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At least 919 records · Page 51Linked to original sources
PubMed2004

Smoking prevents the intravascular remodeling of high-density lipoprotein particles: implications for reverse cholesterol transport.

Smoking is a leading cause of atherosclerosis acting trough a wide spectrum of mechanisms, notably the increase of the proatherogenic effect of dyslipidemia. However, a severe atherosclerotic disease is frequently observed in smokers who do not present an overt dyslipidemia. In the present study, we sought to determine if abnormalities in lipid metabolism occur in normolipidemic smokers, focusing especially on the components of intravascular remodeling of high-density lipoprotein (HDL) For this purpose, we measured lipid transfer proteins and enzymes involved in the reverse cholesterol transport (RCT) system in 29 adults: 15 smokers and 14 controls. The blood samples were drawn in the fasting state, immediately after the smokers smoked 1 cigarette. The composition of HDL particles was analyzed after isolation of HDL fractions by microultracentrifugation. We observed that normolipidemic smokers present higher total plasma and HDL phospholipids (PL) (P < .05), 30% lower postheparin hepatic lipase (HL) activity (P < .01), and 40% lower phospholipid transfer protein (PLTP) activity (P < .01), as compared with nonsmokers. The plasma cholesteryl ester transfer protein (CETP) mass was 17% higher in smokers as compared with controls (P < .05), but the endogenous CETP activity corrected for plasma triglycerides (TG) was in fact 57% lower in smokers than in controls (P < .01). Lipid transfer inhibitor protein activity was also similar in both groups. In conclusion, the habit of smoking induces a severe impairment of many steps of the RCT system even in the absence of overt dyslipidemia. Such an adverse effect might favor the atherogenicity of smoking.

Adult↗
PubMed2004

The value of a pilot study in breast-feeding research.

OBJECTIVE: To test the integrity of a protocol for a randomised controlled trial (RCT) to examine the effectiveness of skin-to-skin care compared to routine care on the initiation and duration of breast feeding and to provide data to be used in the power calculation for a proposed trial. DESIGN: Randomised pilot study. SETTING: Warrington Hospital, Cheshire, UK. PARTICIPANTS: Women at 36 weeks' gestation with healthy singleton pregnancies, who intended to breast feed, who had 'booked' for care at Warrington Hospital and had given informed consent to participate. Twenty-eight women were randomised in the pilot study. METHOD: Women were randomly allocated to receive either routine or skin-to-skin care following birth. The first breast feed was assessed using the Breast-feeding Assessment Tool (BAT). Mothers were followed up at discharge from hospital and again at four months to provide details of duration of breast feeding. FINDINGS: 66 women were approached to participate in the trial and 44 consented (67% consent rate). Twenty-eight women were randomised in the study and 26 breast feeds were observed (93%). The pilot study identified procedural changes that were required in the design of the main study, provided an estimate of recruitment rates and confirmed the previously calculated sample size. CONCLUSION: The pilot study demonstrated that a large RCT of skin-to-skin versus routine care was feasible. This is an example of how a pilot study has the ability to identify unforeseen challenges in the conduct of the trial as well as allowing necessary changes to be made to the design that will increase the quality of the subsequent research.

Adult↗
PubMed2005

Criteria to rationalize population screening to control oral cancer.

Screening populations for the early detection of asymptomatic malignancies and potential malignancies are intuitively attractive strategies to control or reduce the burden of oral cancer on society. Subsequent preventive and/or therapeutic measures must, however, be substantiated by prospective randomized controlled trials (RCT) to markedly improve patient outcomes to reconcile such usages of 'scarce' healthcare resources. This strategic objective is more likely to be achieved by adopting the precedent established by cardiology, where prevention is emphasized over the treatment of occult lesions. For example, the screening identification of individuals at high oral carcinogenic risk will offer potential educational opportunities to change their behaviors, and/or optimize the implementation of contemporary preventive and therapeutic measures for non-compliant individuals. The imperative to substantiate the effectiveness of the screening assays (tests) by prospective RCT also cannot be ignored to safeguard the public against potential false-negative or false-positive diagnoses.

Carcinoma, Squamous Cell↗
PubMed2006

Herbal medicines for the treatment of rhinosinusitis: a systematic review.

