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PubMed1994

Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk?

Several aspects of Western diets, alcohol use, and exercise patterns which are related to the risk of colorectal cancer have systemic effects in common. Those which increase the risk of colorectal cancer are positively associated with serum triglycerides and plasma glucose; those which decrease risk are negatively associated with serum triglycerides and plasma glucose. These observations suggest the hypothesis that serum triglycerides and/or plasma glucose may themselves be associated with colorectal cancer risk. Evidence for associations between colorectal neoplasia and triglycerides and glucose comes from two recent studies of adenomatous polyps, presumed precursors for colorectal cancer, and from previous studies of diabetes and cancer. In addition, three randomized trials, one in humans and two in animal models, suggest that diets which would be expected to increase serum triglycerides and plasma glucose increase the levels of cellular indicators of colorectal cancer risk. Biological mechanisms explaining associations between colorectal neoplasia and serum triglycerides and/or plasma glucose might involve luminal or circulatory effects: (a) triglycerides and/or glucose may be associated with fecal bile acids, acids which are positively associated with colorectal cancer risk in epidemiological studies and which promote colorectal cancer in animal models; (b) serum triglycerides and/or plasma glucose might influence circulating hormones, such as insulin, which might themselves be involved in cancer development; (c) serum triglycerides and/or plasma glucose might be indicators of energy available through the circulation for neoplastic cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Acids and Salts↗
PubMed1994

Evaluation of the effects of various factors on the serum triglyceride level in young adults.

The life style of young adults has been receiving attention with a view to its improvement to preventing coronary heart diseases (CHD) in later life. In this study, for determining the influence of different life styles on the serum triglyceride level, we carried out surveys and laboratory studies on the relationships of the nutritional intake, physical activity, and cigarette smoking and alcohol consumption of young adults with their serum triglyceride levels. The nutritional survey indicated a significant correlation between the serum triglyceride level and carbohydrate intake (p < 0.01). In the survey of physical activity, a significant inverse correlation was found between the energy expenditure per kg body weight and the serum triglyceride level (p < 0.05). No significant relationship was found of smoking or drinking with the serum triglyceride level. The body mass index was found to have effects on both the serum triglyceride and total cholesterol levels. Of the factors examined, carbohydrate intake and energy expenditure per kg body weight had the greatest effects on the serum triglyceride level. Considering the trend for young people to consume large quantities of carbonated drinks, in which most of carbohydrate is sucrose, we tested the affect of a high carbohydrate diet on one group of subjects and found that it caused a significant increase in the serum triglyceride level (p < 0.05). Another group for whom a mild exercise regimen was prescribed showed slight, but not significant decrease in the serum triglyceride level. These results suggest that at least optimal nutrition and physical activity including weight control during adolescence are important for preventing CHD.

Adult↗
PubMed1997

Effect of lipid transfer activity and triglyceride hydrolysis on apolipoprotein B immunoreactivity in modified low density lipoproteins.

Consequences of alterations in the size and the lipid composition of low density lipoproteins (LDL) on apolipoprotein (apo) B immunoreactivity were analyzed using two distinct anti-apoB monoclonal antibodies (Mabs), i.e., 4G3, which recognizes an epitope closed to the binding site to the LDL receptor, and 2D8, which is directed against a distal region. Inhibition analysis revealed that the lipid transfer-mediated triglyceride enrichment of LDL isolated from 12 native human plasmas is associated with significant reductions in the expression of 2D8 and 4G3 epitopes (P < 0.05 in both cases). In contrast, triglyceride hydrolysis of triglyceride-rich LDL significantly increased apoB immunoreactivity as compared with non-lipolyzed counterparts (P < 0.05 with 2D8 and 4G3 Mabs). Among all the modified LDL fractions studied (n = 36), immunoreactivity of 2D8 and 4G3 epitopes correlated negatively and significantly with the triglyceride content (P < 0.01 in both cases), but with neither the size nor the other lipid parameters of LDL particles. Furthermore, changes in the triglyceride content of LDL correlated significantly with changes in apoB immunoreactivity after in vitro treatment with either lipid transfer activity alone (P < 0.01 with 2D8 and 4G3 Mabs) or lipid transfer activity combined with triglyceride hydrolysis (P < 0.01 with 2D8 and 4G3 Mabs). Finally, both the triglyceride content of native LDL and the total triglyceride level in 12 normolipidemic human plasmas correlated negatively and significantly with the expression of 2D8 epitope (P < 0.03 in both cases) and 4G3 epitope (P < 0.02 in both cases). It is concluded that triglycerides constitute a major determinant of the immunoreactivity of 2D8 and 4G3 apoB epitopes in LDL.

