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Peripheral arterial disease (PAD) is a powerful marker of the risk of cardiovascular events such as stroke and myocardial infarction, even in asymptomatic patients. The development of PAD is underpinned by both modifiable risk factors (including smoking, diabetes, dyslipidaemia, hypertension and obesity) and non-modifiable risk factors (including male gender and increased age). Optimizing medical management of risk factors–with tight control of diabetes, antiplatelet therapy and exercise–can significantly reduce the risk of cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

Obesity is defined as abnormal or excessive accumulation of body fat, which always causes serious harm to body health. In this work, an anti-obesity strain, Lactiplantibacillus plantarum BHP03 (L. plantarum), was explored. This strain showed good reproductive and acid production abilities. And its simulated intestinal fluid tolerance was better than that of Lacticaseibacillus rhamnosus GG（LGG). The in vitro lipid-lowering indicators (inhibition rate of pancreatic lipase, bile-acid salt binding capacity) of L. plantarum BHP03 were at the same level as LGG, but L. plantarum BHP03 exhibited better ability to clear cholesterol. Further, L. plantarum BHP03 was used to intervene high-fat diet mice by oral administration. The results showed that high (109 CFU/day) and low (108 CFU/day) doses of L. plantarum BHP03 could alleviate excessive weight gain caused by high-fat diet and improve the symptoms of hepatorenal enlargement and liver fatty lesions. In addition, high dose L. plantarum BHP03 significantly reduced the content of the serum total cholesterol and low-density lipoprotein cholesterol in mice. Moreover, high dose L. plantarum BHP03 enhanced the species richness of intestinal flora in mice fed with high-fat diet, decreasing the abundance of harmful bacteria such as Staphylococcus and increasing the abundance of beneficial bacteria such as Dubosiella , Akkermansia , Bifidobacterium and Lactobacillus. Therefore, it could be concluded that high dose L. plantarum BHP03 was more effective in preventing obesity and balancing gut microbiota. These findings may provide a theoretical basis for the application of lactobacilli to develop functional foods related to anti-obesity. • L. plantarum BHP03 had a good lipid-lowering ability in vitro. • L. plantarum BHP03 showed good anti-obesity effects on mice with high-fat diets. • L. plantarum BHP03 had an improving effect on serum cholesterol related indicators. • L. plantarum BHP03 could improve the dysbiosis of intestinal flora in mice. [ABSTRACT FROM AUTHOR]

Peripheral arterial disease (PAD) is a powerful marker of the risk of cardiovascular events such as stroke and myocardial infarction, even in asymptomatic patients. The development of PAD is underpinned by both modifiable risk factors (including smoking, diabetes, dyslipidaemia, hypertension and obesity) and non-modifiable risk factors (including male gender and increased age). Optimizing medical management of risk factors–with tight control of diabetes, antiplatelet therapy and exercise–can significantly reduce the risk of cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing age, atherosclerotic cardiovascular disease, diabetes mellitus, hypertension and obesity. A large proportion of patients with these conditions are treated with lipid lowering medication and questions regarding the safety of continuing lipid-lowering medication in patients infected with COVID-19 have arisen. Some have suggested they may exacerbate their condition. It is important to consider known interactions with lipid-lowering agents and with specific therapies for COVID-19. This statement aims to collate current evidence surrounding the safety of lipid-lowering medications in patients who have COVID-19. We offer a consensus view based on current knowledge and we rated the strength and level of evidence for these recommendations. Pubmed, Google scholar and Web of Science were searched extensively for articles using search terms: SARS-CoV-2, COVID-19, coronavirus, Lipids, Statin, Fibrates, Ezetimibe, PCSK9 monoclonal antibodies, nicotinic acid, bile acid sequestrants, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. There is no evidence currently that lipid lowering therapy is unsafe in patients with COVID-19 infection. Lipid-lowering therapy should not be interrupted because of the pandemic or in patients at increased risk of COVID-19 infection. In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests. Image 1 • Patients with ASCVD and obesity are at increased risk of severe illness and mortality if infected with COVID-19. • There is no convincing evidence to suggest harm from lipid lowering therapy if patients develop SARS-CoV-2. • Patients treated for hyperlipidaemia should not interrupt their treatment because of COVID-19 pandemic. • Continue lipid lowering therapy in patients with confirmed diagnosis of COVID-19 unless possible risks outweigh benefits. • In patient treated for COVID-19, drug interactions with lipid lowering therapies should be investigated and assessed. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Patients suffering an acute coronary syndrome (ACS) are at increased risk for future cardiovascular events. Effective management of hyperlipidaemia in such patients is essential. We aimed to document the use of lipid-lowering therapy (LLT) and low-density lipoprotein cholesterol (LDL-C) target achievement in patients hospitalised with an ACS in Thailand.Methods: The Dyslipidemia International Study (DYSIS) II was a multinational, observational study that enrolled patients over 18 years of age who were hospitalised with an ACS in 2013-2014 and survived until discharge. Patients were analysed according to whether or not they were treated with LLT prior to hospital admission. A lipid profile was carried forward from blood taken within the first 24 hours after admission, and attainment of the LDL-C target of <70 mg/dL (1.8 mmol/L) for very high-risk subjects was reported. Details of LLTs were collected. Lipid levels, LLT use and cardiovascular events since discharge were collected at a follow-up interview 4 months later.Results: A total of 320 ACS patients were enrolled from seven sites across Thailand, 188 (58.8%) of whom were being treated with LLT prior to the acute event. The mean LDL-C levels of the LLT and no LLT patients were 106.2 ± 39.4 mg/dL (2.75 ± 1.02 mmol/L) and 139.8 ± 46.6 mg/dL (3.62 ± 1.21), respectively, with 15.4% and 4.5% having an LDL-C level below 70 mg/dL (1.8 mmol/L). Lipid-lowering therapy consisted mainly of statins, with an atorvastatin-equivalent daily dosage of 17 ± 13 mg/day. At the 4-month follow-up, LDL-C target attainment remained low at 26.7% for the initial LLT group and 24.1% for the no LLT group. Although most patients were being treated with LLT at this point, the dosage was still low (28 ± 16 mg/day) and there was little use of combination therapy.Conclusion: In this cohort of Thai ACS patients, LDL-C levels were highly elevated, placing them at extreme risk of recurrent adverse cardiovascular events. Lipid-lowering therapy was widely used after the ACS; however, treatment was rarely optimised. Huge improvements are required in the management of hyperlipidaemia in Thailand. [ABSTRACT FROM AUTHOR]

