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Fasting increases serum total cholesterol, LDL cholesterol and apolipoprotein B in healthy, nonobese humans.

Voluntary fasting is practiced by many humans in an attempt to lose body weight. Conflicting results have been published on the effects of food deprivation on serum lipids. To study the effect of acute starvation on serum lipids, 10 nonobese (93-124% of ideal body weight), healthy adults (6 men, 4 women, 21-38 y old) fasted (no energy) for 7 d. Fasting increased total serum cholesterol from 4.90 +/- 0.23 to 6.73 +/- 0.41 mmol/L (37.3 +/- 5.0%; P < 0.0001) and LDL cholesterol from 2.95 +/- 0.21 to 4.90 +/- 0.36 mmol/L (66.1 +/- 6. 6%; P < 0.0001). Serum apolipoprotein B (apo B) increased from 0.84 +/- 0.06 to 1.37 +/- 0.11 g/L (65.0 +/- 9.2%; P < 0.0001). The increases in serum cholesterol, LDL and apo B were associated with weight loss. Fasting did not affect serum concentrations of triacylglycerol and HDL cholesterol. Serum concentrations of insulin-like growth factor-I (IGF-I) decreased from 246 +/- 29 (prefast) to 87 +/- 10 microg/L after 1 wk of fasting (P < 0.0001). We conclude that, in nonobese subjects, fasting is accompanied by increases in serum cholesterol, LDL and apo B concentrations, whereas IGF-I levels are decreased.

Adult↗

[Levels of cholesterol, HDL-cholesterol, LDL cholesterol and triglycerides in blood serum of children from Silesia].

In order to estimate the mean and borderline total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride levels, a group of 1151 children aged 7 to 15 years was examined. They were randomly chosen from elementary schools in Katowice, the capital city of Silesia. Significantly lower total cholesterol levels were found in 14-15 year old boys and girls than in children from the younger age groups. The highest borderline total cholesterol level was found in children aged 10 years. Older children had the lowest borderline HDL-cholesterol values. As the prevention of coronary disease should already start in childhood, it is necessary to assess the mean and borderline lipoprotein levels in school children. The present work, together with the previously published papers from different parts of Poland, may contribute to establishing normal values for our country.

Adolescent↗

[Small dense LDL concentration is closely associated with serum apolipoprotein B, comparisons of non-LDL cholesterol or LDL cholesterol].

Small dense low-density lipoprotein (sd LDL) is more atherogenic than large buoyant (lb) LDL, which is relatively high in particle number (as estimated by apolipoprotein [apo] B) and poor in cholesterol (C) content. Because recent epidemiological studies have shown that serum apo B is a stronger predictor of the risk of coronary heart disease (CHD) than LDL-C, we assumed that this strong predictive power of apo B for CHD is attributable to a close association with sd LDL concentration. On the other hand, non-HDL-C has been proposed as an integrated CHD risk marker containing all atherogenic apo B-containing lipoproteins. We examined which apo B or non-HDL-C is superior marker in reflecting sd-LDL particles. Eighty-one subjects with dyslipidemia were studied. Sd LDL (density, 1.044 approximately .063g/ml) and large buoyant LDL (density, 1.019 approximately 1.044g/ml) were separated by the ultracentrifugation method and LDL size was measured by gradient gel electrophoresis. LDL-C, non-HDL-C, and apo B were highly associated with each other(r=0.78 approximately 0.87), and all were associated with C, apo B, and TG in sd-LDL. However, multivariate regression analysis revealed that only apo B was constantly and independently associated with sd-LDL concentrations. Mean LDL diameter was negatively associated with apo B but not with non-HDL-C. These results suggest that apo B is superior to non-HDL-C in reflecting a potent atherogenic lipoprotein, sd-LDL, which may explain a potent predictive power of apo B for CHD.

Adult↗

[Total cholesterol, LDL-cholesterol and apoprotein B in umbilical cord blood: cross-sectional study].

