Hyperlipidemias: China

Liu ZL, Wu SX, Gao GD. · Guang'anmen Hospital, China Academy of TCM, Beijing 100053. · Zhongguo Zhong Xi Yi Jie He Za Zhi. · Pubmed #15074091 No free full text.

Abstract: 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.

Zhou JF, Wang JY, Luo YE, Chen HH. · Second Affiliated Hospital of College of Medicine, Brain Medicine Research Institute of Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China. · Biomed Environ Sci. · Pubmed #14631835 No free full text.

Abstract: OBJECTIVE: To investigate whether hypertension, abnormal lipometabolism, obesity, cigarette smoking and alcohol drinking affect the intracerebral hemorrhagic volumes (IHV) in patients with spontaneous intracerebral hemorrhage (SIHP), and to explore the roles of these factors in spontaneous intracerebral hemorrhage (SIH). METHODS: Five hundred patients with acute SIH and 200 healthy adult volunteers (HAV) were enrolled in a study of independently randomized controlled design, in which the levels of systolic pressure (SP) and diastolic pressure (DP), and total cholesterol (TCH), triacylglycerols (triglycerides, TG), high density lipoprotein cholesterol (HDL-CH), low density lipoprotein cholesterol (LDL-CH) in serum as well as the level of erythrocytic membrane cholesterol (EM-CH) were measured, and the body mass index (BMI), daily cigarette smoking consumption (DCSC) and daily pure alcohol consumption (DPAC) were calculated. RESULTS: Compared with the average parameters in the HAV group, those of SP, DP, TG, LDL-CH and BMI in the SIHP group were significantly increased (P < 0.0001), while those of HDL-CH and EM-CH were significantly decreased (P < 0.0001). The linear regression and correlation analysis showed that with increased SP, DP, LDL-CH, BMI, DCSC, DPAC and aging as well as decreased HDL-CH and EM-CH, the IHV levels in SIHP were increased gradually (P < 0.0001-0.01). The linear stepwise regression analysis suggested that there existed a close correlation among the values of SP, DP, TCH, TG, HDL-CH, LDL-CH, EM-CH, BMI, DCSC, DPAC, age and IHV of the SIH patients, and that Y = -12.4583 + 0.1127SP -1.1977EM-CH + 0.9788LDL-CH + 0.2477BMI + 0.0382DCSC + 0.0248DP, P < 0.0001 approximately 0.05. CONCLUSIONS: The findings in the present study suggest that significantly increased systolic and diastolic pressure, low density lipoprotein cholesterol, body mass index and daily cigarette smoking consumption, and significantly decreased erythrocytic membrane cholesterol may be likely the main factors affecting intracerebral hemorrhagic volumes in patients with acute spontaneous intracerebral hemorrhage.

Mao EQ, Tang YQ, Zhang SD. · Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. · World J Gastroenterol. · Pubmed #14606112 links to  free full text

Abstract: AIM: To investigate a formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis (HL-SAP). METHODS: Thirty-two consecutive patients with severe acute pancreatitis were included in the clinical trial. All of them met the following five criteria for admission to the study, namely the Atlanta classification and stratification system for the clinical diagnosis of SAP, APACHEII score more than 8, time interval for therapeutic intervention less than 72 hours after onset of the disease, serum triglyceride (TG) level 6.8 mmol/l or over, and exclusion of other etiologies. They were divided into severe acute pancreatitis group (SAP, 22 patients) and fulminant severe acute pancreatitis group (FSAP, 10 patients). Besides the conventional therapeutic measures, Penta-association therapy was also applied in the two groups, which consisted of blood purification (adsorption of triglyceride and hemofiltration), antihyperlipidemic agents (fluvastatin or lipanthyl), low molecular weight heparin (fragmin), insulin, topical application of Pixiao (a traditional Chinese medicine) over the whole abdomen. Serum triglyceride, pro-inflammatory cytokines and anti-inflammatory cytokines were determined before blood purification (PF), at the end of blood purification (AFE) and on the 7th day after onset of the disease (AF7) respectively. Simultaneously, severity of the diseases was assessed by the APACHE II system. Prognosis was evaluated by non-operation cure rate, absorption rate of pseudocyst, time interval pseudocyst absorption, hospital stay and survival rate. RESULTS: Serum triglyceride level (mmol/L), TNFalpha (U/ml) concentration and APACHE II score were significantly decreased (P<0.05) at AFE and AF7, as compared with PF. However, serum IL-10 concentration (pg/ml) was increased significantly (P<0.001) at AFE, and decreased significantly (P<0.05) at AF7 when compared with PF. Operations: The First surgical intervention time was 55.8+/-42.6 days in SAP group (5 patients) and 12.2+/-6.6 days in FSAP group (7 patients), there was a significant difference between the two groups (P=0.02). The number of operations in the two groups was 1.33+/-0.5 vs 3.5+/-1.2 (P=0.0037), respectively. Prognosis: Non-operation cure rate, absorption rate of pseudocyst, hospital stay and survival rate in SAP group and FSAP group were 100% (22/22) vs 11.1% (1/9), 77.3% (17/22) vs 11.1% (1/9), 54.2+/-35.9 vs 99.1+/-49.5 days (P=0.008) and 100%(22/22) vs 66.7% (6/9) (P=0.0044). The time for absorption of pseudocyst was 135.1+/-137.5 days in SAP group. CONCLUSION: Penta-association therapy is an effective guideline in the treatment of hyperlipidemic severe acute pancreatitis at its early stage (within 72 hours).

Li JJ, Chen MZ, Chen X, Fang CH. · Department of Cardiology, Renmin Hospital, Wuhan University School of Medicine, Wuhan, People's Republic of China. · Clin Cardiol. · Pubmed #14579918 No free full text.