OBJECTIVES: To assess the efficacy of herbal medicines for treating rhinosinusitis. DATA SOURCE: Five electronic databases, bibliographies of located papers, manufacturers, and experts in the field. REVIEW METHODS: Inclusion of randomized clinical trials (RCT) testing any herbal medicine in rhinosinusitis, as sole or adjunctive treatment. Data were extracted independently by two reviewers following a predetermined protocol. RESULTS: Ten RCTs, testing six different herbal products against placebo (8 RCTs) or "no additional treatment" (2 RCTs) were included. Four RCTs tested Sinupret as adjunctive treatment for either acute (3 RCTs) or chronic (1 RCT) rhinosinusitis. The quality of these studies varied, but two in acute sinusitis, including the largest and best quality study, and one in chronic sinusitis reported significant positive findings. Three RCTs tested bromelain in either acute sinusitis (2 RCTs) or patients of mixed diagnosis (chronic and acute sinusitis), and all reported some positive findings. Metanalysis of the two RCTs in acute sinusitis suggested that adjunctive use of bromelain significantly improves some symptoms of acute rhinosinusitis. Single RCTs were identified for 4 other herbal products (Esberitox, Myrtol, Cineole, and Bi Yuan Shu) as treatments for sinusitis, all reported some positive results. The median methodological quality score was 3 of 5. CONCLUSION: Evidence that any herbal medicines are beneficial in the treatment of rhinosinusitis is limited, particularly in chronic rhinosinusitis. There is encouraging evidence that Sinupret and bromelain may be effective adjunctive treatments in acute rhinosinusitis. Positive results from isolated RCTs of four other herbal products require independent replication.

Clinical Trials as Topic↗
PubMed2005

Implementation and effectiveness of a primary care based physical activity counselling scheme.

The aim of the project was to reach inactive people through primary care offices and motivate them to become more active for health purposes. Physical activity questionnaires based on the transtheoretical model (TM) of behaviour change were handed out to every person entering one of five primary care offices. All inactive people were entered into a randomised controlled trial (RCT). Individuals assigned to the feedback group were given feedback from their physician concerning their physical activity level. In addition, the advice plus group received further advice and stage matched leaflets and was offered a 45-min counselling session. Changes in physical activity behaviour were measured 7 weeks as well as 14 months after the intervention. Physicians and patients alike reacted positively to the project. Ninety percent of patients entering the primary care offices were willing to participate. Ninety percent of inactive people agreed to be entered into the RCT. The follow-up rate in this trial was 82% at 14 months. At 7 weeks, 35% of patients in the feedback group were now classified as active and 38% of patients in the advice plus group. At 14 months, 47% of the subjects in both groups were active. Inactive people can be reached effectively through primary care offices. Patients receiving feedback from their physician concerning their physical activity level improved their behaviour to the same extent as patients who were given further advice and written materials, and were offered a counselling session.

Adolescent↗
PubMedDate not supplied

Intra-articular morphine 5 mg after knee arthroscopy does not produce significant pain relief when administered to patients with moderate to severe pain via an intra-articular catheter.

BACKGROUND AND OBJECTIVES: Intra-articular (IA) morphine for postoperative analgesia after knee arthroscopy is controversial. The IA catheter technique for test drug administration allows baseline pain assessment before inclusion. Results from one such randomized controlled trial (RCT) in patients with moderate to severe pain have shown equal effects of IA saline with or without morphine 2 mg. However, the IA catheter technique may have an unintended placebo effect. The aims of this placebo-controlled RCT were (1) to compare the analgesic effect of IA saline 1 mL (placebo) with morphine 5 mg given through an IA catheter and (2) to analyze the impact on pain of immediate or delayed removal of the IA catheter. METHODS: Sixty patients operated under general anesthesia had an IA catheter inserted at the end of arthroscopy. Patients who reported moderate or severe postoperative pain during the following hour were randomized to IA saline 1 mL (placebo) or IA morphine 5 mg and to immediate or delayed removal of IA catheter. RESULTS: Forty of 60 patients (67%) developed moderate to severe pain within 1 hour. In addition, 5 patients experienced intolerable pain and were excluded. Significantly more women (24/26) than men (26/39) reported at least moderate pain (P = .018) during the first hour after surgery. There were no differences between IA morphine 5 mg and placebo in pain intensity or pain relief at any time during the 48-hour observation period. There was no detectable effect on pain intensity of early compared with late removal of the IA catheter. CONCLUSIONS: IA morphine 5 mg does not produce clinically significant pain relief in patients with moderate or severe pain after knee arthroscopy.