The aim of the present study was to evaluate, in a large series of term newborns, the prevalence of hypercholesterolemia in cord blood, using as parameters, levels of plasma cholesterol, LDL-cholesterol and apo B higher than mean + 2 standard deviations, alone or in association. Data reported here represent the results of a transversal study. 1275 term newborns were studied. In everybody, in cord blood samples, at birth, cholesterol, triglycerides, HDL-cholesterol, apoprotein B and LDL-cholesterol have been assayed. In 3.13% of them (40 subjects), cholesterol levels > mean + 2 standard deviations were present. Moreover, only 6 subjects (0.47%) showed all three parameter levels higher than mean + 2 standard deviations, and 4 subjects (0.31%), in spite of normal cholesterol levels, presented high LDL-cholesterol and apo B levels. Integrated utilization of these parameters in the neonatal screening of familial hypercholesterolemia will have to be confirmed by follow-up studies.

Apolipoproteins B↗

A single daily dose of soybean phytosterols in ground beef decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men.

BACKGROUND: Consumption of phytosterol-supplemented margarine lowers total plasma cholesterol (TC) and LDL-cholesterol concentrations in older middle-aged hypercholesterolemic individuals. The effects of incorporating phytosterols into lower-fat foods on the plasma lipids of young men at increased risk of developing cardiovascular disease have not been studied. OBJECTIVE: We tested the hypothesis that a single daily dose of soybean phytosterols added to ground beef will lower plasma TC and LDL-cholesterol concentrations in mildly hypercholesterolemic young men. DESIGN: In a triple-blind, 4-wk study, 34 male college students with elevated plasma TC (5.85 +/- 0.70 mmol/L), LDL cholesterol (4.02 +/- 0.60 mmol/L), and TC:HDL cholesterol (5.5 +/- 1.2) were randomly assigned to the control (ground beef alone) or treatment (ground beef with 2.7 g of phytosterols) group. The phytosterol mixture was two-thirds esterified and one-third nonesterified and consisted of beta-sitosterol (48%), campesterol (27%), and stigmasterol (21%). RESULTS: Consumption of phytosterol-supplemented ground beef lowered plasma TC and LDL-cholesterol concentrations and TC:HDL cholesterol from baseline by 9.3%, 14.6%, and 9.1%, respectively (P < 0.001). The LDL particle size did not change, suggesting that the decrease was primarily of particle number. The decreases were similar in subjects with (n = 8) and without (n = 9) a family history of premature cardiovascular disease. No significant changes were found in the control group. CONCLUSION: Phytosterol-supplemented ground beef effectively lowers plasma TC and LDL cholesterol and has the potential to become a functional food to help reduce the risk of cardiovascular disease.

Adult↗

Omega-3 fatty acid intake results in a relationship between the fatty acid composition of LDL cholesterol ester and LDL cholesterol content in humans.

The relationship between the fatty acid composition of the low density lipoprotein (LDL) cholesterol ester and LDL cholesterol content was assessed in 26 free-living, normal subjects. Dietary intakes of 14:0, 16:0, 18:0, 18:1, 18:2omega6, 18:3omega3, 20:4omega6, 20:5omega3, 22:6omega3 were calculated from seven-day food records kept by each subject at baseline and after three months of supplementation with olive, flaxseed or fish oil, respectively. A randomized cross-over design was used. The fatty acid content of specific foods was calculated. Fasting blood samples, taken at the beginning and end of each supplementation period, were analyzed for the fatty acid content present in individual lipoproteins. There was a significant correlation between 20:5omega3 and 22:6omega3 intake and the content of these fatty acids in the LDL cholesterol ester fraction. During the fish oil treatment period the 16:0 and 18:0 content of the LDL cholesterol ester was highly predictive of LDL cholesterol content. This relationship was not observed during the baseline or placebo (olive oil) supplement period.

Adult↗

Percentile reference values of lipid risk factors of ischaemic heart disease: cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides in individuals aged 20 to 60 years in Plovdiv region.