Antibodies, Monoclonal↗
PubMed2000

Do triglycerides provide meaningful information about heart disease risk?

BACKGROUND: Prior research suggests that adding triglyceride determinations to measurements of total cholesterol and cholesterol subfractions may improve the prediction of coronary heart disease (CHD). OBJECTIVE: To determine the additional value of measuring triglyceride levels, in addition to cholesterol levels and subfractions, for predicting CHD. STUDY DESIGN: A set of secondary analyses of previously reported studies. METHODS: We performed secondary analyses of data from the Multiple Risk Factor Intervention Trial, the Lipid Research Clinics Coronary Primary Prevention Trial, and the Lipid Research Clinics Prevalence and Mortality Follow-Up Study. Predictor variables included the levels of fasting triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting blood glucose; age; blood pressure; cigarette smoking; body mass index; and postmenopausal estrogen use. Analytic methods included Cox proportional hazards models, calculation of stratified crude incidence rates, and measurement of the area under the receiver operating characteristic curve. MAIN OUTCOME MEASURES: Outcome variables were fatal and nonfatal myocardial infarctions. RESULTS: With few exceptions, no significant interactions between cholesterol subfractions and triglyceride levels were found and receiver operating characteristic curve analyses revealed that triglyceride measurements did not improve discrimination between those subjects who did and did not suffer CHD events. In men, categorical analyses employing both triglyceride and cholesterol levels were similar to those using cholesterol categories alone. In the one study of women, those subjects with both a high-risk cholesterol profile and high triglyceride levels were more likely to have a CHD event, though this finding was based on fewer subjects and CHD events. CONCLUSION: These data suggest that, in men, measurement of serum triglyceride levels does not provide clinically meaningful information about CHD risk beyond that obtainable by measurement of serum cholesterol subfractions alone.

Cholesterol, HDL↗
PubMed1996

Self-monitoring of triglycerides by type 2 diabetic patients: variability in fasting and postprandial levels.

Triglycerides are an important risk factor for coronary heart disease in Type 2 (non-insulin-dependent) diabetes mellitus. Although Type 2 diabetic patients have an exaggerated postprandial triglyceride response to a fat meal test, little is known about the variability of triglyceride concentrations in day-to-day life. We have studied the variability in triglyceride concentrations in 24 Type 2 diabetic patients over 6 months by having them record fasting and postprandial triglyceride concentrations at home using a Reflotron dry chemistry analyser. All patients were able to use the analyser effectively, with a correlation of 0.97 between patients' monthly Reflotron readings and those recorded by the laboratory. Over 1600 measurements were performed. The results demonstrate a large variation in both fasting (median 1.95 mmol l-1, range 0.8-6.7 mmol l-1) and postprandial triglyceride concentrations (median 2.68 mmol l-1, range 0.8-6.7 mmol l-1). This variation was accounted for by both a large intra- and inter-individual variation. Although there was a strong correlation overall between fasting and postprandial triglyceride concentrations r = 0.925 (p < 0.001), this did not apply on an individual basis. In conclusion, the large variability in triglyceride concentrations should be considered before introducing pharmacological therapy for hypertriglyceridaemia in Type 2 diabetes mellitus.

Body Mass Index↗
PubMed2004

Predictive relationships for the effects of triglyceride ester concentration and water uptake on solubility and partitioning of small molecules into lipid vehicles.