Abstract: BACKGROUND: Rapid lowering of low-density lipoprotein (LDL) cholesterol levels as well as C-reactive protein (CRP) by administration of drugs may produce early benefit to the coronary endothelium in patients with coronary heart disease and reduce angina and coronary events after revascularization. Limited information has been available in evaluating a potentially effective first 2-week therapeutic approach for the treatment of patients with hypercholesterolemia using a statin. HYPOTHESIS: The study was undertaken to investigate whether a rapid LDL cholesterol and CRP reduction can be achieved by 2-week simvastatin therapy using a common lipid-lowering protocol in patients with hypercholesterolemia. METHODS: Forty-two patients were randomly assigned to 20 or 40 mg/day of simvastatin. Blood samples were drawn at Day 0 and at Day 14 for measuring lipid profile, CRP levels, and hepatic enzymes in all patients. RESULTS: The results showed that both doses of simvastatin (20 and 40 mg) induced significant reductions in total cholesterol (TC, 25 and 38%) and LDL cholesterol (31 and 46%) compared with baseline. However, the highest dose of simvastatin (40 mg) resulted in significantly greater reductions in TC and LDL cholesterol (p = 0.04, p = 0.02, respectively) compared with the group receiving 20 mg (p < 0.04, p < 0.02, respectively). A less significant reduction was observed in mean triglycerides (TG) level (16 and 25%) compared with TC and LDL cholesterol. There was no significant difference in mean high-density lipoprotein (HDL) cholesterol levels compared with baseline in either group. In addition, both doses of simvastatin induced significant reductions in mean CRP levels on Day 14 (22.3 and 23.1%) in a non dose-dependent manner (p < 0.001, respectively. CONCLUSIONS: Our data suggest that a common daily dose of simvastatin, especially 40 mg, is an effective 2-week therapy for patients with hypercholesterolemia, and benefit to the vascular endothelium can be derived quickly by reduction of CRP levels.

Zhu WL, Feng NP, Ma J, Wang Y, Ye GJ. · Department of Nutrition and Food Hygiene, Peking University, Beijing 100083, China. · Zhonghua Liu Xing Bing Xue Za Zhi. · Pubmed #14521771 No free full text.

Abstract: OBJECTIVE: To evaluate the effect of dietary intervention on lipidemia in school-aged children. METHODS: The levels of serum lipids profile were detected in 316 school children aged 7 - 11, from those the subjects of dietary intervention were selected by total cholesterol level above 4.26 mmol/L or low density lipoprotein cholesterol level above 2.23 mmol/L. The subjects were randomly divided into intervention group (120) and control group (40). Children in intervention group were fed with low-cholesterol and low-saturated fatty acid diet, and the control group with normal diet. The duration of intervention was three months. Before and after the intervention, the food intakes, health-related questionnaire and physical examination (height, weight, skinfolds thickness and so on) in the two groups were studied. RESULTS: Compared with the control group, serum cholesterol levels of children under intervention were not significantly changed (TC: 4.64 vs 4.68 mmol/L, P > 0.05; LDL-C: 2.66 vs 2.62 mmol/L, P > 0.05), but the apoA(1) level increased from 1,378.4 mg/L to 1,441.3 mg/L (P < 0.05). There were no changes for any serum lipids indexes in the control group while the dietary intakes of energy, cholesterol and SFA decreased markedly in the intervention group, with the percent of energy from fat decreased from 40.7% to 31.2% and SFA below to 10% (7.7%). Along with the increase of the scores of knowledge on health among children under intervention, the living and eating habit improved (the total scores increased from 24.6 to 27.4, P < 0.05). The increase of height was not significantly different between the two groups. CONCLUSION: With the family-based high-risk intervention strategy on the dietary adjustment, the knowledge on health, living and eating habit could be effectively improved in children with lipidemia. However, further research about the intervention effect on the serum cholesterol levels by strengthening the interventional degree, needs to be further studied.

Xiao Y, Zhang ZT, Wang JB, Zhu WL, Zhao Y, Yan SF, Li Y. · Department of Nutrition and Food Hygiene, Peking University Health Science Center, Beijing 100083, China. · Biomed Environ Sci. · Pubmed #12964783 No free full text.

Abstract: OBJECTIVE: To examine the effect of community-based dietary intervention on hyperlipidemia. METHODS: A total of 180 hyperlipidemia individuals with TG>2.26 mmol x L(-1) (200 mg x dL(-1)) and/or TC>5.72 mmol x L(-1) (220 mg x dL(-1)) were selected from 428 eligible subjects in eight communities of Beijing. They were randomly divided into intervention group (n=108) and control group (n=72). Dietary intervention was provided for the intervention group for 6 months. Information on dietary intakes, physical examinations and blood samples was collected. Serum lipids were assayed at baseline and endpoint of the study period. RESULTS: Respective decrease in dietary intake of total calories, fat, cholesterol and cooking oil by 13.62%, 24.75%, 24.40%, and 22.43%, in the intervention group was observed. The percentages of total calories from fat, carbohydrate and protein appeared to be desirable after study. Reduced body weight and BMI were also observed. There was a respective 5.61% and 7.06% decrease in total serum cholesterol and low-density lipoprotein cholesterol in the intervention group, while no significant changes were found in the control group. CONCLUSIONS: Community-based dietary intervention can effectively improve dietary patterns, control body weight, and decrease the levels of total serum cholesterol and low-density lipoprotein cholesterol.

Liu YH, Yang QD, Zhu WB, Wang WZ, Wu SP, Hong Z, Xu HW, Zhou YH, Huang MS. · Neurological Institute, Xiangya Hospital, Central Southern University, Changsha 410008, China. · Zhonghua Yu Fang Yi Xue Za Zhi. · Pubmed #12839661 No free full text.