Adult↗
PubMed2006

The burden of illness in perinatal and neonatal care: the epidemiologist's role.

Clinical research to improve outcomes of pregnancy and perinatal/neonatal care and to reduce the burden of illness is grounded in modern principles of evidence-based clinical practice. The central tool for creating convincing evidence is the randomised controlled trial (RCT). However, creating evidence is only one step to the overall goal of reducing the burden of illness. Once new evidence has been created by a RCT it must be synthesised with existing evidence, the evidence must be applied and disseminated into clinical practice, and the effect of the new evidence on the specific illness being targeted must be re-evaluated. Perinatal/neonatal epidemiologists require multiple skills to understand not only how to evaluate the burden of illness and to identify problems that might have solutions, but also how to create and synthesise evidence, apply it in practice and evaluate its clinical application, even though they need not be equally expert in all areas.

Cost of Illness↗
PubMed2005

Doctor-patient interaction in a randomised controlled trial of decision-support tools.

In this paper, we draw on the analytic perspectives of ethnomethodology to explore doctor-patient encounters in an experimental trial of a complex intervention: an efficacy randomised controlled trial (RCT) of decision-support tools in the UK. We show how the experimental context in which these encounters take place pervades the interactions within them. We argue that two interactional orders were at work in the encounters that we observed: (i) the ceremonial order of the consultation and (ii) the assemblage of the decision-support tool trial. We demonstrate how doctors in the trial oscillate between positions as authoritative clinician and neutralistic decision-support tool-implementer, and patients move between positions as passive recipients of clinical knowledge and as active subjects required to render their experience as calculable in terms of the demands of the decision-support tools and the broader trial they are embedded in. We demonstrate how the RCT coordinates the world of the clinical environment and the world of experimental evidence.

Decision Support Systems, Clinical↗
PubMed2005

Antithrombin replacement in neonates: is there any indication?

INTRODUCTION: Activation of the coagulation system and severe acquired antithrombin (AT) deficiency are common and prognostically important findings in sick and preterm neonates. It has been hypothesised that treatment of the acquired AT deficiency with AT concentrate may improve the outcome of conditions such as the neonatal respiratory distress syndrome (RDS), intracranial hemorrhage (ICH) and sepsis. MATERIALS AND METHODS: We performed a systematic review of randomised controlled trials (RCTs) of AT replacement therapy in newborn infants. RESULTS: Two full-length trial reports were found. Both were placebo-controlled. The first RCT examined the effects of AT therapy in 122 preterm infants with RDS. Administration of AT prolonged rather than shortened the duration of mechanical ventilation and oxygen therapy. The second RCT determined whether AT replacement decreased the incidence of ICH in 60 preterm infants who were born before 30 weeks of gestation. No beneficial effect on ICH was found. CONCLUSIONS: Preterm infants with RDS do not benefit from therapy with AT concentrate and may be harmed. There is also little evidence that the administration of AT reduces the risk of ICH. The role of AT replacement during neonatal sepsis remains uncertain.

Antithrombin III↗
PubMed1999

Trends in the use of pharmacotherapies for acute myocardial infarction among physicians who design and/or implement randomized trials versus physicians in routine clinical practice: the MILIS-TIMI experience. Multicenter Investigation on Limitation of Infarct Size. Thrombolysis in Myocardial Infarction.

BACKGROUND: Although studies have documented that randomized, controlled trials (RCTs) have a measurable influence on clinical practice, investigators have uncovered important deficiencies in the application of RCT findings to the management of acute myocardial infarction (AMI). Little is known about the extent to which physicians who design and/or implement clinical trials differ from physicians in routine practice in their translation of the literature. METHODS: Our aims were to (1) evaluate recent trends in selected treatments of AMI in relation to the publication of RCTs, statistical overviews, and task-force guidelines, and (2) compare prescribing practices in AMI management between physicians in routine clinical practice and physicians who design and/or implement RCTs. We reviewed the use of aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and calcium channel blockers on entry and at discharge in patients enrolled in the MILIS, TIMI 1, 2, 4, 5, 6, and 9B trials with ST-elevation (and depression in MILIS) myocardial infarction for a period approaching 2 decades (August 1978 to September 1995). We hypothesized that physicians who participate in RCTs apply the findings of the published literature more promptly and thoroughly than physicians in routine practice. RESULTS: Use of aspirin, beta-blockers, and angiotensin converting enzyme inhibitors exhibited a statistically significant time-related increase at discharge and, excepting beta-blockers, at enrollment across the trials. Prescription of calcium channel blockers showed a statistically significant decrease at discharge only. For all medications under study, increases and decreases in use associated with publication of clinical data occurred earlier and more steeply for the discharge cohort (prescriptions by physicians participating in RCTs) than for the enrollment cohort (prescriptions by physicians in routine practice). Recent prescribing practices (1994 to 1995) among RCT investigators and their colleagues have higher concordance with published findings than those of physicians in routine practice. CONCLUSIONS: Physicians who design and/or implement RCTs translate the results of the medical literature more promptly and to a greater extent than physicians in routine clinical practice. Differences between different physician classes need to be studied further amid efforts to reconfigure health care delivery that currently favor more dominant roles for primary care physicians.