The ability to predict drug solubility and partitioning in triglyceride solvents from the chemical structures of the solute and the triglyceride would be highly useful in drug formulation development and in screening drug candidates for lipid solubility and possibly drug bioavailability. This study explores the role of triglyceride ester concentration on small molecule partitioning between lipid vehicles and water, including the effect of ester concentration on water uptake. The influence of solvated water is further examined in studies of small molecule solubility in dry and water saturated lipid vehicles varying in triglyceride ester concentration. A series of model solutes with varying hydrogen bond donating/accepting abilities was chosen for this study while triglyceride ester concentrations were varied by using squalane/tricaprylin solvent mixtures. General linear free energy solvation relationships having the form utilized previously by Abraham were obtained at each solvent composition. An examination of the solvent descriptors indicated that those descriptors representing the sensitivity of the solvent to the solute dipolarity/polarizability, s, and to the hydrogen bond acidity of the solute, a, vary systematically with the concentration of ester moieties in the solvent mixture. An empirical equation has been derived that offers the potential for predicting triglyceride/water partition coefficients and in certain cases, solubility in hydrated, fully-saturated triglyceride solvents for any small molecule for which Abraham solute descriptors can be obtained. Water uptake in triglyceride vehicles is shown to be approximately linear with water activity and may also be described by the empirical relationship developed for other solutes providing an adjustment is made in the value of its hydrogen bond acidity parameter. Water uptake enhances the solubility of benzamide and N-methylbenzamide and a modest "water-dragging" effect by N-methylbenzamide in the triglycerides is observed.

Dose-Response Relationship, Drug↗
PubMedDate not supplied

Indinavir did not further increase mean triglyceride levels in HIV-infected patients treated with nucleoside reverse transcriptase inhibitors: an analysis of three randomized clinical trials.

OBJECTIVES: Metabolic abnormalities including hyperlipidemia have developed in patients infected with the human immunodeficiency virus (HIV) after treatment with protease inhibitor drugs. It is unclear whether the deleterious effects on plasma triglyceride concentrations observed in patients receiving highly active antiretroviral therapy are a class effect of protease inhibitors. Hypertriglyceridemia may constitute a risk factor for cardiovascular disease. The purpose of this retrospective analysis of HIV-infected patients enrolled in three randomized, double-blind trials of indinavir therapy was to determine whether indinavir use was associated with a larger increase in triglyceride levels than treatment without a protease inhibitor. METHODS: Using a mixed-effects model, we compared average changes in nonfasting plasma triglyceride levels among randomized treatment groups for each protocol separately. RESULTS: The median increase in triglyceride levels during the 1st year of antiretroviral monotherapy was less with indinavir than with either zidovudine or stavudine. The combination of indinavir and nucleoside-analogue reverse-transcriptase inhibitors (NRTI) resulted in smaller increments in triglyceride levels than NRTI monotherapy. Indinavir also augmented the reduction in triglyceride levels observed with combination therapy using zidovudine and lamivudine in persons with far advanced HIV-infection. However, up to 7% of patients receiving a NRTI and indinavir experienced elevations of nonfasting triglyceride levels in excess of 750 mg/dl. CONCLUSIONS: On average, the combination of indinavir and NRTI therapy was not associated with a greater elevation of non-fasting triglyceride levels in HIV-infected men with at least moderately advanced immunosuppression than treatment with NRTI drugs alone.

Antiretroviral Therapy, Highly Active↗
PubMed1976

[Changes of triglycerid-fatty acids in healthy volunteers during acute ethanol ingestion with and without blocking peripheral lipolysis (author's transl)].