Abstract: OBJECTIVE: To evaluate the effects of community intervention on risk factors of cerebrovascular disease. METHODS: With cluster sampling, 2,586 and 2,723 women and men aged 35 to 74 were selected randomly as intervention cohort and control cohort, respectively, from about 300 thousand community population in Beijing, Shanghai and Changsha, during 1997 to 2000. Their blood pressure, levels of blood lipid, body mass index (BMI) were measured and status of smoking and alcohol consumption were surveyed as indices of evaluation. Health education for smoking quit, alcohol consumption restriction and reinforced treatment for diabetic and hypertensive patients were implemented in the intervention communities. And, 2,544 and 2,533 persons in the two cohorts responded three years after intervention, and then all the indices mentioned above were measure again for them. RESULTS: Average reduction in systolic blood pressure by 3.21 mm Hg and serum level of total cholesterol by 0.58 mmol/L was achieved in intervention cohort after intervention, but with 0.48 mmol/L increase in triglyceride. Average blood levels of both high density lipoprotein-cholesterol (HDL-C) and glucose increased in the two cohorts after intervention, but with 0.30 mmol/L net increase of blood glucose in control cohort. There was no significant difference in average increase of HDL-C between the two cohorts. BMI increased by 0.56 in control cohort, and no significant change in intervention cohort. Proportion of smoking decreased by 5.4% in men and 2.4% in women of intervention cohort, and no change in control cohort. CONCLUSION: Level of risk factors for cerebrovascular disease reduced significantly with community intervention.

Li QL, Zhang YF. · Department of Cardiology, Affiliated Tongren Hospital, Capital Medical University, Beijing 100730. · Zhongguo Zhong Xi Yi Jie He Za Zhi. · Pubmed #12800412 No free full text.

Abstract: OBJECTIVE: To grasp the therapeutic effect of Taizhi'an (TZA) in lowering blood lipid level. METHODS: Three hundred patients with hyperlipidemia were randomly divided adopting numerical table method into 7 groups, the Taizhi'an group (A, n = 90), the half-dose Fenofibrate plus Taizhi'an group (B, n = 30), the full-dose Fenofibrate group (C, n = 30), the half-dose Simvastatin plus Taizhi'an group (D, n = 30), the full-dose Simvastatin group (E, n = 30), the Zhibituo group (F, n = 60) and the Xuezhikang group (G, n = 30). The effect in different groups were compared after 8 weeks treatment. RESULTS: In group A, the total cholesterol (TC) lowered by 12.7%, triglyceride (TG) lowered by 22.1% and the high density lipoprotein cholesterol (HDL-C) increased by 13.1%, the total effective rate being 82%. The therapeutic effect in group B was similar to that in group C, and that in group D was similar to that in group E (P > 0.05). The therapeutic effect of Taizhi'an was similar to that of Xuezhikang and Zhibituo, but was better than Zhibituo in lowering TG, LDL-C and increasing HDL-C, and better than Xuezhikang in lowering TG and increasing HDL-C (P < 0.05). CONCLUSION: When Taizhi'an used in combination with half-dose Simvastatin, it could not only enhance the blood lipid regulatory effect of Simvastatin but also reduce the dosage used and alleviate its adverse reaction. Compared with Xuezhikang and Zhibituo, Taizhi'an got the similar therapeutic effect, but was superior in regulating blood lipids.

Tong N, Ran X, Chen P, Li G, Tian H. · Department of Endocrinology, First Affiliated Hospital, WCUMS, Chengdu 610041, China. · Hua Xi Yi Ke Da Xue Xue Bao. · Pubmed #12733372 No free full text.

Abstract: OBJECTIVE: This clinical trial was designed to assess the lipids regulating effects of domestic simvastatin (DS, produced by Chengdu Huayu Pharmaceutical Co.) in patients with hyperlipidemia. METHODS: 160 hyperlipidemic patients were randomly divided into 3 groups (A, B and C). Groups A and B were subjected to single-blind trial; group C was for open trial. Group A took DS 10 mg q.n., group B Zocor 10 mg q.n. and group C DS 10 mg q.n. respectively for 8 weeks. All the patients were followed up at the 4th week and 8th week. 155 patients finished the trial with 59 cases in group A, 47 cases in group B and 39 cases in group C. RESULTS: At the 4th week, serum total cholesterol (TC) in group A, B and C decreased by 16.88%, 19.23% and 14.10%; serum triglycerides (TG) decreased by 19.27%, 15.66% and 17.96%; HDL-C increased by 7.69%, 7.46% and 6.69%; and LDL-C decreased by 23.02%, 27.84% and 24.43%, respectively; there was no significant difference among the three groups (P > 0.05). At the 8th week, serum TC in groups A, B and C decreased by 25.03%, 26.53% and 25.22%. TG decreased by 23.85%, 24.74% and 24.75%; HDL-C increased by 9.23%, 8.95% and 8.39%; and LDL-C decreased by 33.72%, 35.50% and 30.99%, respectively; still, no significant difference among the three groups was observed (P > 0.05). The incidence rates of side effects in the three groups were similar. The clinical effects were more significant at the 8th week than at the 4th week for Zocor and DS. CONCLUSION: These data suggest that DS is as effective and safe as Zocor in clinical use for lipids regulating serum.

Tan KC, Tso AW, Tam SC, Pang RW, Lam KS. · Department of Medicine, University of Hong Kong and Clinical Biochemistry Unit, Queen Mary Hospital, Hong Kong. · Diabet Med. · Pubmed #12421432 No free full text.