Inflammation drives coronary artery disease and atherosclerosis implications. Lipoprotein entry, retention, and oxidative modification cause endothelial damage, triggering innate and adaptive immune responses. Recruited immune cells orchestrate the early atherosclerotic lesions by releasing proinflammatory cytokines, expediting the foam cell formation, intraplaque haemorrhage, secretion of matrix-degrading enzymes, and lesion progression, eventually promoting coronary artery syndrome via various inflammatory cascades. In addition, soluble mediators disrupt the dynamic anti- and prothrombotic balance maintained by endothelial cells and pave the way for coronary artery disease such as angina pectoris. Recent studies have established a relationship between elevated levels of inflammatory markers, including C-reactive protein (CRP), interleukins (IL-6, IL-1β), and tumour necrosis factor-alpha (TNF-α) with the severity of CAD and the possibility of future cardiovascular events. High-sensitivity C-reactive protein (hs-CRP) is a marker for assessing systemic inflammation and predicting the risk of developing CAD based on its peak plasma levels. Hence, understanding cross-talk interactions of inflammation, atherogenesis, and CAD is highly warranted to recalculate the risk factors that activate and propagate arterial lesions and devise therapeutic strategies accordingly. Cholesterol-inflammation lowering agents (statins), monoclonal antibodies targeting IL-1 and IL-6 (canakinumab and tocilizumab), disease-modifying antirheumatic drugs (methotrexate), sodium-glucose transport protein-2 (SGLT2) inhibitors, colchicine and xanthene oxidase inhibitor (allopurinol) have shown promising results in reducing inflammation, regressing atherogenic plaque and modifying the course of CAD. Here, we review the complex interplay between inflammatory, endothelial, smooth muscle and foam cells. Moreover, the putative role of inflammation in atherosclerotic CAD, underlying mechanisms and potential therapeutic implications are also discussed herein. [Display omitted] • IFN-γ and TNF upregulates migration and adhesion of leukocytes via CX3CL1. • SR-BI- and ALK-1-mediated LDL transcytosis is associated with LDL build-up. • IL-6 elevates TNF and hs-CRP levels via of NF-κB and JAK/STAT3 activation. • Canakinumab lowers hospitalisation and mortality rate in heart failure patients. • Tocilizumab attenuates prothrombotic and inflammatory properties of monocytes. [ABSTRACT FROM AUTHOR]

Hyperlipidaemia is described as "excessive phlegm" and "blood stasis" in the classic theory of traditional Chinese medicine. Exocarpium Citri Grandis has the effect of dispelling blood stasis and removing phlegm, which can better meet the treatment needs of this disease. However, there is still a lack of focus and depth in the study of the chemical composition of this medicine, and the correlation between the study of relevant medicinal substances and the efficacy of dispelling stasis and removing phlegm is insufficient. To address this issue, this study was carried out to validate the overall efficacy and identify and determine the chemical composition of Exocarpium Citri Grandis. The regulatory mechanism of the PXR-CYP3A4/FXR-LXRα pathway and its active ingredients were screened, and a pharmacokinetic study of active ingredients was performed. The obtained multidimensional data were statistically analysed and comprehensively evaluated. The quality marker of Exocarpium Citri Grandis in the treatment of hyperlipidaemia based on the PXR-CYP3A4/FXR-LXRα mechanism to exert the efficacy of dispelling blood stasis and removing phlegm was finally determined. Based on the above experiments, we identified 27 compounds from the ethanol extract of Exocarpium Citri Grandis. Among them, naringenin, meranzin hydrate, apigenin, caffeic acid phenethyl ester, anacardiin, hesperidin and naringin can significantly regulate all or part of the targets in the PXR-CYP3A4/FXR-LXRα pathway. It also has suitable content and pharmacokinetic characteristics in vivo. In conclusion, this study established quality markers to characterize the efficacy of Exocarpium Citri Grandis in dispelling blood stasis and removing phlegm, which provides a scientific basis for the targeted evaluation of the hypolipidaemic activity of this medicinal plant. [Display omitted] • Progressively deepening investigation of ECG's mechanism based on TCM effects. • Seven active ingredients were screened as quality markers for ECG. • Contribution of each component is evaluated by statistics accompany with data excation. [ABSTRACT FROM AUTHOR]

Lipoprotein apheresis (LA) is a well-established therapy for lowering lipid levels in serious cases of dyslipidaemia, including high levels of lipoprotein(a) [Lp(a)]. This method lowers both LDL cholesterol and Lp(a) by more than 60% in most of patients; however, because randomized clinical studies could be extremely difficult, also other markers of the effect of this procedures on vascular health are of importance. Therefore, in addition to changes in plasma lipids and Lp(a) during LA, we also analysed the response of biomarkers associated with vascular integrity: small non-coding microRNAs (miRNAs). We analysed the changes in miRNAs in two women (age 70 and 72 years) with clinically manifest extensive and progressive atherosclerotic disease and high levels of Lp(a) and with different clinical course who were treated by LA. In both women we analysed changes of 175 circulating plasma miRNAs using pre-defined serum/plasma focus panels at the beginning of and one year after the therapy. In addition to reduced levels of plasma lipids and Lp(a), circulating plasma levels of miR-193a-5p ; - 215-5p; -328-3p ; -130a-3p ; -362-3p ; -92b-3p decreased, and levels of miR-125a-5p; -185-5p; -106a-5p; -320b; -19a increased (all P < 0.05) in both women. Moderate differences were found between both women with regard to the different course of atherosclerotic disease. Long-term LA substantially changes circulating plasma miRNAs associated with vascular integrity reflected different clinical course in both women. If confirmed, this approach could improve the assessment of the effectiveness of this therapy on an individual basis. [ABSTRACT FROM AUTHOR]

To clarify the effect of loofah Luffa cylindrica and fermented loofah on hyperlipidemia, the in vitro bile acid lowering capacity and blood lipid levels of ddY mice fed high-fat diet supplemented with loofah were determined. Furthermore, the caecal microbiomes patterns were analysed using 16S rDNA amplicon sequencing with a next generation sequencer (MiSeq) system. Green loofah was homogenized and autoclaved (LH), and subsequently fermented with Lactobacillus plantarum Uruma-SU4 (FL). In vitro bile acid (taurocholic, glycocholic and deoxycholic acids (DCA)) lowering capacity was significantly high in FL. The levels of plasma triacylglyceride in mice which were fed a high-fat diet containing 17% beef tallow was lowered by 5% dried FL (FLD) and was unaffected by dried LH (LHD). Caecal Lactobacillus johnsonii and Clostridium disporicum known as predominant lactic acid bacteria in mice gut and urso-DCA producer, respectively, were increased by FLD. On the other hand, Flintibacter butyricus was lowered by both LHD and FLD. These results suggest that if green loofah cannot be consumed as a fresh vegetable, lactic acid fermentation may be useful in generating effective nutritional supplements and functional foods. Unlabelled Image • L. plantarum Uruma-SU4 was selected for loofah homogenate (LH) fermentation. • In vitro bile acid lowering capacity of fermented LH (FL) was higher than that of LH. • Dried FL (FLD) rather than dried LH (LHD) showed hypolipidemic effect in beef-tallow fed mice. • Caecal Lactobacillus johnsonii, regarded as a beneficial symbiont, was increased by FLD. • Cl. disporicum, a ursodeoxicholic acid producer, was also increased by FLD. [ABSTRACT FROM AUTHOR]

Polysaccharide peptides from Ganoderma lucidum (GLPP) have the potential to ameliorate lipid metabolic disorders, in part through modulating specific gut microbiota and regulating the mRNA expression levels of the genes involved in lipid and cholesterol metabolism, suggesting GLPP as a potential novel functional food for the treatment or prevention of hyperlipidaemia and gut microbiota dysbiosis. • GLPP have the potential to prevent serum and hepatic lipid metabolic disorders. • GLPP attenuate high-fat diet-induced hepatic steatosis and gut microbiota dysbiosis. • GLPP modulate the relative abundance of functionally relevant enterotypes. • mRNA expressions levels involved in bile acids homeostasis were regulated by GLPP. • GLPP modulate lipid metabolism via the catabolism of cholesterol into bile acids. This study aimed to investigate the effects of polysaccharide peptides from Ganoderma lucidum (GLPP) on hyperlipidaemia and gut microbiota dysbiosis in high-fat diet (HFD)-exacerbated hypercholesterolemic rats. Results showed that oral administrations of GLPP markedly alleviated the dyslipidaemia through decreasing the serum levels of triglyceride (TG), cholesterol (TC), free fatty acids (FFA) and low-density lipoprotein cholesterol (LDL-C), and significantly suppressing hepatic lipid accumulation and steatosis. Metagenomic analysis revealed that GLPP supplementation produced significant structure changes on the intestinal microbiota in HFD-fed rats, in particular modulating the relative abundance of functionally relevant microbial phylotypes compared with the HFD group. The Spearman's correlation analysis revealed that the serum and hepatic lipid profiles were negatively correlated with Jeotgalicoccus , Ignavigranum , Sporosarcina , Bacteroides , Anaerovorax , Parasutterella , Alistipes and Alloprevotella , but positively correlated with Allobaculum , Phascolarctobacterium , Psychrobacter , Enterorhabdus , Blautia and Roseburia. Meanwhile, the GLPP treatment regulated the mRNA expression responsible for hepatic lipid metabolism and promoted fecal excretion of total bile acids (BAs). These findings indicated that GLPP ameliorate lipid metabolic disorders through modulating gut microbiota structure and regulating the genes involved in hepatic lipid and cholesterol metabolism. [ABSTRACT FROM AUTHOR]