This investigation decided to answer the question of the origin of fatty acids for the increased synthesis of triglycerides in acute ethanol-induced hyperlipoproteinemia. Healthy persons ingested 0.5 g of ethanol/kg body weight initially and 0,15 g of ethanol/kg and hour for 12 hours. The fatty acids of plasma triglycerides were determined before and after ingestion of ethanol in persons fasting and nourished isocaloricaly, with and without blocking peripheral lipolysis by nicotinic acid and with addition of glucose. The fasting persons triglycerides fatty acids increased to 165.7 % of the initial value after 12 hours of ethanol ingestion, with a preferential increase in palmitic-, oleic- and stearic acid. When lipolysis in adipose tissue was blocked by 0.5 g of nicotinic adic/hour the triglyceride-fatty acids reached only 116.2% after 12 hours, with a decrease in oleic acid, which is present in adipose tissue to a higher degree than in plasma triglycerides. When nourished isocaloricaly, the enhancement of plasma triglyceride-fatty acids could not be suppressed by nicotinic acid. The changes in concentration and pattern of triglyceride-fatty acids announce that the fatty acids used for increased synthesis of triglycerides in fasting persons come from adipose tissue preferentially. In contrast ethanol-ingested hyperlipoproteinemia during ingestion of a food which cannot be suppressed by nicotinic acid, seems to orginate from fatty acids of the food and for de novo synthesis of fatty acids in the liver.

Adipose Tissue↗
PubMed2003

Post-prandial triglyceride profile in a population-based sample of Type 2 diabetic patients.

AIMS/HYPOTHESIS: Postprandial lipaemia is considered an emerging risk factor for cardiovascular disease also in the Type 2 diabetic population. However, little information exists on the daily triglyceride profile of these patients, especially during everyday life. The aim of the study was to evaluate the daily triglyceride profile of Type 2 diabetic patients during their everyday life. METHODS: 145 Type 2 diabetic patients (66 men/79 women, age range 45-65 years) at a health district near Naples, Italy, participating in a screening survey for the evaluation of diabetic complications, and 30 non-diabetic subjects of the same area underwent four daily capillary triglyceride profiles by Accutrend (Roche)-a previously validated method. RESULTS: Triglyceride values (mmol/l; Means +/- SE) were 2.22+/-0.08 at fasting, decreased before lunch (2.03+/-0.07), reached a peak 3 h after lunch (2.73+/-0.09) and remained substantially high before dinner (2.47+/-0.09) (all p<0.001 vs fasting). The triglyceride profile of non-diabetic subjects was significantly lower at each point (average difference of 0.73 mmol/l). The percentage of patients with values above 2.25 mmol/l was 61% 3 h after lunch and 49% before dinner. Moreover, in 30% of patients with optimal fasting values (<1.69 mmol/l) triglyceride concentrations 3 h after lunch ranged between 1.69 and 2.25 mmol/l, and in 31% they were above 2.25 mmol/l. CONCLUSION/INTERPRETATION: Most Type 2 diabetic patients have postprandial triglycerides above optimal concentrations for several hours after meals. Moreover, optimal fasting concentrations are not always a good predictor of postprandial triglycerides.

Aged↗
PubMed1999

Lowering effects of four different statins on serum triglyceride level.

OBJECTIVES: The main effect of statins is the decrease of serum level of low-density lipoprotein (LDL) cholesterol, due to the inhibition of intracellular cholesterol biosynthesis which brings about an upregulation of LDL receptors. A minor effect is the decrease of serum triglycerides. The present study was undertaken to verify whether all statins are effective in reducing serum triglycerides and whether their effect on triglycerides is related to the LDL cholesterol lowering activity. METHODS: Of 197 hypercholesterolaemic patients on stable low-fat low-cholesterol diet, 49 were put on atorvastatin 10 mg per day, 48 on fluvastatin 40 mg per day, 50 on pravastatin 20 mg per day and 50 on simvastatin 10 mg per day. RESULTS: After 2 months, mean percentage change in serum triglycerides and LDL cholesterol resulted to be significantly different among the four treatment groups, whereas the ratio between the percentage decrease in serum triglycerides and that of LDL cholesterol (Deltatriglyceride/DeltaLDL cholesterol ratio) was not significantly different. Only baseline serum triglycerides resulted to be significantly associated with Deltatriglycerides/DeltaLDL cholesterol ratio. All statins are then effective in decreasing triglyceride levels. CONCLUSION: The lack of a significant difference in Deltatriglycerides/DeltaLDL cholesterol ratio among the treatment groups suggests that the more effective the statin is in decreasing LDL cholesterol, the more it will also be in decreasing serum triglycerides.