Abstract: AIMS: Post-prandial lipaemia is prolonged and exaggerated in patients with Type 2 diabetes mellitus, with an accumulation of atherogenic triglyceride-rich lipoprotein remnants. We postulate that orlistat, a gastrointestinal lipase inhibitor, may cause changes in post-prandial lipoprotein metabolism by reducing dietary triglyceride absorption. METHODS: The acute effect of a single dose of 120 mg orlistat on post-prandial glucose, lipids, remnant lipoproteins and free fatty acids (FFA) was evaluated in a randomized, double-blind, placebo-controlled cross-over study of 63 overweight patients with Type 2 diabetes mellitus (body mass index 30.4 +/- 3.8 kg/m2). Either a single dose of orlistat or placebo was given before a standard mixed meal containing 70 g of fat and plasma triglyceride (TG), remnant-like particles cholesterol (RLP-C) and FFA were sampled at 2-h intervals for 8 h. RLP-C was measured by an immunoseparation assay and FFA by an enzymatic colorimetric method. RESULTS: The concentrations of plasma TG (P < 0.0001), RLP-C (P = 0.003), and FFA (P < 0.0001) were significantly lower at 2 h after orlistat compared with placebo. Both plasma RLP-C (P = 0.04) and FFA (P < 0.0001) remained lower after orlistat than placebo at 4 h. The incremental area under the curve (iAUC) above baseline fasting level for both TG and RLP-C was significantly more reduced after orlistat than placebo (iAUC-TG 5.8 (3.7-8.2) mmol/l x h-1 vs. 5.7 (4.1-10.9), respectively, P = 0.04; iAUC-RLP-C: 0.53 (0.23-1.04) mmol/l x h-1 vs. 0.56 (0.35-1.40), respectively, P = 0.02). The test meal was well tolerated by all subjects, with only three subjects reporting faecal urgency after orlistat. CONCLUSIONS: Orlistat has a beneficial effect on post-prandial lipaemia in overweight Type 2 diabetic patients and lowers plasma TG, RLP-C and FFA in the early post-prandial period.

Ma L, Xu L, Yin S, Yang Y, Nie D, Li Z, Xie S, Feng J. · Sun Yat-Sen Memorial Hospital, Zhong Shan Medical University, Guangzhou 510120, China. · Zhonghua Xue Ye Xue Za Zhi. · Pubmed #11877018 No free full text.

Abstract: OBJECTIVE: To study in vitro and in vivo effect of hypercholesterolemia (HC) on expression of platelet CD(62P) and CD(41) and their changes after treatment with pravastatin. METHODS: Twenty patients with HC were given 10 - 20 mg/d pravastatin orally for 4 - 8 weeks. Changes of blood cholesterol and expression of platelet CD(62P) and CD(41) were detected by flow cytometry. RESULTS: After 4 and 8 weeks' treatment, blood cholesterol level and platelet aggregation function decreased. The expression of CD(62P) average fluorescence intensity decreased from 31.8 +/- 7.8 to 27.2 +/- 6.9 and 26.8 +/- 4.9; CD(62P) (%) from (31.3 +/- 9.3)% to (26.4 +/- 7.4)% and (25.3 +/- 9.1)% (P < 0.05); CD(41) from 483.2 +/- 263.9 to 348.1 +/- 192.4 and 306.8 +/- 128.0 (P < 0.05), respectively. Similar results were obtained in vitro study. CONCLUSION: Improvement of platelet function and expressions of CD(62P) and CD(41) in HC patients after prevastatin treatment may be resulted from enhancing arteriosclerosis regression. It suggested from the in vitro result that pravastatin might play a direct effect on platelet function.

Wang Z, Huang Y, Zou J, Cao K, Xu Y, Wu JM. · Department of cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjiang 210029, China. · Int J Mol Med. · Pubmed #11745001 No free full text.

Abstract: Low to moderate consumption of red wine reportedly has a relatively greater benefit than other alcoholic beverages in the prevention of atherosclerosis and coronary heart disease (CHD). This beneficial effect is increasingly attributed to the polyphenol resveratrol, present in red wine. In the present study, we investigated the effects of resveratrol and red wine on aggregation of platelets isolated from healthy, normotensive male volunteers and in rabbits with experimental hypercholesterolemia. Platelet aggregation rate (PAR) was measured using Born's method. The results showed that aggregation of platelets from healthy subjects induced in vitro by collagen (5 microg/ml), thrombin (0.33 units/ml), and ADP (4 microM) was significantly inhibited by 10-1000 microM resveratrol, in a concentration-dependent manner. Hypercholesterolemic rabbits showed enhanced ADP-induced platelet aggregation; the average PAR increased from 39.5+/-5.9% in normal animals to 61.0+/-7.0% in the high-cholesterol fed group (n=8, p<0.001). Resveratrol (4 mg/kg/day) inhibited ADP-induced platelet aggregation in vivo by maintaining the PAR at 35.7+/-6.3% (vs. 39.5+/-5.9% for control rabbits, n=8, p=0.228), but had no effect on serum lipid levels. Similarly platelet aggregation in hypercholesterolemic rabbits was also inhibited when animals received intragastrically Chinese red wine (with or without alcohol, 4 ml/kg/day). These results suggest that resveratrol can inhibit platelet aggregation both in vitro and in vivo, which conceivably could be one of the mechanisms by which this red wine polyphenol exerts its cardioprotective effects.

Chan MH, Mak TW, Chiu RW, Chow CC, Chan IH, Lam CW. · Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong. · J Clin Endocrinol Metab. · Pubmed #11549708 links to  free full text

Abstract: Animal studies, experimental models on cell lines, and epidemiological case-control studies have all suggested the possibility that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors have a beneficial effect on bone metabolism. However, all epidemiological studies are not prospective in nature and based on either measurement of bone mineral density or fracture risk. They also differ in recruitment criteria, definition of statin exposure, and outcome assessment. We performed a first prospective study using specific biochemical bone markers on 17 hypercholesterolaemic non-osteoporotic subjects treated with a therapeutic dose of simvastatin 20 mg daily for 4 weeks. Our results show that serum osteocalcin concentration increased significantly (p-value < 0.05) 4 weeks after therapy, whereas other bone markers including serum bone-specific alkaline phosphatase activity, urine deoxypyridinoline, and urine cross-linked N-telopeptides of type I collagen did not show any significant changes. Our data support that simvastatin causes a beneficial effect on bone metabolism as reflected by an increase in serum osteocalcin concentration. This added beneficial effect of statins on bone metabolism could potentially allow statins to become the first effective anabolic agent for the treatment of osteoporosis. We urge that priority should be given to a randomised controlled study to re-evaluate this group of drugs.

