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PubMed2001

[Molecular mechanism of hyperlipidemia and future aspects on the therapy].

Elucidating the mechanism of the onset of atherosclerosis is indispensable to understanding the significance of treatment of hyperlipidemia. Atherosclerotic lesions can be characterized as accumulations of cholesterol esters and pathologic reactions by various cell groups. Plasma lipid abnormalities such as hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol are known as important risk factors for atherosclerotic diseases. The purpose of treating plasma lipid abnormalities is to prevent or treat atherosclerosis. Future studies are required for the development of a powerful therapy for hyperlipidemia by understanding the molecular basis of polygenic hyperlipidemia which is most commonly observed in advanced countries.

Arteriosclerosis↗
PubMed2001

[Statins and diabetic hyperlipidemia].

Type 2 diabetic patients show frequent lipid abnormalities characterized by increased triglyceride and decreased HDL-cholesterol levels, but also by qualitative and metabolic abnormalities of all lipoproteins (VLDL, IDL, LDL et HDL). Treatment of diabetic hyperlipidemia is important in order to reduce the incidence of cardiovascular events, which is high in type 2 diabetes. Treatment with statins is recommended when hypercholesterolemia is associated with diabetes. But the efficacy of statins in the treatment of the typical diabetic hyperlipidemia (hypertriglycerideùmia, decreased HDL-cholesterol) remains to be demonstrated, since their effects on triglycerides and HDL-cholesterol is moderate. However, the new statins (cerivastatine, atorvastatine), which are more powerful to reduce hypertriglyceridemia could be useful for the treatment of diabetic hyperlipidemia. But, only on going clinical trials with statins in diabetic patients will be able to precise their possible efficacy on the prevention of cardiovascular disease.

Cholesterol, HDL↗
PubMed1998

[The role of apolipoprotein A-I in the very early stage of experimental hyperlipidemia].

OBJECTIVE: To find out the change of serum total cholesterol, HDL cholesterol, LCAT activity, and the expression of apoA-I mRNA in liver and intestine in the very early stage of experimental hyperlipidemia of rabbits. METHODS: Experimental hyperlipidemia models were established by cholesterol feeding in NZW rabbits. Animals of the experimental groups were sacrificed by the end of the 1st, 2nd, 4th and 7th week respectively. Serum total cholesterol (TC), free cholesterol (FC), LCAT activity, HDL were assayed. Slot blot were used to analyze the expression of apoA-I mRNA in liver and intestine. RESULTS: TC and FC were noticed to be elevated at the end of the 1st week after cholesterol feeding. The increase of LCAT activity was proportional to the levels of serum lipid. Serum HDL-C level did not drop down by the 7th week of cholesterol feeding. Analysis of lipid infiltration area in aorta of the experimental group rabbits showed apparent lipid disposition in intima since the 4th week of cholesterol feeding. Slot blot results showed that apoA-I mRNA level increased at the end of the 1st week in the small intestine. The expression in liver was much weaker than in intestine. CONCLUSION: In the very early stage of experimental hyperlipidemia, serum TC, FC, LCAT activity increase remarkably and apoA-I, mainly produced in the small intestine, plays an important role in activating LCAT.

Animals↗
PubMed1998

[ABR feature of medial and old patients with hyperlipidemia].

Sixteen medial and old patients with essential hyperlipidemia who were tested auditory brain-stem response (ABR) with click repetition rate 20/s and 40/s, respectively. In comparison with 12 medial and old people with normallipidemia and 10 health people, the IL and IPL of ABR of the hyperlipidemia group are longer than that of other two groups. There is statistical significant difference among the 3 groups of ABR date. The result showed that the hearing function of the medial and old patients with hyperlipidemia dropped potentially in early phase. Increasing the click repetition rate can improve the detection probability of positive reaction of ABR.

Aged↗
PubMed2001

[Hyperlipidemia in patients with inner ear disturbances].

The aim of this study was to evaluate the occurrence of hyperlipidemia in patients suffering from vertigo, and/or tinnitus and/or hearing loss of unknown origin. 48 patients (25 women and 23 men) were included into this study. All patients had a negative previous medical history of any metabolic, cardiovascular or neurological disorders. Our results were compared to the control group of 31 healthy persons (16 women and 15 men). All subjects had a complete neurootologic examination, appropriate audiometric and vestibular studies. In biochemical evaluation lipid phenotype studies were performed. Hyperlipidemia were classified according to Friedricson criteria. There were some differences in lipid phenotype and severity of hyperlipidemia between this two group.

Adult↗
PubMed2000

Astragalus mongholicus and Angelica sinensis compound alleviates nephrotic hyperlipidemia in rats.