Summary Background & aims The aims of this systematic review were to define the epidemiology and pathophysiology of hyperlipidaemic pancreatitis, establish its association with clinical outcome and define management strategies. Methods The Cochrane, Embase and Medline databases were searched, limited to the last decade, for articles on hyperlipidaemic pancreatitis. All randomised controlled trials, observational studies and case series (with a minimum of 10 patients) on hyperlipidaemic pancreatitis were included. Results Thirty-eight studies with 1979 patients were included. The median admission triglyceride concentration was 42.8 mmol/L (range 13.6–108.6 mmol/L) [3785 mg/dL (range 1205–9612 mg/dL)]. Severe hypertriglyceridaemia (>1000 mg/dL, 11.0 mmol/L) was present in 1.7% of the adult population, and about 15–20% of these developed hyperlipidaemic acute pancreatitis. Medical management of severe hyperlipidaemia at onset of acute pancreatitis has not been investigated fully. However, tight regulation of triglyceride concentration after presentation with acute pancreatitis was found to reduce the risk of recurrence. Plasmapheresis reduced concentrations of triglycerides by up to 85%, but this did not impact morbidity or mortality. All studies included defined hyperlipidaemia as a more severe form of pancreatitis. Conclusion The available evidence suggests an increasing risk of acute pancreatitis in patients with hyperlipidaemia and a more severe form of pancreatitis. There is some evidence to suggest biochemical benefit of using novel techniques like plasmapheresis without the desired physiological benefit. However, there is a need for an international consensus on the management of hyperlipidaemic pancreatitis. More rigorous and methodologically robust studies are required to inform such consensus guidelines. [ABSTRACT FROM AUTHOR]

Abstract Metabolic syndrome (MetS) is associated with osteoporosis due to the underlying inflammatory and hormonal changes. Annatto tocotrienol has been shown to improve medical complications associated with MetS or bone loss in animal studies. This study aimed to investigate the effects of annatto tocotrienol as a single treatment for MetS and osteoporosis in high-carbohydrate high-fat (HCHF) diet-induced MetS animals. Three-month-old male Wistar rats were randomly divided into five groups. The baseline group was euthanized at the onset of the study. The normal group received standard rat chow and tap water. The remaining groups received HCHF diet and treated with three different regimens orally daily: (a) tocopherol-stripped corn oil (the vehicle of tocotrienol), (b) 60 mg/kg annatto tocotrienol, and (c) 100 mg/kg annatto tocotrienol. At the end of the study, measurements of MetS parameters, body compositions, and bone mineral density were performed in animals before sacrifice. Upon euthanasia, blood and femur of the rats were harvested for the evaluations of bone microstructure, biomechanical strength, remodelling activities, hormonal changes, and inflammatory response. Treatment with annatto tocotrienol improved all MetS parameters (except abdominal obesity), trabecular bone microstructure, bone strength, increased osteoclast number, normalized hormonal changes and inflammatory response in the HCHF animals. In conclusion, annatto tocotrienol is a potential agent for managing MetS and osteoporosis concurrently. The beneficial effects of annatto tocotrienol may be attributed to its ability to prevent the hormonal changes and pro-inflammatory state in animals with MetS. Highlights • Supplementation of annatto tocotrienol improves most of the medical conditions associated with MetS in male rats. • Supplementation of annatto tocotrienol does not cause any change in bone mineral density but prevents trabecular bone loss. • Annatto tocotrienol is a potential single agent targeting both MetS and bone loss concurrently. • The effects of annatto tocotrienol may be due to its ability to normalize hormonal changes and inflammatory response. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Yijin-Tang (YJT) is a traditional prescription for the treatment of hyperlipidaemia, atherosclerosis and other ailments related to dampness phlegm, a typical pathological symptom of abnormal body fluid metabolism in Traditional Korean Medicine. However, a holistic network pharmacology approach to understanding the therapeutic mechanisms underlying hyperlipidaemia and atherosclerosis has not been pursued. Aim of the study To examine the network pharmacological potential effects of YJT on hyperlipidaemia and atherosclerosis, we analysed components, performed target prediction and network analysis, and investigated interacting pathways using a network pharmacology approach. Materials and Methods Information on compounds in herbal medicines was obtained from public databases, and oral bioavailability and drug-likeness was screened using absorption, distribution, metabolism, and excretion (ADME) criteria. Correlations between compounds and genes were linked using the STITCH database, and genes related to hyperlipidaemia and atherosclerosis were gathered using the GeneCards database. Human genes were identified and subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results Network analysis identified 447 compounds in five herbal medicines that were subjected to ADME screening, and 21 compounds and 57 genes formed the main pathways linked to hyperlipidaemia and atherosclerosis. Among them, 10 compounds (naringenin, nobiletin, hesperidin, galangin, glycyrrhizin, homogentisic acid, stigmasterol, 6-gingerol, quercetin and glabridin) were linked to more than four genes, and are bioactive compounds and key chemicals. Core genes in this network were CASP3, CYP1A1, CYP1A2, MMP2 and MMP9. The compound-target gene network revealed close interactions between multiple components and multiple targets, and facilitates a better understanding of the potential therapeutic effects of YJT. Conclusions Pharmacological network analysis can help to explain the potential effects of YJT for treating dampness phlegm-related diseases such as hyperlipidaemia and atherosclerosis. [ABSTRACT FROM AUTHOR]

Background and aims Real-world evidence on treatment of hyperlipidaemia (HLD) in Japan is limited. We aimed to describe treatment patterns, persistence with, and adherence to treatment in Japanese patients with HLD. Methods Retrospective analyses of adult HLD patients receiving drug therapy in 2014–2015 were conducted using the Japan Medical Data Center (JMDC) and Medical Data Vision (MDV) databases. Depending on their HLD treatment history, individuals were categorised as untreated (UT) or previously treated (PT), and were followed for at least 12 months. Outcomes of interest included prescribing patterns of HLD drug classes, persistence with treatment at 12 months, and adherence to treatment. Results Data for 49,582 and 53,865 patients from the JMDC and MDV databases, respectively, were analysed. First-line HLD prescriptions for UT patients were predominantly for moderate statins (JMDC: 75.9%, MDV: 77.0%). PT patients most commonly received combination therapy (JMDC: 43.9%, MDV: 52.6%). Approximately half of the UT patients discontinued treatment during observation. Within each cohort, persistence rates were lower in UT patients than in PT patients (JMDC: 45.0% vs. 77.5%; MDV: 51.9% vs. 85.3%). Adherence was ≥80% across almost all HLD drug classes, and was slightly lower in the JMDC cohort than MDV cohort. Conclusions Most common prescriptions were moderate statins in UT patients and combination therapy in PT patients. The high discontinuation rate of HLD therapy in UT patients warrants further investigation and identification of methods to encourage and support long-term persistence. [ABSTRACT FROM AUTHOR]