Chan JC, Ko GT, Leung DH, Cheung RC, Cheung MY, So WY, Swaminathan R, Nicholls MG, Critchley JA, Cockram CS. · Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong. · Kidney Int. · Pubmed #10652036 links to  free full text

Abstract: Long-term effects of angiotensin-converting enzyme inhibition and metabolic control in hypertensive type 2 diabetic patients. BACKGROUND: In hypertensive type 2 diabetic patients, treatment with angiotensin-converting enzyme (ACE) inhibitors is associated with a lower incidence of cardiovascular events than those treated with calcium channel-blocking agents. However, the long-term renal effects of ACE inhibitors in these patients remain inconclusive. In 1989, we commenced a placebo-controlled, double-blind, randomized study to examine the anti-albuminuric effects of enalapril versus nifedipine (slow release) in 102 hypertensive, type 2 diabetic patients. These patients have been followed up for a mean trial duration of 5.5 +/- 2.2 years. We examined the determinants, including the effect of ACE inhibition on clinical outcomes in these patients. METHODS: After a six-week placebo-controlled, run-in period, 52 patients were randomized double-blind to receive nifedipine (slow release) and 50 patients to receive enalapril. After the one-year analysis, which confirmed the superior anti-albuminuric effects of enalapril (-54%) over nifedipine (+11%), all patients were continued on their previously assigned treatment with informed consent. They were subdivided into normoalbuminuric (N = 43), microalbuminuric (N = 34), and macroalbuminuric (N = 25) groups based on two of three 24-hour urinary albumin excretion (UAE) measurements during the run-in period. Renal function was shown by the 24-hour UAE, creatinine clearance (CCr), and the regression coefficient of the yearly plasma creatinine reciprocal (beta-1/Cr). Clinical endpoints were defined as death, cardiovascular events, and/or renal events (need for renal replacement therapy or doubling of baseline plasma creatinine). RESULTS: In the whole group, patients treated with enalapril were more likely to revert to being normoalbuminuric (23.8 vs. 15.4%), and fewer of them developed macroalbuminuria (19.1 vs. 30.8%) compared with the nifedipine-treated patients (P < 0.05). In the microalbuminuric group, treatment with enalapril (N = 21) was associated with a 13.0% (P < 0.01) reduction in 24-hour UAE compared with a 17.3% increase in the nifedipine group (N = 13). In the macroalbuminuric patients, enalapril treatment (N = 11) was associated with stabilization compared with a decline in renal function in the nifedipine group, as shown by the beta-1/Cr (0.65 +/- 4.29 vs. -1.93 +/- 2.35 1/micromol x 10-3, P < 0.05) after adjustment for baseline values. Compared with the normoalbuminuric and microalbuminuric patients, those with macroalbuminuria had the lowest mean CCr (75.5 +/- 24.1 vs. 63.5 +/- 21.3 vs. 41.9 +/- 18.5 mL/min, P < 0.001) and the highest frequency of clinical events (4.7 vs. 5.9 vs. 52%, P < 0. 001). On multivariate analysis, beta-1/Cr (R2 = 0.195, P < 0.001) was independently associated with baseline HbA1c (beta = -0.285, P = 0.004), whereas clinical outcomes (R2 = 0.176, P < 0.001) were independently related to the mean low-density lipoprotein cholesterol (beta = 2.426, P = 0.018), high-density lipoprotein cholesterol (beta = -8.797, P = 0.03), baseline UAE (beta = 0.002, P = 0.04), and mean CCr during treatment (beta = -0.211, P = 0.006). CONCLUSION: In this prospective cohort analysis involving 102 hypertensive, type 2 diabetic patients with varying degrees of albuminuria followed up for a mean duration of five years, we observed the importance of good metabolic and blood pressure control on the progression of albuminuria and renal function. Treatment with enalapril was associated with a greater reduction in albuminuria than with nifedipine in the entire patient group, and especially in those with microalbuminuria. In the macroalbuminuric patients, the rate of deterioration in renal function was also attenuated by treatment with enalapril.

Tan KC, Janus ED, Lam KS. · Department of Medicine, University of Hong Kong, Queen Mary Hospital, China. · Am J Cardiol. · Pubmed #10532516 No free full text.

Abstract: The effects of fluvastatin therapy on parameters of coagulation and fibrinolysis were evaluated in patients with diabetic dyslipidemia in a randomized, placebo-controlled study. Fluvastatin therapy was associated with a small reduction in factor VII coagulant activity, von Willebrand factor, and in plasminogen activator inhibitor 1 and tissue plasminogen activator antigens, but the effects of fluvastatin on hemostatic factors were much less marked than its effects on plasma lipids.

Xie JP, Liu GL, Qiao JL, Gu Q, Gai YN, Huang SF, Gao AA, Zhou Y, Li XH, Wang CY, Liu RQ, Jia JJ. · Acupuncture College of Beijing University of CM, Beijing 100029, China. · Zhongguo Zhen Jiu. · Pubmed #19489487 No free full text.