Adrenergic beta-Antagonists↗
PubMed2004

Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid?

OBJECTIVE: To examine the test-retest reliability, validity, and responsiveness of several outcome measures in the treatment of patellofemoral pain. DESIGN: Evaluation of the clinimetric properties of individual outcome measures for patellofemoral pain treatment, using data collected from a previously published randomized controlled trial (RCT). SETTING: General community and private practice. PARTICIPANTS: The data from 71 persons enrolled in an RCT of a conservative intervention for patellofemoral pain were used to evaluate the measures' validity and responsiveness. A subset of this cohort (n=20) was used to assess reliability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Three 10-cm visual analog scales (VASs) for usual pain (VAS-U), worst pain (VAS-W), and pain on 6 aggravating activities (walking, running, squatting, sitting, ascending and descending stairs) (VAS-activity); the Functional Index Questionnaire (FIQ); the Anterior Knee Pain Scale (AKPS); and the global rating of change. RESULTS: The test-retest reliability ranged from poor (intraclass correlation coefficient [ICC]=.49) to good (ICC=.83), and the measures correlated moderately with each other (r range,.56-.72). Median change scores differed significantly between improved and unimproved persons for all measures. The effect sizes for VAS-U (.79), VAS-W (.88), and the AKPS (.98) were large, indicating greater responsiveness than the FIQ (.37) and VAS-activity (.66). Similarly, the AKPS and VAS-W were the most efficient measures for detecting a treatment effect when compared with a reference measure (VAS-U, which was assigned a value of 1). The minimal difference that patients or clinicians consider clinically important for the AKPS is 10 (out of 100) points and for the VAS it is 2cm (out of 10cm). CONCLUSIONS: The AKPS and VAS for usual or worst pain are reliable, valid, and responsive and are therefore recommended for future clinical trials or clinical practice in assessing treatment outcome in persons with patellofemoral pain.

Adolescent↗
PubMed1999

Pharmacological characterisation of amylin-related peptides activating subfornical organ neurones.

Amylin, calcitonin gene-related peptide (CGRP) and calcitonin are structurally related peptides with overlapping peripheral and central actions. Amylin and calcitonin excite the majority of neurones in the subfornical organ (SFO), where high densities of so-called C-type G-protein-coupled receptors have been detected. Subcutaneous injection of these hormones stimulates drinking similar to angiotensin II (ANGII), a dipsogen acting via the SFO. We now show that in addition to amylin and rat calcitonin (rCT), CGRP and salmon calcitonin (sCT) also excite SFO neurones. In extracellular recordings of an in vitro slice preparation of the SFO, 78% of all neurones (n=31) superfused with CGRP (10(-6) M) were excited. The excitatory effect was dose-dependent and reversible with an average threshold concentration of 5x10(-7) M, which is approximately 15-fold higher than reported for amylin-induced excitations. sCT (10(-7) M), which behaves as a non-competitive agonist at amylin as well as calcitonin receptors, caused irreversible excitatory responses in 96% of all recordings (n=26). Amylin-, CRGP- and rCT-induced excitations could be blocked by the selective amylin receptor antagonist AC187 (10(-5) to 10(-6) M), whereas sCT-induced excitations were not inhibited. The receptor antagonist human CGRP(8-37) (10(-6) M) partly caused agonistic responses, but did not block CGRP-induced excitations. The pharmacological profile observed in the present work, and in a recent publication using the same preparation, indicating (1) that CGRP is a weaker agonist in the SFO than amylin, (2) that sCT excites SFO neurones, and (3) that responses are blocked by AC187 but not by CGRP(8-37), is inconsistent with activation via CGRP receptors, but is instead consistent with involvement of amylin (C3) and calcitonin (C1) receptors, which are co-localized to a high degree on the same subset of SFO-neurones. We propose that it is unlikely that blood-borne CGRP has a significant effect on neurones in the SFO.