A metabolomics method based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) was used to investigate the effect of Lactobacillus plantarum NCU116 on the metabolites of hyperlipidaemic rat model feed by high-fat diet. Nine potential biomarkers (Pantothenic Acid, 5-Hydroxyindole acetaldehyde, Glycocholic Acid, Biliverdin IX, l -Leucine, 2-Phenylethanol glucuronide, Taurocholic acid, Indoleacrylic acid and 2-Arachidonoylglycerol) were identified and the pathway features were analyzed by Mass Profiler Professional (MPP) software. Meanwhile, clustering of principal components analysis (PCA), partial least squares-discriminant analysis (PLS-DA) and hierarchical clustering analysis (HCA) produces and biological pathways including tryptophan metabolism, bile secretion, fatty acid biosynthesis, glucose homeostasis, protein digestion and absorption were affected by L. plantarum NCU116. This study demonstrated that L. plantarum NCU116 improved hyperlipidaemic rats via metabolism pathways of amino acids, bile, fatty acids and glucose. [ABSTRACT FROM AUTHOR]

Enteromorpha prolifera is an edible alga that is used as a traditional herb to treat many diseases. Previous work has indicated that its polysaccharides lower cholesterol and improve glucose metabolism in rats. Thus, we evaluated the effects of E. prolifera polysaccharides (EP) on lowering serum triglycerides (TGs) in high-fat diet-induced hyperlipidaemic rats and the underlying mechanisms. The administration of EP (200 mg/kg body weight/d) significantly reduced the liver weight and liver index as well as the serum TG levels ( P  < .05) in high-fat-fed rats. Real-time PCR and Western blotting analysis revealed that EP significantly lowered the mRNA and protein expression of hepatic acetyl-CoA carboxylase (ACC), which is responsible for fatty acid synthesis. Further study showed that EP suppressed SREBP-1c to regulate the expression of ACC. These results suggest that EP may be beneficial against hyperlipidaemia and may reduce the risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

As a popular healthy tea beverage, Jinsi Huangju has been consumed in China for hundreds of years. However, its active ingredients which dissolved in hot water have not been fully determined. In this study, 14 compounds were identified by different spectroscopic techniques, including 11 compounds identified in this plant for the first time. For in-depth studies, apigenin-7- O -6″-malonylglucoside (8) and luteolin-7- O -6″-malonylglucoside (9) were synthesized for the first time by 5 steps in 1.2% overall yields. Further analyses of the natural compounds showed that 8 could inhibit pancreatic lipase, reduce cellular lipid contents, and attenuate insulin resistance in vitro. Furthermore, 8 restore lipid and inflammatory profiles in the plasma and liver (TG, TC, ALT, AST, LDL-C, HDL-C, MPO, and IL-6) and attenuated hepatic steatosis in NAFLD mouse models. In conclusion, Jinsi Huangju and its active ingredients are candidates for developing drug, functional foods and therapeutic strategies for hyperlipidaemia and NAFLD. [Display omitted] • Eleven compounds identified from Chrysanthemum morifolium (Jinsi Huangju) for the first time. • Flavonoids 8 and 9 were synthesized for the first time by 5 steps in 1.2% overall yields. • 8 inhibited pancreatic lipase, ameliorated lipids and insulin resistance. • 8 improved hyperlipidemias, liver injury and inflammatory profiles in NAFLD mice. • 8 recovered spleen and adipose tissue indices and regulated AMPK pathway in vivo. [ABSTRACT FROM AUTHOR]

Few studies have evaluated the effects of age and illness on serum triglyceride concentrations in neonatal foals. The objectives of this study were to evaluate triglyceride concentrations in neonatal foals and their dams through serial measurement immediately postpartum and at 1–2 days and 10–12 days of age, as well as to measure them in sick foals. Serially measured serum triglycerides in seven healthy foals varied with age. Median (range) triglyceride concentrations were 28 mg/dL (12–50 mg/dL), 89 mg/dL (51–264 mg/dL), and 60 mg/dL (28–135 mg/dL) immediately postpartum, at 1–2 days of age, and 10–12 days of age, respectively ( P < 0.001). Triglyceride concentrations varied hourly by up to 117 mg/dL in individual foals. The dams had lower triglycerides (median, 20 mg/dL; range, 12–49 mg/dL) than the foals, once foals were >24 h old. Sick foals <24 h old had lower triglycerides than sick foals aged 1–7 days (median, 41 mg/dL [range, 16–116]; median, 110 mg/dL [range, 24–379 mg/dL]; P < 0.001). Age and triglyceride concentration showed a non-linear association independent of foal health status ( P = 0.01). Sick foals with positive bacterial cultures had higher triglycerides than those with negative cultures (median, 111 mg/dL [range, 10–379 mg/dL] and median 53 mg/dL [range, 17–271 mg/dL], respectively; P = 0.033). Nonsurvivors had higher triglycerides than survivors (median, 116 mg/dL [range, 41–379 mg/dL] and median, 55 mg/dL [range, 10–311 mg/dL], respectively; P = 0.04). In conclusion, triglycerides were highest in healthy neonatal foals aged 1–2 days, and in nonsurviving sick foals and those with positive bacterial cultures. Age was associated with triglyceride concentration regardless of health status. [ABSTRACT FROM AUTHOR]

HIV/AIDS patients have suppressed immune system, making them vulnerable to many opportunistic infections including tuberculosis (TB). The patients who are co-infected with TB undergo combined regimens with anti-retroviral drugs such as zidovudine (AZT) and anti-tubercular drug such as isoniazid (INH) for therapy leading to hepatotoxicty. Silibinin (SBN), extracted from Silybum marianum commonly called as “Milk thistle” is used against several drugs-induced hepatotoxicity. The present study evaluates the ameliorative effect of SBN against AZT alone, INH alone, and INH + AZT-induced toxic insults to liver of rats. Wistar albino rats (n = 6/groups) were given INH and AZT (25 and 50 mg mg/kg b.w.) respectively either alone or in combination for a sub-chronic period of 45 days orally. Another group of rats received SBN (100 mg/kg b.w.) along with INH and AZT. The group that received propylene glycol served as control. AZT alone, INH alone and INH + AZT treatments showed parenchymal cell injury and cholestasis by highly significant increase in the activities of marker enzymes (aspartate and alanine transaminase, alkaline phosphatase, argino succinic acid lyase), bilirubin and protein. The presence of hyperlipidaemia was observed by analyzing lipid profiles in serum/liver/adipose tissue, gene expression (RT-PCR) of Phase-I and II metabolizing enzymes and western blot. Transmission electron microscopy study also revealed large vacuoles with membraneous debri, pleomorphic mitochondria, disruption of endoplasmic reticulum, presence of lipid droplets, breakage in cellular and nuclear membrane. SBN simultaneous treatment showed ameliorative effect against INH + AZT-induced hepatotoxicity and hyperlipidemia in rats. [ABSTRACT FROM AUTHOR]