OBJECTIVE: To investigate the mechanism of lipid-lowering effect of the Astragalus mongholicus and Angelica sinensis compound (A&A) on nephrotic hyperlipidemia in rats. METHODS: Rats with nephrotic syndrome from accelerated nephrotoxic serum nephritis were used. They were divided into two groups: A&A treatment group and nephrotic control group. Normal rats were used as a normal control group. Serum lipids, serum lipoprotein lipase (LPL) and lecithin-cholesterol acyltransferase (LCAT) were assayed biochemically and enzymatically. mRNAs of hepatic hydroxy-methyl glutaryl-CoA reductase (HMG-CoA-R) and low-density lipoprotein receptor (LDL-R) were assessed by Northern blot. RESULTS: In nephrotic control group hyperlipidemia was found. The activities of serum LPL and LCAT were low. Hepatic HMG-CoA-R mRNA increased temporarily at the early stage while LDL-R mRNA decreased gradually. In A&A treatment group, serum total cholesterol (TC), triglyceride (TG), low-density lipoproteins (LDL) and very low-density lipoproteins (VLDL) were significantly lower than those in nephrotic control group. There was no change in the amount of hepatic HMG-CoA-R mRNA, but hepatic LDL-R mRNA and activities of serum LPL and LCAT increased significantly. CONCLUSIONS: A&A alleviates hyperlipidemia considerably in nephrotic rats. A&A improves disorders of lipid metabolism perhaps through up-regulating the expression of hepatic LDL-R gene and through increasing the activities of serum LPL and LCAT.

Angelica sinensis↗
PubMed1999

[The effects of Xuezhikang on serum lipid profile, thromboxane A2 and prostacyclin in patients with hyperlipidemia].

OBJECTIVE: To study the effects of Xuezhikang on lipid profile, thromboxane (TX) A(2), prostacyclin (PGI(2)) in patients with hyperlipidemia. METHODS: 91 patients with hyperlipidemia were randomly divided into a treatment group (n = 47, Xuezhikang 1.2 g/d Bid, p.o) and control group (n = 44, gemfibrozil 1.2 g/d Bid, p.o). serum lipids, TXB(2) and 6-Keto-PGF(1alpha) were determined before and 8 weeks after the treatment. RESULTS: (1) After 8 weeks of treatment, the level of serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) decreased by 21.6% (P < 0.01) and 33.3% (P < 0. 01) in the Xuezikang group and by 20.4% (P < 0.01) and 24.8% (P < 0.01) in the gemfibrozil group respectively. Serum high density lipoprotein cholesterol (HDL-C) level elevated by 33.7% in the Xuezhikang group (P < 0.01) and 26.9% in the gemfibrozil group (P < 0.01). The effect of Xuezhikang was the same as gemfibrozil. There was no statistically significant difference between the effects of these two drugs. Triglyceride (TG) level decreased by 23.3% in the Xuezhikang group (P < 0.01) and 40.3% in the gemfibrozil group (P < 0.01). TG lowering effect of gemfibrozil was superior to that of Xuezhikang (P < 0.05). (2) The level of lipoprotein (a) [LP (a)] in the plasma decreased by 28.2% (P < 0.01) in the Xuezhikang group and by 4.9% (P > 0.05) in the gemfibrozil group. LP (a) lowering effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01). (3)The Level of thromboxane (TX) B(2) in the plasma decreased by 34.2% in the Xuezhikang group (P < 0.01) and by 8.4% in the gemfibrozil group (P < 0.01). TXB(2) lowering effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01). The level of 6-KetO-PGF(1alpha) in the plasma elevated by 65.4% in the Xuezhikang group (P < 0.01) and by 11.7% in the gemfibrozil group (P < 0.01); the effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01). CONCLUSION: Xuezhikang could markedly decrease the level of TC and LDL-C and elevate that of HDL-C in patients with hyperlipidemia and the effects of Xuezhikang were the same as those of gemfibrozil. TG lowering effect of gemfibrozil was superior to that of Xuezhikang, but Xuezhikang could markedly decrease the level of Lp (a) and regluate the balance between TXA(2) and PGI(2), its effect being superior to that of gemfibrozil.

Aged↗
PubMed2002

Hyperlipidemia in adolescents.