Amyloid↗
PubMed2002

Assessment of key elements to determine causation and risk factors in dentistry.

The best research method for assessing therapeutic modalities is the RCT. The prospective nature and the randomization of the subjects in an RCT provide the greatest opportunity to control bias and offer the most valid answer to the clinical question. Observational studies generate hypotheses about causation and should be viewed as a first step in the continuum of health care delivery. The preponderance of evidence will mount as the hypotheses are tested by additional prospective, longitudinal, observational trials. The clinician's involvement is to design and implement therapeutic strategies to alter the causal exposure, intervene in the dose-response gradient, and block the pathophysiologic mechanisms. Dentistry is an art and a science. Moving through the continuum from causation hypothesis to therapeutic intervention is the science of dentistry. It is the science of dentistry that will change the scope of the profession in this millennium.

Bias↗
PubMedDate not supplied

[Distinction, limits and complementarity between efficacy and effectiveness studies: new perspectives for psychotherapy research].

Perron et al. (2004) criticize the collective expertise conducted by the INSERM on the efficacy of different psychotherapy methods for different mental disorders. They say the work is biased in favour of Cognitive and Behavioral Therapies (CBT), while there is a negative bias regarding other methods, in particular psychodynamic therapies. Philippe Cialdella, a specialist of methodology and quantitative analysis in psychiatry, exposes an counter-argument in 10 points and brings welcome clarifications on the methodology and statistics. There is neither statistical bias in the INSERM report (which anyway is not a meta-analysis, but a literature analysis), nor in the first or second level studies on which it is based, mainly Randomised Controlled Trials (RCT). Though some arguments of P. Cialdella could be discussed in detail, his work comes to the conclusion that we can thus trust the results of the INSERM on one point: positive results can be obtained by psychotherapy with the experimental patients involved in the RCTs, and these findings are reliable. This is an important result in favour of psychotherapy, but it does not answer a very fundamental question: do we have reliable evidence that there is no systematic difference between the population constituted of patient-treatment-therapist (as a whole) found in RCTs, and the population constituted of patient-treatment-therapist (as a whole) in real contexts? A detailed analysis of what are efficacy studies and their methodology shows that this is not the case, and that it is hence not possible to generalize the results obtained by RCTs to clinical practice in real situations. Comorbidities and complex pathologies, choice of the therapist by the patient, interpersonal factors, conditions of use of manuals, contextual and social parameters, amongst other parameters make the real situation radically different from the RCT one, and the results impossible to generalize. Effectiveness studies in real situations do not solve the problem either. They have low internal validity, and though the population studied is close to a real one, too many uncontrolled parameters make the results unreliable. Moreover, outcome studies, whether they are efficacy or effectiveness studies, generally test a therapy "as a whole" versus another one, as defined in a manual, or by psychotherapy "trademarks". This design totally fails to offer a detailed view of what really happens during the therapy between the patient and the therapist, and it gives no possible insights into the change process elements. Only clinically highly representative quasi-experimental prospective studies can help us to understand change processes in real situations and incrementally improve treatment procedures. Daniel B. Fishman in the year 2000 made an ambitious and really interesting proposal about using pragmatic case studies in a systematic and scientific manner. Numerous reliable methodological tools, such as the Psychotherapy Process Q-Sort for example, as well as the tremendous innovations made in information and communication technologies make it possible today to implement such a proposal. It will enable us to really compare the resulting differences between the different approaches used in clinical settings, in relations with the type of intervention carried or in the real therapies, during clinically significant periods of time, and with various and ecologically valid samples. This is a possible solution to the difficult question of the use of outcome research to improve psychotherapy practice.

Cognitive Behavioral Therapy↗
PubMed1998

Effects of peroxynitrite on plasma components of the reverse cholesterol transport pathway.