Abstract: OBJECTIVE: To investigate the clinical effects of electroacupuncture (EA) at Fenglong (ST 40) on blood lipids. METHODS: Two hundred and four patients of hyperlipidemia were randomly divided into a Fenglong group and a Xuezhikang group, 102 cases in each group. The patients in the Fenglong group were treated with electroacupuncture at Fenglong (ST 40). After arrival of qi, the needles were connected with acupoint nerve stimulator (LH 202 H type, HANS). The primary parameters of EA: for high triglycerides (TG) type, AM 50 Hz, intensity 1 mA, needle-retained time 20 min, twice per week; for high cholesterol (CHO) type, AM 100 Hz, intensity 1 mA, needle-retained time 30 min, thrice per week; for high low-density-lipoprotein (LDL-C) type, the same parameters as the high CHO type except the tolerable and comfortable intensity; for the mixing type, corresponding methods were alternatively used. The patients in the Xuezhikang group received Xuezhikang capsule orally, 2 capsules each time and twice daily, for total 11 weeks. RESULTS: The total effective rates of the Fenglong group and the Xuezhi-kang group were 83.0% and 85.9%, respectively, with no significant difference between the two groups (P > 0.05), and there was no significant differences in the function of regulating blood lipids between the two groups (all P > 0.05). After one month follow-up survey, the total CHO, TG and LDL-C decreased and high-density-lipoprotein (HDL-C) increased, of which there was a significant difference in TG reduction (P < 0.05). There were no relapses in both groups. CONCLUSION: EA at Fenglong (ST 40) can effectively regulate blood lipids with a better after-effect, which can be applied as a safe and effective method to replace medication for regulating blood lipids.

Xian X, Ding Y, Zhang L, Wang Y, McNutt MA, Ross C, Hayden MR, Deng X, Liu G. · Institute of Cardiovascular Sciences and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China. · Biochem Biophys Res Commun. · Pubmed #19481534 No free full text.

Abstract: Enhanced susceptibility to atherosclerosis from severe hypertriglyceridemia (HTG) resulting from lipoprotein lipase (LPL) deficiency has been demonstrated in our recent findings which employed a unique mouse model. In the present study we provide further evidence that severe HTG due to LPL deficiency also promotes an atherothrombotic response to arterial injury induced by ferric chloride in a severe combined hyperlipidemic mouse model. Methods and results: A mouse model (LPL(-/-)XApoE(-/-) double knockout, DKO) with severe combined hyperlipidemia was established by crossing ApoE and LPL-deficient mice. The common carotid arteries of ApoE knockout (EKO) and DKO mice were subjected to injury by ferric chloride, and the formation of arterial thrombosis together with various markers were compared in these lesions. DKO mice demonstrated significantly enhanced thrombus formation overlying atherosclerotic plaque after injury, which contained smooth muscle cells, macrophages, and neutral lipid. The area of neointima, mean intima/media ratios, and the percentage of luminal stenosis were significantly greater (P<0.01) in DKO mice. Compared with EKO mice, the expression of von Willebrand factor (vWF) and plasminogen activator inhibitor type 1 (PAI-1) were increased in DKO mice. Conclusions: Severe combined hyperlipidemia promotes thrombosis after ferric chloride injury to atherosclerotic vessels and HTG plays a major role in the process.

Li SG. · Chinese People's Liberation Army General Hospital, Beijing 100853, China. · N Engl J Med. · Pubmed #19403906 No free full text.

This publication has no abstract.

Xie W, Sun C, Liu S. · College of Animal Sciences and Technology, Northwest A&F University, YangLing, ShanXi 712100, China. · Zhongguo Zhong Yao Za Zhi. · Pubmed #19385191 No free full text.

Abstract: OBJECTIVE: In order to investigate the possible mechanism of its function to degrade lipid, we detect the effects of hawthorn flavanone to the influence on blood-fat levels and adipogenesis genes transcription expression in fat and muscle tissue of hyperlipoidemia mouse. METHOD: In this experiment, a total of 48 mouse were randomised to four groups and irrigated with two different concentrations (1.5 g kg(-1) body weight and 3.0 g kg(-1) body weight) of hawthorn flavanone, and killed in 0 h, 1 h, 2 h and 4 h. To estimate the content of TC, TG and HCL-C in blood: Total RNA was isolated from adipose and muscle, Real-time RT-PCR was used to analyze expression changes of adipogenesis genes (SREBP-1c, FAS, HSL and TGH) with time series; to analyze the correlation between TG in blood and some kinds of adipogenesis genes and the ratio of FAS/HARMEAN (HSL, TGH) mRNA in adipose. RESULT: Hawthorn flavanone was able to cut down the level ofTC, TG and HDL significantly in blood and achieved the lowest level at 1 h. In adipose tissue, hawthorn flavanone up-regulated FAS, HSL and TGH, and achieved the level of significance (P<0.05), the expression level of FAS and TGH was ascend after 1 h, but HSL descend. The expression level of SREBP-1c was descend rapidly and achieved the level of significance after treating with hawthorn flavanone at 1 h (P<0.05), after that it rise again to even higher than the level of before treatment. After treating with hawthorn flavanone, the ratio of FAS/HARMEAN (HSL, TGH) in adipose was significantly descend and achieved the lowest level at 1 h (P<0.01), but it was descendsubsequently. In muscle tissue, hawthorn flavanone was able to significantly up-regulated the expression of FAS and HSL and lower dose group showed greater increasing, the change of SREBP-1c was similar in adipose tissue except the more heavily upgrade. CONCLUSION: Hawthorn flavanone had the function of depressing the concentration of blood-fat, it co-adjusted lipid metabolism of animal by regulating the transcription expression of FAS, HSL, TGH and SREBP-1c especially HSL and SREBP-1c transcription level.

Xu L, Liu Y, Wang T, Qi Y, Han X, Xu Y, Peng J, Tang X. · College of Pharmacy, Dalian Medical University, 9 Western Lvshun South Road, Dalian 116044, China. · J Chromatogr B Analyt Technol Biomed Life Sci. · Pubmed #19372064 No free full text.