Coronary artery disease is the leading cause of morbidity and mortality in the United States. Studies increasingly indicate that atherosclerotic lesions are evident in the vasculature by late adolescence, and that hyperlipidemias are a common and remediable contributor to their development. Hence, health care providers dealing with adolescents must be familiar with contemporary concepts about the etiology, classification, and management of hyperlipidemias in children and adolescents. This chapter briefly reviews lipid metabolism, emphasizing lipoprotein composition, key components, enzymes, cellular receptors, transport, uptake, and fate. This framework provides a rational classification with exclusion and treatment of secondary causes such as obesity, poorly controlled diabetes, hypothyroidism, and oral contraceptive therapy, followed by currently recommended approaches to the primary hyperlipidemias, which affect at least 1:500 persons. Guidelines for screening adolescents at risk and incremental treatment with diet and lipid-lowering medications, including statins, are reviewed in the context of current national recommendations.

Adolescent↗
PubMed2002

[Disorder of lipid metabolism in visceral fat syndrome--relation to familial combined hyperlipidemia].

'Visceral fat syndrome' is a clinical entity compatible with Syndrome X, Deadly quartet, and insulin resistance syndrome. All of these entities express the pathophysiology of multiple risk factor syndrome in which multiple risks of arteriosclerosis, i.e., hypertension, hyperlipidemia, and glucose intolerance, cluster in an individual. The accumulation of visceral fat plays a crucial role in the pathogenesis of visceral fat syndrome. On the other hand, familial combined hyperlipidemia (FCHL) is a common hyperlipidemia associated with premature arteriosclerosis. The pathogenesis of FCHL is not fully elucidated but the visceral fat accumulation may play an important role in the pathophysiology of FCHL. In this review, we will discuss the relationship between visceral fat syndrome and FCHL.

Female↗
PubMed2003

[Regulatory effect of yishou tiaozhi tablet on lipids in patients with primary hyperlipidemia].

OBJECTIVE: To study the regulatory effect of Yishou Tiaozhi Tablet (YSTZT) on blood lipids in patients with primary hyperlipidemia. METHODS: One hundred and sixty-eight patients with primary hyperlipidemia were randomly divided into two groups. The treated group was treated with YSTZT 4 tablets 3 times a day, and the control group was treated with Zocor by oral taking 1 tablet before sleep every evening. The therapeutic course for both groups was 60 days. The effect in regulating blood lipids in patients was observed. RESULTS: The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), arteriosclerosis index (AI), apo-lipoprotein B (apoB), TC/HDL-C lowered and apoA/apoB ratio increased obviously in the treated group. As compared the effects between the two groups, the lowering of TC, AI and apoB in the two groups were similar (P > 0.05), effect of YSTZT in lowering TG was superior but in lowering of LDL-C was inferior to those of Zocor respectively (all P < 0.01). The effect of both remedies in elevating HDL-C was not satisfactory. The total effective rate of YSTZT was 91.9%, its individual effects were similar to those of SJZ respectively except in lowering TG and raising HDL-C. The adverse reaction occurred in YSTZT treatment course was mild without any influence on the medication. CONCLUSION: YSTZT had definite regulatory effect on the blood lipids and lipoproteins in patients with hyperlipidemia.

Adult↗
PubMed2003

[Relations of lipoprotein lipase gene polymorphism at Pvu II locus and dietary intervention predisposition in hyperlipidemia population].

In order to investigate the relation of lipoprotein lipase (LPL) gene polymorphism at Pvu II locus and dietary intervention predisposition in hyperlipidemia population, 436 hyperlipidemia patients were screened selected from some communities in western urban districts in Beijing, and then separated into two groups, intervention (248) and control group(188). The serum lipids profile, dietary intakes data were collected and physical examination was conducted in all subjects. Also, the LPL-Pvu II polymorphisms were analyzed by PCR-RFLP. The results showed that the total energy intake, cholesterol level and percentage of energy from dietary fat, and the serum levels of TC, LDL-C and HDL-C were significantly decreased (P < 0.05) after 6-month dietary intervention in intervention group compared with the control group. The decrease range of TC and LDL-C in carriers with LPL-Pvu II (+/+) genotype was much more than others(+/- and -/- genotypes). The results from multiple linear regression analysis showed that the susceptible factors of dietary intervention included LPL-Pvu II (+) allele, the high baseline levels of TC and LDL-C and overweight. The conclusions could be primarily drawn that the variants of LPL-Pvu II locus were important determinants of variation in serum cholesterol response to dietary change in hyperlipidemia population.

Alleles↗
PubMed2003

Smoking and hyperlipidemia are important risk factors for coronary artery spasm.