Objective: Preclinical evidence suggests that increased cholesterol levels might be involved in the pathophysiology of osteoarthritis of the hand (HOA), but evidence from observational studies remains scarce. We aimed to analyse the association between hyperlipidaemia and incident HOA.Design: We conducted a matched (1:1) case-control study using the UK-based Clinical Practice Research Datalink (CPRD). Cases were patients aged 30-89 years with an incident diagnosis of HOA between 1995 and 2014. In multivariable conditional logistic regression analyses, we calculated odds ratios (OR) for incident HOA in patients with hyperlipidaemia, categorized by gender, age, previous duration of hyperlipidaemia, and recent statin treatment.Results: Among 19,590 cases and 19,590 controls, we observed an increased risk of HOA in patients with hyperlipidaemia (OR 1.37, 95% confidence intervals (CI) 1.28-1.47), when compared to patients without hyperlipidaemia. Thus, of all HOA cases in our study population, 3.6% may have been attributable to the presence of hyperlipidaemia (population attributable risk). Most patients with HOA were elderly, but the strength of the association between HOA and hyperlipidaemia inversely correlated with increasing age, with the highest OR of 1.72 (95% CI 1.24-2.38) in patients aged 29-49 years. Categorization by previous hyperlipidaemia duration, as well as sub-classification of patients with hyperlipidaemia into those with and without recent statin use did not meaningfully change the effect estimate.Conclusions: Our results suggest that hyperlipidaemia may be an independent risk factor for new onset HOA. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and aims We estimated the extent of undertreatment and overtreatment with cholesterol-lowering therapy according to European guidelines in individuals in the Danish general population without ischemic cardiovascular disease and diabetes. Methods We examined 92,348 such individuals aged 35–100 years recruited from 2004 through 2014 in the Copenhagen General Population Study. Each individual was assigned their 10-year risk of fatal cardiovascular disease according to the European SCORE chart based on age, sex, smoking, total cholesterol, and systolic blood pressure. European guidelines recommend cholesterol-lowering therapy definitely at ≥10% risk and LDL cholesterol ≥1.8 mmol/L, definitely at 5–9% risk and LDL cholesterol ≥2.5 mmol/L, possibly at 1–4% risk and LDL cholesterol ≥3 mmol/L, but not at <1% risk. Results 3858 individuals had ≥10% risk, 16,255 had 5–9% risk, 49,131 had 1–4% risk, and 23,104 had <1% 10-year risk of fatal cardiovascular disease. In these groups, 81%, 86%, 93%, and 99% did not receive cholesterol-lowering therapy. Definite undertreatment and overtreatment according to guidelines were found in 19% and 0.2% or in 187,660 and 1570 per million 35–100 year olds without ischemic cardiovascular disease and diabetes. If definite and possible undertreatment and overtreatment were combined, the corresponding numbers were 52% and 3% or 519,416 and 29,194 per million. Conclusions In the Danish general population, ∼190,000 per million 35–100 year olds without ischemic cardiovascular disease and diabetes are not treated to LDL cholesterol goals according to European guidelines. Conversely, ∼1600 per million received cholesterol-lowering therapy without endorsement in European guidelines. [ABSTRACT FROM AUTHOR]

Crabapples are used as food and for the treatment of diarrhoea, indigestion and other digestive diseases in China. The anti-hyperlipidaemic and anti-hyperglycaemic effects of the extracts were evaluated on high-fat diet-induced obese mice. We found that the extracts of five crabapple varieties lowered serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels, and decreased serum triglyceride (TG) contents and improved fasting glucose levels in the mice. All extracts notably elevated the mRNA expression and protein levels of cholesterol 7 alpha-hydroxylase (CYP7A1), the crucial enzyme for cholesterol homeostasis, in the mouse liver. The extracts also displayed strong antioxidant activity in vitro . To our knowledge, this is the first study to show that the crabapples could lower cholesterol levels. Our data suggest that crabapple may lower cholesterol through the enhancement of CYP7A1 function in liver, and crabapple may be used as nutraceuticals to prevent or treat hyperlipidaemia and other metabolic disorders. [ABSTRACT FROM AUTHOR]

Yan-Sheng-Yin (YSY), a Chinese natural dietary supplement that promotes good health, is entirely composed of natural foods. Whether YSY is a potential adjuvant intervention for reducing hyperlipidaemia, atherogenesis, or obesity is unclear. This study evaluated the inhibitory effects and mechanisms of YSY for hyperlipidaemia, atherogenesis, and obesity. Experimental results showed that YSY reduced body weight, hyperlipidaemia, fatty liver, and atherogenesis in hyperlipidaemic mice. In addition, YSY promoted lipid metabolism by inducing adiponectin secretion and activation (phosphorylation) of 5′ adenosine monophosphate-activated protein kinase (AMPK) and by suppressing the activation of acetyl-CoA carboxylase (ACC) and HMG-CoA reductase (HMGCR). Moreover, YSY inhibited adipocyte differentiation by suppressing peroxisome proliferator-activated receptor gamma (PPAR-γ) and CCAAT/enhancer-binding proteins (C/EBPs). Furthermore, the antihyperlipidaemic effect of YSY was observed in the clinical trial. Our findings suggest that YSY is an adjuvant intervention for treating and preventing hyperlipidaemia, atherogenesis, and obesity. [ABSTRACT FROM AUTHOR]

Dietary fibre intakes have consistently been associated with reduced risk of diabetes and metabolic syndrome. We investigated in 12 healthy subjects if administration of dietary fibre partially hydrolysed guar gum (PHGG) induces beneficial impact on hyperglycaemia, hyperlipidaemia and incretins metabolic hormones. Administration of 6 g/PHGG with each meal for 12 months significantly lowered the postprandial plasma glucose (PG), reduced both the fasting and postprandial insulin (IRI) and triacylglycerol (TG) levels (p = 0.05). Low-density lipoprotein (LDL) was lower, whereas high-density lipoprotein (HDL) level was significantly increased (p < 0.01). Plasma leptin, high-sensitive C-reactive protein (hs-CRP) and fasting glucagon like peptide (GLP-1) were also lowered. In fact, 3 out of 6 glucose intolerant subjects turned out to be normal glucose tolerant after only 3 months of PHGG supplementation. Therefore, this preliminary study revealed that inclusion of PHGG in diets potentially impact on metabolic health profiles by affecting circulating metabolites that are responsible for glycaemia, hyperinsulinaemia and hyperlipidaemia factors. [ABSTRACT FROM AUTHOR]

The effects of blackcurrant and strawberry fibre on high-fat diet-induced metabolic disorders in rats were compared. The blackcurrant and strawberry preparations were obtained from fruit pomace and contained 66.5 and 51.3% dietary fibre and 4.9 and 5.5% polyphenols, respectively. A high-fat diet was supplemented with the blackcurrant or strawberry fibre for the entire 8 weeks of experimental feeding or for 4 weeks, starting at week 5. Obesity, dyslipidaemia, hyperinsulinaemia and altered microbial metabolism in the distal intestine were noted in rats fed a high-fat diet. The 8-week supplementation with blackcurrant fibre decreased body weight, whereas both fibres decreased epididymal fat mass, increased the caecal concentration of short-chain fatty acids, prevented hyperinsulinaemia and decreased cholesterolaemia. Thus, pomace-derived blackcurrant and strawberry fibre attenuate disorders induced by a high-fat diet; however, initial dietary supplementation is more efficient than the same, but delayed, intervention. [ABSTRACT FROM AUTHOR]