1408 men and 1069 women aged 20 to 60 years selected at random from the Plovdiv region were studied during an epidemiological screening. Statistical analysis of the data was carried out using a SPSS/PC+ program. The percentiles (reference values and intervals) of the lipid risk factors were determined. The reference intervals and values at the 75th and 90th percentile for both sexes showed a prevalence of cholesterol, HDL-cholesterol and LDL-cholesterol for women, and of HDL-cholesterol at the 90th percentile for men below the age of 45 years. The derived percentile reference values for cholesterol, LDL-cholesterol and triglycerides are higher than the respective values for some European and American populations. A moderate and high lipid risk was identified for women over the age of 40-45 and in men in the age range 20-60 from all age groups. The established reference values for individuals of both sexes aged 20 to 60 years make it possible to diagnose and monitor dyslipidemias. They can be used for the purposes of the educational lipid program of the Plovdiv region population.

Adult↗

State of the art treatment of the most difficult low density lipoprotein (LDL) cholesterol problems: LDL apheresis.

The patient benefit from reduction of an excessively elevated low density lipoprotein (LDL) cholesterol is now well established, especially when there is proven coronary atherosclerosis. Dietary adherence can lower LDL cholesterol by a maximum of 10% to 15%. The addition of a cholesterol-lowering medication frequently can achieve a major LDL cholesterol reduction. However, a small group of patients with a very high LDL cholesterol respond poorly to diet and pharmaceutical treatments. These same patients have the highest incidence for very premature coronary atherosclerosis and associated cardiac events. A few medical centers, including the University of Kentucky, have established a new program to benefit these difficult high-risk patients. The technique is known as LDL apheresis, an effective process for removal of LDL cholesterol. The procedure is highly effective but very costly and third-party approval barriers are preventing access to this essential treatment for some very high-risk coronary atherosclerosis patients.

Humans↗

Cholesterol-rich LDL perfused at physiological LDL-cholesterol concentration induces platelet aggregation and PAF-acetylhydrolase activation.

The aim of this research was to perform an in vivo study on the relationships between lipid oxide (LP), platelet aggregation and PAF-acetylhydrolase in a model using perfusion of cholesterol-rich LDL media diluted to physiological LDL-cholesterol concentration. Normal rabbits were infused with LDL (d 1.025-1.063 g/ml) extracted from rabbits previously fed either with standard food (I-LDL group), 1% cholesterol food (II-LDL group) or 1% cholesterol plus probucol (IV-LDL group). CU2+ modified II-LDL was also infused (III-LDL group). After dilution as above, LP increased significantly in III- and II-LDL media. After perfusion, LP significantly increased in III- and II-LDL groups as compared to baseline values and to control. Compared to the I-LDL group, PAF-acetylhydrolase and platelet aggregation significantly increased in III- and II-LDL groups. These data indicate the property of cholesterol- rich LDL to activate PAF-acetylhydrolase and enhance platelet aggregation, even when perfused through a medium containing a physiological LDL-cholesterol concentration.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗

Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia.

The aim of this study was to investigate whether consumption of a newly developed oat milk deprived of insoluble fiber would result in lower serum cholesterol and low-density lipoprotein (LDL) cholesterol levels in men with moderate hypercholesterolemia. The study had a randomized, controlled double-blind design, and oat milk was compared with an identically flavored control drink. Sixty-six men were recruited from a screening program and were randomly assigned to two groups. Each group took either oat milk or a control drink (rice milk) for 5 weeks (0.75 liters/day) and then switched to the other drink regimen for another 5-week period with a 5-week washout period between the test periods. The oat milk contained more dietary fiber, especially beta-glucan (0.5 g/100 g), than the control drink (<0.02 g/100 g). Both drinks were well appreciated and got similar sensory evaluation, indicating that the double-blind design had been attained. In the final analysis 52 subjects remained. Compared with the control drink, intake of oat milk resulted in significantly lower serum total cholesterol (6%, p = 0.005) and LDL cholesterol (6%, p = 0.036) levels. The decrease in LDL cholesterol was more pronounced if the starting value was higher (r = -0.55, p < 0.001). The concentration of high-density lipoprotein cholesterol was not significantly different after consumption of the two drinks. Serum triglycerides did not change significantly after intake of oat milk, but a significant increase was observed after intake of the control drink (p = 0.003). It is concluded that also oat milk deprived of insoluble fiber has cholesterol-reducing properties.