OBJECTIVE: To investigate the role of coronary artery spasm in the etiology of chest pain lacking significant coronary stenosis and to identify the clinical risk factors related to coronary artery spasm. METHODS: Two hundred and seventy five patients with chest pain, but without significant coronary artery stenosis underwent the intracoronary acetylcholine test. Coronary artery spasm was diagnosed while coronary artery stenosis increased to 90% and was accompanied by the usual chest pain with or without ischemic changes on electrocardiogram. Logistic regression was employed to investigate the relationships between coronary artery spasm and sex, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and results of electrocardiographic treadmill stress test. Left ventricular ejection fraction and end diastolic pressure were compared between spasm group and non-spasm group. RESULTS: Coronary artery spasm was detected in 103 out of 271 patients, a rate of 38%. Logistic regression analysis showed that smoking and hyperlipidemia increased the relative risk of coronary artery spasm 4.2 times and 2.3 times, respectively. There was a significantly negative relationship between diabetes mellitus and coronary artery spasm. Furthermore, there was no significant difference of left ventricular ejection fraction and end diastolic pressure between spasm group and non-spasm group. CONCLUSIONS: Coronary artery spasm was one of the important etiological factors for patients with chest pain but no coronary artery stenosis. Smoking and hyperlipidemia were the main clinical risk factors for coronary artery spasm.

Acetylcholine↗
PubMed2003

[Combination therapy with fluvastatin and fenofibrate in ischemic heart disease patients with combined hyperlipidemia and type 2 diabetes].

AIM: To assess efficacy of combination therapy with fluvastatin and fenofibrate in ischemic heart disease (IHD) patients with combined hyperlipidemia and type 2 diabetes. MATERIAL: Patients with IHD and combined hyperlipidemia with (n=56)) or without type 2 diabetes (n=30). METHODS: After 8-week diet period the patients were randomized to 4 weeks monotherapy with either fluvastatin (40 mg/day) or micronized fenofibrate (200 mg/day). In patients whose low-density lipoprotein cholesterol (LDL CH) remained > 2,6 mmol/1 and triglycerides (TG) > 2.3 mmol/1 combination of fluvastatin 40 mg/day and fenofibrate 200 mg/day was used for the next 12 weeks. RESULTS: Target levels of LDL CH and TG were achieved in 75 and 88%, respectively, of diabetics, and in 73 and 88%, respectively, of non-diabetics. CONCLUSION: The use of combination of fluvastatin and fenofibrate was more effective then monotherapy for correction of lipid abnormalities in combined hyperlipidemia both in diabetics and non-diabetics with IHD.

Adult↗
PubMed2003

Is the treatment of hyperlipidemia as secondary prevention adequate in different age groups in Israel?

BACKGROUND: Treatment of hyperlipidemia is important for secondary prevention in patients suffering from coronary heart disease. It has been proven that "young elderly" (patients aged 65-75 years) can benefit from the treatment at least as much as younger patients. OBJECTIVE: To assess the adequacy of treatment as part of secondary prevention in "young elderly" and younger patients. METHODS: In this prospective study, 389 patients discharged from the hospital with the diagnosis of coronary heart disease were divided according to age groups. Data were collected regarding lipid profile examinations, dietary and drug therapy, and results of lipid profiles. RESULTS: Less than one-third of the patients achieved target low density lipoprotein levels. More patients in the older age group achieved the treatment goals. The goals were achieved despite the fact that the percentage of patients treated with lipid-lowering drugs was lower in the older age group. CONCLUSION: The percentage of patients treated for hyperlipidemia as part of a secondary prevention plan in Israel is similar to that in other developed countries. The fact that more "young elderly" patients achieve adequate lipid profiles compared to younger patients indicates that there is no age discrimination towards this patient group. The finding that less than one-third of the patients reach the treatment goals should prompt physicians to treat hyperlipidemia more aggressively.

Adult↗
PubMed1992

Nephrotic hyperlipidemia: primary abnormalities in both lipoprotein catabolism and synthesis.

One of the most prominent manifestations of the nephrotic syndrome is hyperlipidemia. Lipoprotein synthesis is increased and catabolism is reduced in nephrotic patients and animals. The observation that infusion of either albumin or dextran reduces lipid levels suggests that oncotic pressure (pi) may regulate lipogenesis. It has been postulated that prolonged plasma half-life of lipoproteins in nephrosis is a consequence of saturation of catabolic sites and is secondary to the hyperlipidemia that results from increased lipogenesis. However, the absolute rate of triglyceride catabolism is reduced in nephrotic rats in comparison to normal suggesting that defective lipid catabolism may be a cause rather than a consequence of hyperlipidemia. Furthermore, chylomicrons (CM) and very-low-density lipoproteins (VLDL) are cleared normally in rats with hereditary analbuminemia despite increased lipid synthesis. When we cause proteinuria in analbuminemic rats, the clearance of CM and VLDL becomes greatly prolonged, suggesting that proteinuria, and not reduced serum albumin or pi, is responsible for defective lipoprotein catabolism. Maneuvers that reduce proteinuria, such as administration of an angiotensin-converting enzyme inhibitor, reduce lipid levels in nephrotic patients and animals even when plasma albumin concentration is unchanged supporting a hypothesis that proteinuria may lead to reduced catabolism of lipoproteins.