Adult↗
PubMed1986

Cyclic fatty esters: synthesis, characterization, and lipolysis of isomeric triglycerides of 9-(6-propyl-3-cyclohexenyl)-(Z)8-nonenoic acid.

Triglycerides of a model cyclic fatty acid (CFA) 9-(6-propyl-3-cyclohexenyl)-(Z)8-nonenoic acid (Ia) were synthesized for biological and toxicity evaluations. The monoacid triglyceride II (CyCyCy) was interesterified with triolein (OOO) to obtain mixtures of diacid triglycerides: III (OOCy), IV (OCyO), V (OCyCy), and VI (CyOCy). The interesterification mixtures were separated by preparative HPLC into two 'critical pairs' of isomeric triglycerides. Triglycerides III-VI were synthesized and a 13C-NMR method was developed to estimate 'critical pairs'. CFA-triglycerides were characterized by IR, NMR, HPLC and capillary GLC, and their relative rates of hydrolysis by lipase were compared. Although tricyclin (II) was completely resistant to lipolysis, triglycerides III and VI hydrolyzed significantly slower than triolein, and the 'critical pairs' hydrolyzed as readily as triolein. Therefore, partial CFA-triglycerides formed in heat-abused fats can undergo lipolysis and likely be absorbed like normal dietary fats.

Chromatography, High Pressure Liquid↗
PubMed1981

Distribution of lipoproteins triglyceride and lipoprotein cholesterol in an adult population by age, sex, and hormone use- The Pacific Northwest Bell Telephone Company health survey.

This report describes the distribution of lipoprotein triglyceride and lipoprotein cholesterol in employees of the Pacific Northwest Bell Telephone Company. Means, medians, and selected percentiles are presented for very low, low, and high density lipoproteins (VLDL, LDL, and HDL, respectively) in 606 randomly selected white subjects aged 20-59. Results are specific for age decade, sex, and female sex hormone usage. Women who use sex hormones have significantly higher concentrations of triglycerides in all of the fractions across all age decades from 20 to 59 than do women not taking hormones. The average VLDL, LDL, and HDL triglyceride levels in women taking hormones are 69, 25 and 18 mg/dl which are considerably higher than the corresponding averages of 44, 17 and 12 mg/dl noted in women not taking hormones. Men have the highest average VLDL triglyceride value (85 mg/dl) but their average triglyceride concentrations in the LDL and HDL fractions (18 and 12 mg/dl) approximate those of women not taking hormones. This study in a well-defined population provides references standards for lipoprotein triglyceride concentrations. These results can be used to evaluate the effect of sex hormone treatment on the lipoprotein triglyceride content in VLDL, LDL and HDL, and to assess triglyceride content as a potential risk factor in men and older women.

Adult↗
PubMed1985

Particle size distribution of high density lipoproteins as a function of plasma triglyceride concentration in human subjects.

Polyacrylamide gradient gel electrophoresis has been used to examine the particle size distribution of high density lipoproteins (HDL) in human subjects with a wide range of plasma triglyceride concentrations. In studies of groups of both male and female subjects, it was confirmed that the concentration of HDL cholesterol decreases with increasing plasma triglyceride concentration. The HDL fraction from subjects with elevated concentrations of plasma triglyceride was depleted of cholesteryl ester and enriched in triglyceride. It was also confirmed that the proportion of HDL subfraction 2 (HDL2) declines as the plasma triglyceride increases. A new finding was that there were also significant changes in the size of particles in HDL subfraction 3 (HDL3). At low concentrations of plasma triglyceride the predominant subpopulation of HDL3 comprised particles of mean radius 4.3 nm. As the triglyceride concentration increased, however, there was a progressive appearance of HDL3 particles of radius 3.9 nm; in plasma samples with the highest concentrations of triglyceride there was an almost complete disappearance of the 4.3-nm particles, with the population of 3.9-nm particles now predominant.

Adult↗
PubMed1983

Plasma lipoproteins, postheparin plasma lipoprotein lipase activity intralipid half-life, triglyceride secretion rate and liver lipids in the mouse fed different cholesterol diets.