Aged↗

Determination of LDL cholesterol and LDL apolipoprotein B following precipitation of VLDL in blood serum with phosphotungstic acid/MgCl2.

A method is described for the selective precipitation of VLDL in blood serum using phosphotungstic acid/MgCl2. The method allows for the calculation of LDL apolipoprotein B as well as for the calculation of LDL cholesterol (following the additional determination of HDL cholesterol). Dependent on the triglyceride and the cholesterol content of the serum, three different procedures were developed using phosphotungstic acid and MgCl2 in different concentrations in the precipitation assay. Within the tested range of 3-10 mmol/l total cholesterol and 1-4 mmol/l triglyceride in blood serum the VLDL were nearly completely precipitated with negligible coprecipitation of LDL and HDL, but 40-50% coprecipitation of Lp(a). Regression analysis of the cholesterol values obtained by precipitation with phosphotungstic acid/MgCl2 (= serum cholesterol - LDL cholesterol), and the cholesterol values obtained by ultracentrifugation (d greater than 1.006 kg/l) revealed a good measure of agreement (r = 0.97, y = 0.93 X + 0.35, n = 76). An equally good measure of agreement was found for the corresponding apolipoprotein B values (r = 0.96, y = 1.03 X - 0.2, n = 61). In the determination of LDL cholesterol a variation coefficient of 4.3% (n = 20) was found in relation to the precision in the series, and a variation coefficient of 4.8% (n = 25) in relation to day to day precision.

Apolipoproteins↗

Association of a leucine(7)-to-proline(7) polymorphism in the signal peptide of neuropeptide Y with high serum cholesterol and LDL cholesterol levels.

High serum levels of total and LDL cholesterol are important risk factors in the development of atherosclerotic coronary artery disease. Cholesterol metabolism is affected by nutritional, environmental and genetic factors. Neuropeptide Y (NPY), which is widely expressed in both the central and peripheral nervous systems, has an important role in the hypothalamic regulation of energy balance by stimulating food intake and favoring energy storage through increased lipoprotein lipase activity in white adipose tissue. As a part of ongoing study of the genetic basis of obesity, we screened the NPY gene for sequence variants. We report here the identification of a common Leu(7)-to-Pro(7) polymorphism in the signal peptide of NPY. Presence of this Pro(7) in NPY was associated with higher serum levels of total and LDL cholesterol in obese subjects participating in two independent Finnish and Dutch studies. Furthermore, normal-weight Finns with Pro(7) also had higher serum levels of total and LDL cholesterol than did subjects with Leu(7)/Leu(7), as analyzed in three subsequent determinations at 5-year intervals during a 10-year follow-up period. The NPY polymorphism was not associated with higher cholesterol levels in normal-weight Dutch. Our study provides evidence that NPY is linked to cholesterol metabolism and that the polymorphism producing Pro(7) in NPY is one of the strongest genetic factors identified thus far affecting serum cholesterol, particularly in obese subjects.

Adult↗

Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis.

We conducted a meta-analysis to determine the effect of consumption of psyllium-enriched cereal products on blood total cholesterol (TC), LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) levels and to estimate the magnitude of the effect among 404 adults with mild to moderate hypercholesterolemia (TC of 5.17-7.8 mmol/L) who consumed a low fat diet. Studies of psyllium cereals were identified by a computerized search of MEDLINE and Current Contents and by contacting United States-based food companies involved in psyllium research. Published and unpublished studies were reviewed by one author and considered eligible for inclusion in the meta-analysis if they were conducted in humans, were randomized, controlled experiments, and included a control group that ate cereal providing </=3 g soluble fiber/d. Eight published and four unpublished studies, conducted in four countries, met the criteria. Analysis of a linear model was performed, controlling for sex and age. Female subjects were divided into two groups to provide a rough estimate of the effect of menopausal status (premenopausal = <50 y, postmenopausal = >/=50 y) on blood lipids. The meta-analysis showed that subjects who consumed a psyllium cereal had lower TC and LDL-C concentrations [differences of 0.31 mmol/L (5%) and 0.35 mmol/L (9%), respectively] than subjects who ate a control cereal; HDL-C concentrations were unaffected in subjects eating psyllium cereal. There was no effect of sex, age or menopausal status on blood lipids. Results indicate that consuming a psyllium-enriched cereal as part of a low fat diet improves the blood lipid profile of hypercholesterolemic adults over that which can be achieved with a low fat diet alone.