Abstract: A sensitive and specific electrospray ionization liquid chromatography-tandem mass spectrometry method was developed to detect diosgenin in the plasma of normal and hyperlipidemic rats. Diosgenin was extracted with n-hexane-ethyl acetate (9:1, v/v) using sarsasapogenin as an internal standard. With multiple reaction monitoring modes, linear calibration curves were obtained in the range 10-1500 ng/mL (r>or=0.9979) and the limit of quantification was 10 ng/mL. Intra- and inter-assay variabilities were within 7.74%, and accuracies were between -5.33% and 1.50%. The assay was successfully applied to study pharmacokinetics in rats after oral administration of diosgenin. Significantly different pharmacokinetics between normal and hyperlipidemic rats were observed, which would be beneficial for the clinical use of diosgenin.

Wang C, Li Y, Zhu K, Dong YM, Sun CH. · Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, P. R. China. · Asia Pac J Clin Nutr. · Pubmed #19329405 No free full text.

Abstract: OBJECTIVE: To investigate the effect of supplementation with multivitamin and mineral on blood pressure and C-reactive protein (CRP) in obese women with increased cardiovascular disease risk as having hypertension, hyperglycemia or hyperlipemia. SUBJECTS AND METHODS: 128 obese Chinese women aged 18-55 years with increased cardiovascular disease risk participated in a 26-week randomized, double-blind, placebo-controlled trial. Subjects were randomized to four groups, and received either one tablet of high-dose multivitamin and mineral supplement (MMS), or one tablet of low-dose MMS (Low MMS), or calcium 162 mg (Calcium) or identical placebo (Placebo) daily during the study. Diastolic blood pressure (DBP), systolic blood pressure (SBP) and serum concentrations of CRP were measured at baseline and end-trial. RESULTS: At baseline, the subjects had an average age of 42.0+/-7.1 years and BMI of 30.9+/-2.8 kg/m2. There were no significant differences between the four groups in baseline characteristics. One hundred and seventeen subjects completed the study. After 26-week supplementation, both SBP and DBP were significantly lower in the MMS group compared to the placebo group (p < 0.05). There was also a non-significant trend of lower DBP at 26-week in the MMS and calcium groups compared to baseline (p < 0.08). At 26-week, the MMS group also had significantly lower serum concentrations of CRP compared with that of baseline and the placebo group (p < 0.05). CONCLUSIONS: Our results showed that supplementation with adequate multivitamin and mineral supplement could reduce blood pressure and serum CRP in obese women with increased cardiovascular disease risk.

Wang Z, Huang Z, Lu G, Lin L, Ferrari M. · Dept. of Cardiology, Second Affiliated Hospital of Fujian Medical Univ., Zhongshan North Road 34, 362000 Quanzhou, Fujian, P. R. China. · Am J Physiol Heart Circ Physiol. · Pubmed #19304947 No free full text.

Abstract: Exposure to an adverse intrauterine environment increases the risk of cardiovascular disease later in adult life. However, the time course relationship between prenatal hypoxia and the onset of atherosclerosis in offspring remains unknown. The purpose of this study is to evaluate the role of reduced fetal oxygen supply on early development of atherogenesis in the adult offspring and further assess its susceptibility to sex-, hyperlipidemia-, and postnatal hypoxemia-related differences. Based on a 4 x 2 full factorial design consisting of four factors of maternal hypoxia, sex, hyperlipidemia, and postnatal hypoxemia, characteristics of growth were determined, and histopathological observation and morphometric analysis of the thoracic aortas were performed in Sprague-Dawley rat offspring. Intrauterine growth restriction, altered body shape at birth, and accelerated postnatal weight gain occurred in the maternal hypoxia group but did not occur in the control group. In 16-mo-old maternal hypoxia offspring, the thoracic aortas exhibited lesions similar to early events in atherosclerosis that involved impaired endothelial cells, thickening and fibration of intimas, infiltration of inflammatory cells to the subendothelial space, and migration and proliferation of vascular smooth muscle cells to the intima. In contrast, no detectable pathological changes were observed in the offspring without maternal hypoxia exposure. Morphometric analysis further demonstrated that prenatal hypoxia caused a significant thickening of intima (P < 0.001) with a main effect of 5.5 mum, an approximately twofold increase compared with controls. In addition, there was a positive additive relationship between prenatal hypoxia and hyperlipidemia on the intimal thickness (P < 0.05). There were no other main effects or interaction among these four factors. In summary, our results indicate that maternal hypoxia during pregnancy leads to early pathological appearances of atherogenesis in adult offspring. This effect was enhanced with hyperlipemia but was unaffected by postnatal hypoxia or sex.

Ma HF, Ren XJ, Tu Y, Lin CX. · School of Acu-moxibustion, Beijing University of Chinese Medicine, Beijing 100029, China. · Zhen Ci Yan Jiu. · Pubmed #19288898 No free full text.