Animals↗
PubMedDate not supplied

Xanthomas: a marker for hyperlipidemias.

Xanthomas are deposits of lipids in the skin and sometimes of the subcutaneous tissue that are expressed clinically as yellowish papules and plaques, nodules, and tumors. They are often, but not always, a consequence of hyperlipidemia. In these cases, a meticulous work-up nearly always reveals some disturbance in regards to the metabolism of the lipids-lack of certain lipoproteins, for example. Xanthoma tuberosum and tendinosum occur in persons with familiar hypercholesterolemia, palmar crease xanthoma in familial dysbetalipoproteinemia, plane xanthoma in persons with an underlying lymphoproliferative disorder (or normolipemic), and eruptive xanthoma in those with a genetically-transmitted lipoprotenemia. In sum, each type of xanthoma and any associated abnormality in lipid metabolism can be diagnosed with specificity. Xanthomas are deposits of lipid in the skin or subcutaneous tissue that manifest clinically as yellowish papules, nodules and tumors. They are often associated with hyperlipidemias, although some of them may be normolipemic. Xanthomas result when abnormalities in the transportation of lipids such as cholesterol, triglycerides and phospholipids cause these lipids to be deposited in the skin and being ingested by tissue macrophages. When they are deposited in the walls of arteries, they promote the development of atherosclerosis. Sometimes, by identifying the clinical variant of the xanthoma, the lipoprotein that is deposited and the clinical associations can be predicted. This discussion will focus on those xanthomas associated with hyperlipidemias.

Humans↗
PubMed2004

[Clinical assessment on treatment of hyperlipidemia with pushen capsule].

OBJECTIVE: To explore the therapeutic effect of Pushen capsule (PSC) in treating primary hyperlipidemia. METHODS: Two hundred and forty patients with primary hyperlipidemia were randomly divided into two groups, the 120 patients in the treated group treated with PSC (4 capsules, tid) and the 120 patients in the control group treated with Zhibituo tablet (3 tablets, tid), and they were administered at the same time with Zhibituo placebo. The therapeutic course for both groups was 4 weeks. The therapeutic effect and the effects on blood lipids and viscosity were observed. RESULTS: The effective rate in the treated group was 76.3%, which was significantly higher than that in the control group (48.7%, P < 0.01). PSC showed a significant lowering effect on TC, TG and LDL-C and raising effect on HDL-C, and the effect in lowering TG was significantly better than that of Zhibituo (P < 0.01). PSC also showed a certain effect in decreasing whole blood viscosity of both high-sheared and low-sheared viscosity. CONCLUSION: Pushen capsule has promising blood lipid regulating effect in patients with hyperlipidemia, and some effects in lowering the blood viscosity.

Adult↗
PubMed2004

[Relationship between gene polymorphism at CETP locus and hyperlipidemia in the middle-aged and the elder].

OBJECTIVE: The relationship between gene polymorphism at CETP locus and hyperlipidemia was examined in a 421 population-based sample (age from 35 to 81) from Xicheng district, Beijing. METHODS: The levels of serum lipid profile, including TC, TG, HDL-C, LDL-C, ApoAI, ApoB were analyzed. The polymorphism of CETP gene were detected by PCR-RFLP method. RESULTS: The genotype frequencies of CETP-TaqIB B1B1, B1B2, B2B2 were 30.4%, 52.0%, 17.6% respectively, and the B1, B2 allele frequencies were 56.4%, 43.6%, and similar to that of Caucasian, Japanese and Taiwanese Chinese. There was no significant difference in the distribution of genotypes between the hyperlipidemia and the normalipidemia. Subjects for the B1B1 genotype had lower HDL-C levels than did B1B2 and B2B2 subjects, but the difference did not reach statistically significant. And there were no statistically significant differences among the genotype groups in the other plasma lipid levels. Several factors may be associated with the negative results: (1) The genetic variation was multiple, polynormal and different among various ethnic population. (2) One gene locus always was "minor gene". (3) Confounding factors. CONCLUSION: The study could not draw the conclusion that the polymorphism at CETP locus was associated with hyperlipidemia in the middle-aged and the elder in Beijing.

Adult↗