Pyracantha fortuneana fruit is a potential source of nutraceutical and therapeutic agents. We investigated the effects of P .  fortuneana fruit extract (PFE) on hyperlipidaemia, obesity, and oxidative stress in rodents. PFE significantly decreased body weight, triacylglycerol, total cholesterol, low-density lipoprotein-cholesterol, and malondialdehyde levels. By contrast, PFE elevated high-density lipoprotein-cholesterol levels, glutathione peroxidase, and superoxide dismutase activities in both preventive and therapeutic rodent groups. These results indicate that the amelioration of PFE on hyperlipidaemia and obesity was highly associated with the improvement of endogenous antioxidant activity. Polyphenols and saponins were quantified by spectrophotometric and HPLC methods. Several new saponin compounds were identified by liquid chromatography and tandem mass spectrometry as ursolic acid (UA) derivatives. The quercetin, rutin, and procyanidin treatments in HepG2 cells showed increases in low-density lipoprotein receptor activity and apolipoprotein-A1, but UA less affected these protein activities. Therefore, PFE could be promising in ameliorating chronic metabolic diseases via multiple constituent synergies. [ABSTRACT FROM AUTHOR]

Background: Obesity has become a major health problem in contemporary society and it is closely related to many chronic diseases, so it is an important issue for measuring adiposity accurately and predicting its future. Prevention and treatment of overweight and obesity has become one of the key prevention and treatment of metabolic disorders. Objective: In this study, we compared the ability of the four anthropometric indicators (body mass index, waist circumstance, waist--height ratio, waist-to-hip ratio) to identify metabolic disorders (hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia) by receiver operating characteristic (ROC) curve analyses and to provide evidence for clinical practice. Methods: In this large scale cross-sectional study, 13,275 Han adults (including 7595 males and 5680 females) received physical examination between January, 2009 and January, 2010 in Xuanwu Hospital of Capital Medical University were investigated by the means of questionnaire, Meanwhile, the physical examination and serological results were recorded. A package known as Statistical Package for Social Scientist (SPSS) was employed to analyse the responses while t-test, one-way analysis of variance (ANOVA), ROC analysis and chi-square statistical methods were used to test the hypotheses. Results: WC, WHtR, WHR and BMI were all significantly (P < 0.001) correlated with all metabolic risk factors regardless of gender. And the area under the curve (AUC) of WHtR was significantly greater than that of WC, BMI or WHR in the prediction of hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia. [ABSTRACT FROM AUTHOR]

annually in Europe, 4 million people die from cardiovascular diseases, the main cause of which is atherosclerosis. In order to slow down the development of atherosclerotic plaques, the main therapeutic goal is to lower LDL cholesterol (LDL-C) level. Undoubtedly, statins are the basis of lipid-lowering therapy for many years. However, a European study shows that only 43% of statin-taking patients achieved their LDL-C targets. PCSK9 inhibitors are a new group of lipid-lowering drugs whose main point of action is the protein discovered in 2003 – the PCSK9 (proprotein convertase subtilisin/kexin 9). This protein is responsible for reducing the density of LDL receptors on the surface of hepatocytes, which increases the value of LDL-C. The discovery of this protein was soon after the basis for the start of research, thanks to which three monoclonal antibodies against PCSK9 were developed - evolocumab, alirocumab, bococizumab - and inclisiran, an inhibitor of PCSK9 synthesis in the liver. In addition to the mechanism of action of PCSK9 inhibitors, resulting in lowering LDL-C level, a number of pleiotropic mechanisms have also been identified, including effects on metabolic processes and inflammation. Until the registration and introduction of above-mentioned drugs into everyday clinical practice, many studies were carried out, in which, in addition to assessing the effectiveness of treatment, the safety and tolerability of the drug were also examined. The purpose of this review is to summarize information on the safety profile of PCSK9 inhibitors, which may help in making therapeutic decision. [Display omitted] • PCSK9 inhibitors do not affect the increase in new cases of diabetes. • Treatment with PCSK9 inhibitors has a lower risk of muscle side effects. • PCSK9 inhibitors do not affect tissue vitamin E levels or steroid hormone synthesis. • In addition to acting on LDL receptors, the PCSK9 has other mechanisms of action. [ABSTRACT FROM AUTHOR]

The antihyperlipidaemic effect and potential mechanisms of Schisandra chinensis fruit extract were investigated in hamsters fed with a high-fat diet. Treating with SF extract significantly decreased the serum levels of total cholesterol, triacylglycerol and low-density lipoprotein cholesterol, alleviated insulin resistance, attenuated inflammation and declined liver lipid accumulation. The expression and activities of key lipid-metabolic regulators were altered to the lipid-lowering side. Screening of different fractions of SF extract for lipid-lowering activities revealed that the lignan-rich fraction was the most effective. Eight abundant lignans were isolated from the major active fraction of SF extract, in which schisandrols A, B and schisandrins B, C showed significant lipid-lowering effects in HepG2 cells, and schisandrin C was potent in decreasing the blood lipids in Triton WR-1339 induced hyperlipidaemic mice. Overall, these results indicated that the extract and lignans in SF were effective regulators of lipogenesis and could be useful for treating hyperlipidaemia. [ABSTRACT FROM AUTHOR]

Despite a significant work on thiadiazoles, continuous efforts are still being made to identify novel heterocyclic compounds with potent biological activities. This review may help the medicinal chemists to develop new leads possessing 1,3,4-thiadiazole nucleus with higher efficacy and reduced side effects. This review throws light on the detailed synthetic approaches which have been used for the synthesis of thiadiazoles. This has been followed by the in depth analysis of the thiadiazoles with respect to their medicinal significance. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine whether clinical inertia is associated with simpler interventions occurring more often than complex changes and the association between clinical inertia and outcomes. Methods: Prevalence of clinical inertia over a 30 month period for hyperglycaemia, hypertension and dyslipidaemia was calculated in a random sample (n =334) of patients attending a diabetes clinic. Comparisons between prevalence of clinical inertia and outcomes for each condition were examined using parametric tests of association. Results: There was less clinical inertia in hyperglycaemia (29% of consultations) compared with LDL (80% of consultations) and systolic BP (68% of consultations). Consultations where therapy was intensified had a greater reduction in risk factor levels than when no change was made. No association was found between treatment intensity scores and changes in HbA1c, LDL or blood pressure over 30 months. Conclusions: Physicians are no more likely to intervene in conditions where simple therapeutic changes are necessary as opposed to complex changes. Greater clinical inertia leads to poorer outcomes. There continues to be substantial clinical inertia in routine clinical practice. Physicians should adopt a holistic approach to cardiovascular risk reduction in patients with diabetes, adhere more closely to established management guidelines and emphasize personal individualized target setting. [Copyright &y& Elsevier]

Highlights: [•] L. plantarum NCU116 showed a significant tendency to protect morphology of liver. [•] L. plantarum NCU116 had the potential ability to regulate lipid metabolism levels. [•] Effect of cholesterol-lowering may relate to expression of LDL receptor and CYP7A1. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: Cydonia oblonga Mill. leaves are traditionally used in Uyghur medicine to treat or prevent cardiovascular disease. Beyond a demonstrated effect on thrombosis, we tested it for an effect on dyslipidemia, in a rat model of hyperlipidemia. Methods: Seventy healthy Sprague Dawley rats were randomly divided into 6 groups: normal controls, model controls, simvastatin, and low-, medium- and high-dose Cydonia oblonga Mill. leaf extracts (COM), orally for 56 days. The normal controls were fed a normal diet, all other groups a high fat diet. Rat weights were recorded over time. Total cholesterol (TC), triglycerides (TG), low and high-density lipoproteins (LDL, HDL), as well as AST, ALT and total protein (TP) were measured in serum at the end of the study. The antioxidant capacity of glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), malondialdehyde (MDA) was measured in liver samples, along with lipoprotein lipase (LPL), and hepatic lipase (HL). Liver pathology was described. Results: COM dose-dependently reduced TC, TG, LDL-C and MDA, inhibited the activity of ALT, AST and LPS, increased HDL-C content, increased the activity of SOD, GSH-PX, LPL and HL, and reduced liver steatosis in hyperlipidaemia rats, which was significant at medium and high doses. The effect of COM was similar to that of simvastatin except for increased LPL and HL which were reduced by COM but not by simvastatin. Conclusion: Cydonia oblonga Mill. leaf extracts have hypolipidaemic and hepatoprotective effects, probably related to increasing antioxidant capacity and lipoprotein metabolism in the liver, and inhibition of lipogenesis. [Copyright &y& Elsevier]