Elimination of cholesterol from arterial tissue, crucial in limiting atherogenesis, may be achieved via high-density lipoprotein (HDL)-mediated reverse cholesterol transport (RCT); components of this pathway can be modulated by oxidative stress. Here we have examined the relations between cholesterol efflux, esterification and transfer in human plasma treated with the powerfully reactive nitrogen species, peroxynitrite. Cellular cholesterol efflux to whole plasma, or to peroxynitrite-modified HDL3, was relatively insensitive to peroxynitrite, as was the transfer of esterified cholesterol. However, plasma cholesterol esterification, via lecithin:cholesterol acyltransferase (LCAT), was markedly inhibited, both directly and indirectly, by peroxynitrite treatment, implying inefficient RCT follows HDL sequestration of cellular cholesterol.

Biological Transport↗
PubMed2001

Effect of atherogenic diet on reverse cholesterol transport in vivo in atherosclerosis susceptible (C57BL/6) and resistant (C3H) mice.

Mice susceptible (C57BL/6) or resistant (C3H) to atherosclerosis induced by a high cholesterol-cholate containing diet (A-diet) were used to study reverse cholesterol transport (RCT) in vivo as measured by loss of cholesterol from a depot created by injection of cationized LDL into the rectus femoris muscle. Plasma total and HDL-cholesterol (HDL-C), total and HDL phospholipid (HDL-PL) levels in chow fed C3H male and female mice were higher than in C57BL/6 mice. After one month on A-diet, plasma cholesterol more than doubled in both strains and genders. The decrease in HDL-C and HDL-PL was twice as great in C57BL/6 as in C3H female mice, while in male C3H mice there was no decrease. The loss of exogenous cholesterol mass (ECM) after injection of cationized LDL was more rapid in C3H than in C57BL/6 mice. In chow fed mice, ECM retained in muscle on day 12 was 37% in C57BL/6 and 20% in C3H females; in males it was 39% and 18% in C57BL/6 and C3H, respectively. On A-diet, 76% were retained in C57BL/6 and 28% in C3H females; these values were 59% and 28% in C57BL/6 and C3H males. Thus, the slow clearance of ECM (which represents RCT) in C57BL/6 mice on A-diet, that could be related to a marked decrease of HDL-PL, might contribute towards their susceptibility to atherosclerosis.

Animals↗
PubMed2001

Studies on the plasma lipid profiles, and LCAT and CETP activities according to hyperlipoproteinemia phenotypes (HLP).

Hyperlipoproteinemia phenotypes (HLP), one of genetic disorders with an estimated prevalence of 0.5-2% in the general population, is responsible for 10% of premature CHD. After first screening with the high cholesterol (>6.47 mM/l) and triglyceride (TG) (>2.6 mM/l) levels without medication, subjects were typed for HLP classification. Differential metabolic effects of HLP types on plasma lipid profiles and the reverse cholesterol transport system (RCT) were studied in 196 HLP types (91.2%) and 19 non-HLP (8.8%). A total of 45% of subjects had primary HLP and the others had NIDDM (10.7%), hypertension (9.3%) and other chronic diseases. Type IV HLP (58.6%) was most predominant and Types IIa, IIb, III and V comprised 16.7, 12.1, 2.3 and 1.4% of the HLP. Type I was not found. Plasma lipids excluding apo A-I and Lp(a) were significantly different among HLP compared to non-HLP (P<0.001). Since Type V and III impact the clearance of TG-riched lipoproteins, TG and VLDL-C levels were higher in V and III. TG and LDL-C were higher in Type II than those in the others because of defect of LDL receptors. LCAT activity, lower in Type III and Type IV and highest in Type V, was highly associated with plasma free cholesterol levels and the ratio of apoB/apoA and LDL/HDL. CETP activity was highest in Type V due to high VLDL-C and TG and low HDL-C. The ratio of LCAT/CETP was not different among HLP types but was significantly lower in HLP than in non-HLP. CETP increased 2-3 times as well as LCAT decreased among HLP patients compared to non-HLP. We conclude non-HLP subjects with high cholesterol and TG levels do not always mean high risk of CHD and the intervention effects of HLP types would lead to impose the risk of CHD by the impact of RCT.

Adult↗
PubMed2003

The effect of physical exercise on reverse cholesterol transport.

High-density lipoproteins (HDL) are recognized for their role in coronary artery disease (CAD) risk reduction. Plasma HDL plays a pivotal role in the reverse cholesterol transport (RCT) process. Physical exercise is well recognized as a modality that affects HDL metabolism. The purpose of this discussion is to describe the effects of physical exercise on RCT.

Apolipoprotein A-I↗