceridemic (type IV) patients, low HDL cholesterol values remained low during total starvation for 2 weeks. Prudent diets in patients with type II and IV hyperlipoproteinemia had no significant effects on HDL cholesterol within 3 weeks, whereas in normal individuals, a high carbohydrate diet given for 10 days caused significant decreases in HDL cholesterol with concomitant increases in HDL triglycerides as compared to a high-fat diet. The HDL triglyceride fatty acid composition changed in healthy volunteers during the day, depending on the type of ingested fat. The data demonstrate the possibility of acute manipulations of HDL in normal patients and the difficulties of normalizing low HDL cholesterol levels in patients by dietary means. Additional information on the function of HDL is desirable before the therapeutic manipulation of HDL cholesterol or other constituents of HDL can be evaluated regarding their effectiveness in the prevention of ischemic vascular disease.

Adult↗

Plasma C-peptide and insulin in trained and untrained subjects.

Plasma insulin and C-peptide were simultaneously determined under various conditions in 11 endurance-trained athletes and 12 nonathletes. Both groups performed an exhaustive ergometer test and an endurance test with 38% of the maximal achieved work load for 45 min. An intravenous glucose tolerance test was also performed. In the basal state, athletes had low plasma insulin and C-peptide concentrations. During exercise, insulin and C-peptide decreased similarly in both groups. In the recovery period, insulin and C-peptide rose within a few minutes. There were differences between the extent as well as the time course of this "rebound" effect after exhaustive or endurance exercise that might be related to glucose alterations. The insulin response but not the C-peptide response after glucose injection was blunted in trained subjects. Results indicate that basal plasma insulin concentrations are lower in athletes due to reduced insulin secretion. During exercise, insulin secretion is diminished independent of the training state. The blunted response of insulin after glucose administration in athletes is due to an enhanced plasma clearance.

Adult↗

Biliary cholesterol saturation and weight reduction--effects of fasting and low calorie diet.

The effects of fasting or a 600-cal diet on biliary lipid composition were studied in 20 persons with overweight. With complete fasting for 20 days and a mean weight loss of 650 g/day, biliary cholesterol fell significantly from 10.1 to 6.9 mol% and the 'lithogenic index' from 1.0 to 0.7. Following fasting, the index, in 10 of the 11 patients, was in the normal range below 1.0. With a 600-cal diet, in agreement with findings by other authors, there was no significant change of individual bile lipids or of the lithogenic index. While it has been shown that lithogenicity increases up to 16 h of fasting, it obviously significantly decreases with continued fasting. Fasting, therefore, in addition to manipulation of dietary cholesterol and, possibly, fiber consumption, appears to be an effective method for rapid lowering of biliary cholesterol saturation.

Adult↗

Urinary sodium excretion in renal stone formers. An epidemiological study.

In the present investigation 238 randomly selected male individuals of the general population (age 19--41 years) and 42 age-matched male patients with recurrent renal stone formation (calcium oxalate and/or calcium phosphate) were studied under outpatient conditions without dietary restrictions. Urinary Na excretion was 207 +/- 82 mmol/24 h (range 55--570) in controls and 208 +/- 100 (range 76--575) in recurrent renal stone formers. Both in controls (r = 0.36; p less than 0.01) and in stone formers (r = 0.4; p less than 0.01) a significant correlation was observed between urinary excretion of sodium and calcium. Urinary sodium excretion was unrelated to systolic or diastolic blood pressure in normotensive or hypertensive individuals. This finding indicates that factors other than sodium are involved in the maintenance of hypertension. Urinary sodium, presumably an index of intake of nutrients, was significantly correlated to several coronary risk factors, e.g. fasting glucose, cholesterol and overweight. There existed a significant inverse relationship between fasting plasma phosphate and urinary sodium, but not between fasting plasma phosphate and serum iPTH or urinary cAMP. This finding points to some function of sodium excretion as one determinant of plasma phosphate.

Adult↗