Abstract: OBJECTIVE: To observe the effect of electroacupuncture (EA) on hippocampal apoptosis protein caspase-9 expression and neuroethology in hyperlipemia plus cerebral ischemia (HL-CI) rats. METHODS: Seventy male SD rats were randomized into control, hyperlipemia (HL), CI, HL-CI, CI + EA, HL-CI + EA I , and HL-CI + EA II groups, with 10 cases in each. HL model was established by feeding the animals with high fat forage for 6 weeks and CI model was established by occlusion of the unilateral middle cerebral artery. EA (1-3 mA, 15 Hz) was applied to bilateral "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) for 20 min every time; and "Baihui" (GV 20) and "Shuigou" (GV 26) were punctured and stimulated by twirling the acupuncture needle with hand continuously for 1 min. Acupuncture was given once daily for 17 days (beginning from the 10th day on before CI) in HL-CI + EA I group, and for 7 days (beginning after CI) in HL-CI + EA II group. The expression of hippocampal Caspase-9 was detected with immunohistochemistry. The score of neuroethology was also measured according to modified Bederson's method. RESULTS: In comparison with normal control and hyperlipemia model groups, Caspase-9 immune reaction (IR) positive cells in the hippocampus in HL-CI group increased significantly (P<0.01). After acupuncture Caspase-9 IR-positive cells decreased remarkably. In comparison with group HL-CI + EA II, Caspase-9 IR-positive cells decreased significantly in HL-CI + EA I (P<0.01). The score of neuroethology also degraded obviously. CONCLUSION: Acupuncture can improve neuroethology symptom, lessen over expression of hippocampal Caspase-9, and prevent CI injury in hyperlipemia rats with concurrent CI.

Huang L, Song XM, Zhu WL, Li Y. · Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100083, China. · Biomed Environ Sci. · Pubmed #19263808 No free full text.

Abstract: OBJECTIVE: To examine the relationship between occurrence of hyperlipidemia, plasma homocysteine and polymorphisms of methylenetetra hydrofolate reductase (MTHFR) gene and methionine synthase (MS) gene. METHODS: A total of 192 hyperlipidemia patients were selected and divided into hypercholesterolemia group, hypertriglyceridemia group, and combined hyperlipidemia group. Another 208 normal individuals were selected as control. Total plasma homocysteine (tHcy) concentration was measured by high-performance liquid chromatography (HPLC). Lipid profiles were measured for all subjects. The polymorphisms of MTHFR gene C677T and MS gene A2756G were analyzed by PCR-RFLP. RESULTS: The tHcy concentration in the combined hyperlipidemia patients was significantly higher than that in the control (15.95 micromol/L vs 13.43 micromol/L, P < 0.05). The prevalence of hyperhomocysteinemia (HHcy) in the combined hyperlipidemia group was significantly higher than that in the control (42.2% vs. 23.0%, P = 0.015), with the odds ratio (OR) of 3.339 (95% CI: 1.260-8.849). The hyperlipidemia patients with HHcy had a higher concentration of total cholesterol (TC) than that in the normal tHcy patients (5.67 +/- 0.95 mmol/L vs. 5.47 +/- 0.92 mmol/L, P=0.034). There was no significant difference in genotype or allele frequencies of MTHFR C677T between the hyperlipidemic and control groups. The hyperlipidemia patients with MTHFR CT/TT genotype had a higher concentration of triglyceride (TG) than those with CC genotype (2.24 +/- 1.75 mmol/L vs 1.87 +/- 0.95 mmol/L, P < 0.05). Individuals with CT/TT genotype had a higher concentration of tHcy than those with 677CC genotype both in the hyperlipidemia group (12.61 +/- 1.24 micromol/L vs. 11.20 +/- 1.37 micromol/L, P < 0.05) and in the control group (14.04 +/- 1.48 micromol/L vs. 12.61 +/- 1.24 micromol/L, P < 0.05). The percentage of MS 2756 GG/AG genotype in the combined hyperlipidemia group was significantly higher than that in the control (26.7% vs. 13.0%, P = 0.012), with the OR of 3.121 (95% CI: 1.288-7.651). The hyperlipidemia patients with MS 2756AG/GG genotype had a higher concentration of TC (5.87 +/- 0.89 mmol/L vs. 5.46 +/- 0.93 mmol/L, P < 0.05) and LDL-C (3.29 +/- 0.81 mmol/L vs. 2.94 +/- 0.85 mmol/L, P < 0.05) than those with AA genotype. However, individuals with 2756AG/GG genotype showed no significant difference in tHcy among those with AA genotype. CONCLUSION: HHcy and MS A2756G mutation may be the risk factors for combined hyperlipidemia. Further study is needed to confirm the role of HHcy and MS A2756G mutation in the development of hyperlipidemia.

Li Q, Fan P, Bai H, Liu R, Huang Y, Wang X, Wu H, Liu Y, Liu B. · Unit of Laboratory Medicine, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, PR China. · Clin Chim Acta. · Pubmed #19239905 No free full text.

Abstract: BACKGROUND: ApoL-I is a newly found component of HDL, and has a potential role in the lipid metabolism. This study was mainly to examine the possible association of the ApoL-I gene polymorphism with endogenous hypertriglyceridemia (HTG) in Chinese population. METHODS: Three hundred and thirty five Han Chinese (102 HTG and 233 healthy control subjects) in Chengdu area were studied using PCR-RFLP analysis. RESULTS: The Lys and Glu allele frequencies of apoL-I gene at Lys166Glu site in HTG and normal control groups were 0.857, 0.143 and 0.801, 0.199, respectively; The Ile and Met allele frequencies of the gene at Ile244Met site in HTG and the control groups were 0.868, 0.132 and 0.812, 0.188 respectively. The 166Glu and 244Met allele frequencies of the 2 polymorphisms in HTG subjects were not different from those in the normal controls, respectively (P>0.05). In HTG group, subjects with genotype Lys/lys of Lys166Glu site had a higher serum mean concentration of TG as compared to those of Glu allele carriers (3.64+/-1.55 mmol/l vs 2.86+/-0.51 mmol/l, P<0.05). Subjects with genotype Ile/Ile of Ile244Met site had a higher serum mean concentration of TG as compared to those of Met allele carriers (3.59+/-1.56 mmol/l vs 2.94+/-0.88 mmol/l, P<0.05). CONCLUSIONS: The Lys166Glu and Ile244Met polymorphisms in apoL-I gene are associated with TG levels in subjects with endogenous hypertriglyceridemia in Chinese. However, these polymorphisms were not associated with the risk of HTG in the population.