Mice (SC), fed a semipurified diet containing cholesterol, cholic acid and sucrose, exhibited, in comparison to control animals (S), an increase in cholesterol, phospholipid and protein of VLDL, LDL1 and LDL2, but triglyceride of the same lipoproteins decreased, as did total plasma triglycerides. Postheparin plasma lipoprotein lipase activity of SC animals was 1.72 times that of S mice. At the same time Intralipid half-life in SC mice was decreased by 52%. Triglyceride secretion rate, after Triton WR 1339 treatment, and liver triglyceride content were reduced in SC animals. HDL mass was decreased in SC mice. Mice (AC) fed a standard diet containing cholesterol showed, in comparison to normal fed animals (A), an increase in cholesterol of VLDL, LDL1 and LDL2 but triglyceride of the same lipoproteins decreased as did total plasma triglycerides. Postheparin plasma lipoprotein lipase activity of AC animals was unmodified as was Intralipid half-life. In AC animals triglyceride secretion rate, after Triton WR 1339 treatment, was reduced but in a less extent than in SC mice. Liver triglyceride was unmodified. HDL mass was decreased in AC mice.

Animals↗
PubMed2005

Pleiotropic genetic effects contribute to the correlation between HDL cholesterol, triglycerides, and LDL particle size in hypertensive sibships.

OBJECTIVE: Abnormalities of HDL cholesterol (HDL-C), triglycerides, and LDL particle size are present in familial dyslipidemic hypertension. We investigated heritability of these three lipid traits and the extent to which shared effects of genes (pleiotropy) contribute to the additive genetic variation in each trait in hypertensive sibships. METHODS: Subjects included 788 individuals (60% women) ascertained through sibships with >/=2 members diagnosed with hypertension before age 60 years. The LDL particle size was measured by polyacrylamide gel electrophoresis. Triglycerides were log transformed to reduce skewness, and age- and sex-adjusted lipid traits were used in the analyses. Heritability and pairwise genetic correlations were computed using a variance components approach. The genetic correlation between a pair of traits was squared to yield genetic covariance, a measure of pleiotropic effects of genes influencing both traits concomitantly. RESULTS: Heritability estimates indicated significant genetic effects on HDL-C (0.58), log triglycerides (0.47), and LDL particle size (0.71). Genetic correlation was strongest between HDL-C and log triglycerides (-0.642), followed by log triglycerides and LDL particle size (-0.493), and HDL-C and LDL particle size (0.334). HDL-C and log triglycerides showed the strongest genetic covariance (41%), followed by LDL particle size and log triglycerides (24%), and HDL-C and LDL particle size (11%). CONCLUSIONS: Multivariate quantitative genetic analyses in hypertensive sibships reveal that pleiotropy contributes to the additive genetic variation in HDL-C, triglycerides, and LDL particle size. These findings provide the rationale for multivariate linkage analyses to identify novel genetic loci with pleiotropic effects on the traits.

Aged↗
PubMed2004

Insulin-loaded W/O/W multiple emulsions: comparison of the performances of systems prepared with medium-chain-triglycerides and fish oil.

Insulin-loaded W/O/W multiple emulsions (ME) composed of medium-chain triglycerides have been shown to decrease the blood glucose level after oral administration to diabetic rats. Fish oil (very long-chain triglycerides) could be an alternative to medium-chain triglycerides because its chronic consumption has beneficial therapeutic effects. The aim of this work was twofold: to obtain stable fish oil containing ME, based on a formulation optimized in a previous work with low medium-chain triglycerides content, and to compare their characteristics to those of ME composed of medium-chain triglycerides. Due to the higher viscosity and surface tension of fish oil compared to medium-chain triglycerides, preparation of ME appeared difficult to achieve. However, a stable unloaded-ME with low fish oil content was formed, by adapting the emulsification process. The characteristics of unloaded fish oil ME were almost similar to those of medium-chain triglycerides ME. In contrast to medium-chain triglycerides ME, the introduction of insulin did not improve the elasticity and consequently the characteristics and stability of fish oil ME. Nevertheless, the insulin-loaded fish oil containing ME was shown to be stable for 6 weeks at 4 degrees C.