Adult↗

Influence of bezafibrate and colestipol on LDL-cholesterol, LDL-apolipoprotein B and HDL-cholesterol in hyperlipoproteinaemia.

A significant increase of LDL-apolipoprotein B by 13% and LDL-cholesterol by 19% was observed in a group of 9 patients with hyperlipoproteinaemia Type III after bezafibrate treatment. Additional administration of colestipol caused a significant decrease of both LDL-apolipoprotein B by 18% and LDL-cholesterol by 25%. In 10 patients of hyperlipoproteinaemia Type IIb a significant decrease of both LDL-apolipoprotein B by 28% and LDL-apolipoprotein B by 18% was observed after bezafibrate therapy. When bezafibrate was given together with colestipol a further decrease of both LDL-cholesterol by 17% and LDL-apolipoprotein B by 16% occurred. HDL-cholesterol concentration increased significantly in both groups of hyperlipaemic patients during therapy. This may be the effect of both bezafibrate and colestipol. It is concluded that bile acid resins may effectively prevent the LDL-cholesterol concentration increase observed sometimes after clofibrate analogues.

Adult↗

Differential influence of LDL cholesterol and triglycerides on lipoprotein(a) concentrations in diabetic patients.

OBJECTIVE: To evaluate the relationship between plasma lipid profiles and lipoprotein(a) [Lp(a)] concentrations in diabetic patients, taking into account the Lp(a) phenotype. RESEARCH DESIGN AND METHODS: We included 191 consecutive diabetic outpatients (69 type 1 and 122 type 2 diabetic patients) in a cross-sectional study Serum Lp(a) was determined by enzyme-linked immunosorbent assay, and Lp(a) phenotypes were assessed by SDS-PAGE followed by immunoblotting. The statistical methods included a stepwise multiple regression analysis using the Lp(a) serum concentration as the dependent variable. The lipid profile consisted of total cholesterol, HDL cholesterol, LDL cholesterol, corrected LDL cholesterol, triglycerides, and apolipoproteins AI and B. RESULTS: In the multiple regression analysis, LDL cholesterol (positively) and triglycerides (negatively) were independently related to the Lp(a) concentration, and they explained the 6.6 and 7.8% of the Lp(a) variation, respectively. After correcting LDL cholesterol, the two variables explained 3.8 and 6.4% of the Lp(a) variation, respectively. In addition, we observed that serum Lp(a) concentrations were significantly lower in patients with type IV hyperlipidemia (mean 1.0 mg/dl [range 0.5-17], n = 16) than in normolipidemic patients (6.5 mg/dl [0.5-33.5], n = 117) and in type II hyperlipidemic patients (IIa 15.5 mg/dl [3.5-75], n = 13; IIb 9 mg/dl [1-80], n = 45); P < 0.001 by analysis of variance. CONCLUSIONS: Lp(a) concentrations were directly correlated with LDL cholesterol and negatively correlated with triglyceride levels in diabetic patients. Therefore, our results suggest that the treatment of diabetic dyslipemia may indirectly affect Lp(a) concentrations.

Adult↗

Relation of high TG-low HDL cholesterol and LDL cholesterol to the incidence of ischemic heart disease. An 8-year follow-up in the Copenhagen Male Study.