The diagnosis of gall bladder mucoceles (GM) in dogs has become increasingly frequent in veterinary medicine. Primary breed-specific hyperlipidaemia is reported in Shetland Sheepdogs and Miniature Schnauzers, breeds in which GM are known to occur more frequently than in other breeds. The objective of this study was to evaluate the association between GM and hyperlipidaemia in dogs. The study design was a retrospective case control study. Medical records of dogs diagnosed with GM at the Veterinary Medical Centre of The University of Tokyo between 1 April 2007 and 31 March 2012, were reviewed. Fifty-eight dogs with CM and a record of either serum cholesterol, triglyceride, or glucose concentrations were included in the study. Hypercholesterolaemia (15/37 cases; odds ratio [OR]: 2.92; 95% confidence interval [Cl]: 1.02-8.36) and hypertriglyceridaemia (13/24 cases; OR: 3.55; 95% CI:1.12-15.91) showed significant association with GM. Pomeranians (OR: 10.69), American Cocker Spaniels (OR: 8.94), Shetland Sheepdogs (OR: 6.21 ), Miniature Schnauzers (OR: 5.23), and Chihuahuas (OR: 3.06) were significantly predisposed to CM. Thirty-nine out of 58 cases had at least one concurrent disease, including pancreatitis (five cases), hyperadrenocorticism (two cases), and hypothyroidism (two cases). A significant association between GM and hyperlipidaemia was confirmed, suggesting that hyperlipidaemia may play a role in the pathogenesis of GM. [ABSTRACT FROM AUTHOR]

The liver and its pleotropic functions play a fundamental role in regulating metabolism, and is also an inevitable target of multiple metabolic disorders. The numerous and constant relationships and feedback mechanisms between the liver and all endocrine organs is reflected by the fact that an alteration of one oftentimes results in the malfunction of the other. Hypo- and hyperthyroidism are frequently associated with hepatic alterations, and thyroid diseases must be excluded in transaminase elevation of unknown cause. Drugs such as propylthiouracil, used in the treatment of hyperthyroidism, may induce liver damage, and other drugs such as amiodarone, carbamazepine, and several chemotherapeutic agents can lead to both thyroid and liver abnormalities. Liver diseases such as hepatitis, hepatocellular carcinoma, and cirrhosis may cause altered levels of thyroid hormones, and alcoholic liver disease, both due to the noxious substance ethanol as well as to the hepatic damage it causes, may be responsible for altered thyroid function. Both excess and insufficiency of adrenal function may result in altered liver function, and adrenocortical dysfunction may be present in patients with cirrhosis, especially during episodes of decompensation. Again an important player which affects both the endocrine system and the liver, alcohol may be associated with pseudo-Cushing syndrome. Sex hormones, both intrinsic as well as extrinsically administered, have an important impact on liver function. While oestrogens are related to cholestatic liver damage, androgens are the culprit of adenomas and hepatocellular carcinoma, among others. Chronic liver disease, on the other hand, has profound repercussions on sex hormone metabolism, inducing feminization in men and infertility and amenorrhoea in women. Lastly, metabolic syndrome, the pandemia of the present and future centuries, links the spectrum of liver damage ranging from steatosis to cirrhosis, to the array of endocrine alterations that are features of the syndrome, including insulin resistance, central obesity, and hyperlipidaemia. Clinical practice must integrally evaluate the effects of the intricate and tight relationship between the liver and the endocrine system, in order to better address all manifestations, complications, and prevent deterioration of one or the other organ-system. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: The antihyperlipidaemic effects of ODP-Ia, one of the main components of Opuntia dillenii Haw. polysaccharides, were studied. Gavage administration of ODP-Ia was observed to significantly decrease serum lipid levels and to increase serum high-density lipoprotein cholesterol level in hyperlipidaemic rats. Similar suppressive patterns were also seen in hepatic total cholesterol and triglyceride levels. Moreover, the ODP-Ia administration significantly increased serum lecithin:cholesterol acyltransferase activity, increased the production of serum NO, inhibited hepatic HMG-CoA reductase activity, augmented serum and hepatic superoxide dismutase activities and decreased the serum and hepatic malondialdehyde contents in hyperlipidaemic rats. In addition, a histopathological examination revealed that ODP-Ia administration significantly suppressed inflammatory cell infiltration and the expression of VCAM-1. Together, these results indicate that ODP-Ia is a potential natural product for the treatment of hyperlipidaemia-related diseases by improving antioxidant levels, modulating the activities of enzymes involved in cholesterol metabolism, promoting the production of NO and suppressing the expression of VCAM-1, thereby suppressing lipid accumulation and inflammatory cell infiltration. [Copyright &y& Elsevier]

Objectives: This study aimed to identify the prevalences of and risk factors associated with the development of gallbladder stones and polyps in a large Chinese population. Methods: Prevalences of and risk factors for biliary stones and gallbladder polyps were retrospectively investigated among subjects who underwent a general check-up at the Health Screening Centres of Peking Union Medical College Hospital and Beijing Charity Hospital between January 2007 and June 2010. Results: A total of 60 064 people were enrolled in the study. Overall prevalences of biliary stones and gallbladder polyps were 4.2% ( n= 2527) and 6.9% ( n= 4119), respectively. Risk factors associated with increased odds ratios (ORs) for the development of biliary stones were female gender (OR = 1.51), age ≥50 years (OR = 2.09), history of hypertension (OR = 1.37), thickened gallbladder wall (cholecystitis) (OR = 1.98), fasting blood glucose ≥6.10 mmol/l (OR = 1.27), body mass index ≥25 kg/m2 (OR = 1.25), systolic blood pressure ≥140 mmHg (OR = 1.31) and diastolic blood pressure ≥90 mmHg (OR = 1.44). Factors associated with gallbladder polyps were female gender (OR = 0.66), thickened gallbladder wall (OR = 2.09), negativity for hepatitis B surface antigen (HBsAg) and positivity for hepatitis B core antibody (anti-HBc) (OR = 2.61), and positivity for both HBsAg and anti-HBc (OR = 3.21). Conclusions: Prevalences of biliary stones and gallbladder polyps among Chinese people are similar to those reported for other populations. Biliary stones appear to be associated with female gender, age, obesity, blood glucose, blood pressure and cholecystitis. Male gender, hepatitis B virus infection and cholecystitis were strong risk factors for the formation of gallbladder polyps. [ABSTRACT FROM AUTHOR]