Emulsions↗
PubMed2003

Effects of baseline level of triglycerides on changes in lipid levels from combined fluvastatin + fibrate (bezafibrate, fenofibrate, or gemfibrozil).

This analysis was conducted to evaluate the effect of baseline triglyceride levels on lipid and lipoprotein changes after treatment with the combination of fluvastatin and fibrates. The analysis involved pooling data from 10 studies that included 1,018 patients with either mixed hyperlipidemia or primary hypercholesterolemia. Patients received a combination of fluvastatin and a fibrate (bezafibrate, fenofibrate, or gemfibrozil) from 16 to 108 weeks. The combination of fluvastatin and a fibrate improved lipid profiles, with reductions in triglycerides, low-density lipoprotein (LDL) cholesterol, and non-high-density lipoprotein (non-HDL) cholesterol that were dependent on baseline triglyceride levels. The greatest triglyceride reductions were observed in patients with high baseline triglyceride levels (> or =400 mg/dl) (41%, p <0.0001). The greatest LDL cholesterol and non-HDL cholesterol reductions occurred in patients with normal baseline triglyceride levels (<150 mg/dl) (35% and 33%, respectively; p <0.0001). The combined fluvastatin-fibrate therapy was well tolerated. Two patients (0.2%) (1 patient on fluvastatin 80 mg + gemfibrozil 1,200 mg and 1 patient on fluvastatin 20 mg + fenofibrate 200 mg) had creatine kinase levels > or =10 times the upper limit of normal, 11 patients (1.1%) had an elevation in alanine transaminase >3 times the upper limit of normal, and 7 patients (0.7%) had elevations in aspartate transaminase >3 times the upper limit of normal. Combined fluvastatin-fibrate therapy takes advantage of the complementary effects of the 2 agents, with the extent of triglyceride, LDL cholesterol, and non-HDL cholesterol lowering dependent on baseline triglyceride levels. The combination of fluvastatin and fibrates was well tolerated with no major safety concerns.

Age Factors↗
PubMed2000

High carbohydrate diets, triglyceride-rich lipoproteins, and coronary heart disease risk.

In this study we compared the effects of variations in dietary fat and carbohydrate (CHO) content on concentrations of triglyceride-rich lipoproteins in 8, healthy, nondiabetic volunteers. The diets contained, as a percentage of total calories, either 60% CHO, 25% fat, and 15% protein, or 40% CHO, 45% fat, and 15% protein. They were consumed in random order for 2 weeks, with a 2-week washout period in between. Measurements were obtained at the end of each dietary period of plasma triglyceride, cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, remnant lipoprotein (RLP) cholesterol, and RLP triglyceride concentrations, both after an overnight fast and throughout an 8-hour period (8 A.M. to 4 P.M.) in response to breakfast and lunch. The 60% CHO diet resulted in higher (mean +/- SEM) fasting plasma triglycerides (206 +/- 50 vs 113 +/- 19 mg/dl, p = 0.03), RLP cholesterol (15 +/- 6 vs 6 +/- 1 mg/dl, p = 0.005), RLP triglyceride (56 +/- 25 vs 16 +/- 3 mg/dl, p = 0.003), and lower HDL cholesterol (39 +/- 3 vs 44 +/- 3 mg/dl, p = 0.003) concentrations, without any change in LDL cholesterol concentration. Furthermore, the changes in plasma triglyceride, RLP cholesterol, and RLP triglyceride persisted throughout the day in response to breakfast and lunch. These results indicate that the effects of lowfat diets on lipoprotein metabolism are not limited to higher fasting plasma triglyceride and lower HDL cholesterol concentrations, but also include a persistent elevation in RLPs. Given the atherogenic potential of these changes in lipoprotein metabolism, it seems appropriate to question the wisdom of recommending that all Americans should replace dietary saturated fat with CHO.

Apolipoproteins↗