High triglyceride (TG) and low HDL cholesterol (HDL-C) is the characteristic dyslipidemia seen in insulin-resistant subjects. We examined the role of this dyslipidemia as a risk factor of ischemic heart disease (IHD) compared with that of high LDL cholesterol (LDL-C) in the Copenhagen Male Study. In total 2910 white men, aged 53 to 74 years, free of cardiovascular disease at baseline, were subdivided into four groups on the basis of fasting concentrations of serum TG, HDL-C, and LDL-C. "High TG-low HDL-C" was defined as belonging to both the highest third of TG and the lowest third of HDL-C; this group encompassed one fifth of the population. "High LDL-C" was defined as belonging to the highest fifth of LDL-C. A control group was defined as not belonging to either of these two groups. "Combined dyslipidemia" was defined as belonging to both dyslipidemic groups. Age-adjusted incidence of IHD during 8 years of follow-up was 11.4% in high TG-low HDL-C, 8.2% in high LDL-C, 6.6% in the control group, and 17.5% in combined dyslipidemia. Compared with the control group, relative risks of IHD (95% confidence interval), adjusted for potentially confounding factors or covariates (age, body mass index, alcohol consumption, physical activity, non-insulin-dependent diabetes, hypertension, smoking, and social class), were 1.5 (1.0-2.1), P < .05; 1.3 (0.9-2.0), P = .16; and 2.4 (1.5-4.0), P < .01, in the three dyslipidemic groups, respectively. In conclusion, the present results showed that high TG-low HDL-C, the characteristic dyslipidemia seen in insulin-resistant subjects, was at least as powerful a predictor of IHD as isolated high LDL-C. The results suggest that efforts to prevent IHD should include intervention against high TG-low HDL-C, and not just against hypercholesterolemia.

Adult↗

Levels of serum total cholesterol and LDL-cholesterol in patients with major depression in acute period and remission.

The aim of the study was to determine the level of total cholesterol and LDL-cholesterol in blood samples taken from 102 patients with recurrent major depression (according to DSM-IV). The analysis was performed during the acute period of major depression in 3 subgroups: with and without suicidal ideation (S+, S-), and after suicidal attempts (AS), and during remission of depressive symptoms. Putative correlations between the level of total cholesterol and severity of depressive symptoms and between total serum cholesterol and LDL-cholesterol and suicidal risk were evaluated. The patients did not suffer from any additional disorders, factors such as specific diet or pharmacotherapy, which could influence the levels of lipids, were absent. The subgroups were identified using clinical evaluation, medical records and Hamilton Depression Rating Scale--HAMD-S as well as a subscale of MMPI-DMS. Biochemical analyses were performed twice in all patients, in the acute period, before pharmacotherapy and after effective pharmacotherapy, in remission. The following parameters were evaluated: total serum cholesterol and LDL-cholesterol, T3, T4, TSH, ALT, AST, proteinogram. In all depressed patients with acute depression symptoms, low levels of total cholesterol and LDL-cholesterol were shown. The level of total cholesterol 160 mg/dl or less and the level of LDL-cholesterol 100 mg/dl or less were observed in persons with suicidal behavior only (S+ and AS). Low total cholesterol and LDL-cholesterol levels in persons in the acute period of major depression provided a useful parameter of suicide risk. A significant statistical correlation between the low level of total cholesterol and suicidal ideation was also found (r = 0.82, p < 0.05) as well as between the low level of serum total cholesterol and severity of depression, as evaluated by HAMD-S (r = 0.27, p < 0.05). During the remission of depressive symptoms, total cholesterol level and LDL-cholesterol increased significantly (p < 0.05) but a significant difference (p < 0.05) between subgroups (S-, S+, AS) were still observed. Low total cholesterol and LDL-cholesterol levels in remission in persons with the diagnosis of recurrent major depression may help to estimate the risk of suicidal behavior in the next depressive disorder. Possibly, low level of serum total cholesterol is a stable feature in some persons with recurrent major depression, probably dependent on their predisposition to autoaggression and presence of depressive disorder.

Blood Proteins↗