Abstract: Ischemic preconditioning (IPC) produces cardioprotection by phosphorylation of glycogen synthaes kinase-3β (GSK-3β) that inhibits the opening of mitochondrial permeability transition pore (MPTP), and this cardioprotective action of IPC is attenuated by hyperlipidaemia. The present study investigated the role of GSK-3β in attenuation of cardioprotective effect of IPC, by hyperlipidaemia in the rat heart. Hyperlipidaemia was produced in rat by feeding high fat diet for six weeks. Isolated perfused rat heart was subjected to 30min of ischemia followed by 120min of reperfusion. Myocardial infarct size was estimated by triphenyltetrazolium chloride (TTC) staining and lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) was analyzed from coronary effluent. IPC significantly decreased the myocardial infarct size and the release of LDH and CK-MB from normal rat heart. IPC induced myocardial protection was attenuated in hyperlipidaemic rat heart. However, cardioprotective effect of pharmacological preconditioning with GSK-3β inhibitors i.e. Lithium Chloride (LiCl) (20mM), Indirubin – 3 Monooxime (1μM) and 3-(2, 4-dichlorophenyl)-4-(1-methyl-1H-indol-3-yl)-1H-pyrrole-2, 5-dione (SB216763) (3μM), was not attenuated. This differential attenuation by hyperlipidaemia, of IPC and pharmacological preconditioning induced cardioprotection is a new finding in our study. GSK-3β inhibition is reported to increase the threshold of opening for MPTP during reperfusion. Administration of atractyloside (20μM), an opener of MPTP, significantly attenuated the cardioprotective effect of IPC in normal heart, and pharmacological preconditioning in the hyperlipidaemic rat heart. Thus, the attenuation of cardioprotective effect of IPC in hyperlipidaemic heart may be due to inhibition of protective signaling pathways upstream of GSK-3β and inhibition of opening of MPTP. [Copyright &y& Elsevier]

Abstract: The phytochemical constituents of a freeze-dried powder of mulberry (Morus alba L.) fruit (MFP) were determined. The hypolipidemic and antioxidant effects of the MFP as a dietary supplement were evaluated in rats who were fed 4 weeks of either a high-fat or a normal diet supplemented with 5% or 10% MFP. Administration of MFP to rats on a high-fat diet resulted in a significant decline in levels of serum and liver triglyceride, total cholesterol, serum low-density lipoprotein cholesterol, and a decrease in the atherogenic index, while the serum high-density lipoprotein cholesterol was significantly increased. In addition, the serum and liver content of thiobarbituric acid related substances, a lipid peroxidation product, significantly decreased, while the superoxide dismutase (SOD) of red blood cell and liver, as well blood glutathione peroxidase (GSH-Px) activities significantly increased. No significant changes in lipid profile in the serum and liver were observed in rats on a normal diet supplemented with MFP, but blood and liver antioxidant status improved, as measured by SOD and GSH-Px activity, and lipid peroxidation was reduced. These beneficial effects of MFP on hyperlipidaemia rats might be attributed to its dietary fiber, fatty acids, phenolics, flavonoids, anthocyanins, vitamins and trace elements content. [ABSTRACT FROM AUTHOR]

The most common neonatal complication of gestational diabetes (GDM) is macrosomia. During early pregnancy an accumulation of maternal fat depots occurs followed by increased adipose tissue lipolysis and subsequent hyperlipidaemia, which mainly corresponds to increased triglycerides (TG) in all circulating lipoproteins. In GDM women, the enhanced insulin resistance and decreased oestrogens are responsible for the reported wide range of dyslipidaemic conditions. In GDM, decreased proportion of long chain polyunsaturated fatty acids in fetus plasma could result from decreased supply, impaired placental transfer or even altered intrauterine metabolism. A positive correlation between maternal TG and neonatal body weight or fat mass has been found in GDM. Augmented oxidative stress and altered adipokines have also been found, with an adverse outcome even in normoglycaemic conditions. Thus, although additional studies are required, overall these findings indicate that altered maternal lipid metabolism rather than hyperglycaemia constitutes a risk for macrosomia in GDM. [Copyright &y& Elsevier]

Abstract: Vascular disease refers to the systemic condition of atherosclerosis that may be manifested by a variety of systematic symptoms and signs. It encompasses peripheral arterial disease (PAD), aortic aneurysms, carotid arterial disease, ischaemic heart disease and conditions such as atherosclerotic renal arterial stenosis. It is now recognized that conditions such as intermittent claudication, a manifestation of PAD, carry prognostic significance for myocardial infarct, stroke and cardiovascular mortality, and this has resulted in increased emphasis on identification and management of the risk factors for vascular disease. Principal modifiable risk factors for atherosclerosis include smoking, hypertension, diabetes mellitus, hyperlipidaemia and hyperhomocysteinaemia. These factors should be treated aggressively in patients with vascular disease. This article reviews the medical management of risk factors for vascular disease. [Copyright &y& Elsevier]

Abstract: Introduction: AAA screening programmes have proven to be beneficial and cost effective worldwide for males greater than 65 years of age, with 4.9% males of 65–75 years of age having an un-diagnosed AAA at screening, resulting in a 42% reduction in the risk of rupture in an English population. This study assessed the incidence of AAA and risk factors for atherosclerosis in Irish males of 55–75 years. Methods: From April 2006 to December 2007, males between the ages of 55 and 75 years, living within the catchment area of Blanchardstown Hospital were invited for AAA screening using duplex ultrasound and cardiovascular risk factor screening. Results: 1.9% (17/904) of the study population had previously un-diagnosed aneurysms detected, with sizes ranging from 3.0cm to 5.8cm (0.6% in 55–65 years old (yo) and 4.2% in 65–75 yo, p <0.01). 33% (302/904) of patients had hyperlipidaemia, while 16% of those with a previous diagnosis of hyperlipidaemia, were inadequately controlled on the test date. 31% of patients had a single elevated blood pressure reading, meriting further investigation for possible hypertension. 3% (28/904) of all patients had a raised glucose levels which had not previously been identified and of those who had a previous history of DM, 46% had abnormal glucose levels. 16% of patients (93/573) were morbidly obese (BMI>30) and 64% (292/573) were overweight. Conclusion: The incidence of AAAs in 65–75-year-old men is similar to international figures. This study confirms that screening for hyperlipidaemia, hypercholesterolaemia, obesity and hypertension may be worthwhile in all males over 55 years, while AAA screening should be reserved for 65–75-year-old Irish males. [Copyright &y& Elsevier]

Abstract: Vascular contractility and endothelium-dependent vasodilatation were studied in mesenteric, aorta and coronary vasculature from male and female LDL receptor deficient (LDLR-/-) and wild type C57BL/6 mice fed either a high-fat Western Diet (WD) or regular animal chow (RD). Endothelium-dependent vasodilatation was also studied in small mesenteric arteries and aorta from C57BL/6 mice following a 20 h exposure in vitro to 30 mM glucose. Compared with RD-fed animals, WD-fed LDLR-/- animals had increased body weights, elevated triglycerides and total cholesterol, but not glucose. Control C57BL6 animals had elevated body weight without increased cholesterol, triglyceride or glucose levels. The contractile sensitivity to cirazoline (pD2) of small mesenteric arteries was the same for RD-fed LDLR-/- and RD-fed C57BL6 mice, but was reduced in WD-fed male LDLR-/- and WD-fed female C57BL/6 mice. Maximum mesenteric contractile values for cirazoline (Emax) were unchanged; however, the Emax for phenylephrine in the aorta from WD-fed male C57BL/6 (but not LDLR-/- or female C57BL/6) mice was reduced. The Emax for acetylcholine-mediated endothelium-dependent vasodilatation in micro- and macro vessels (small mesenteric artery, coronary artery and aorta) from WD-fed LDLR-/- and C57BL/6 mice was unaltered, in contrast to the reduction in Emax for glucose-exposed tissues. Furthermore, the component of acetylcholine-mediated vasodilatation resistant to the combination of inhibitors of nitric oxide synthase, cyclooxygenase and guanylyl cyclase (nitro L-arginine methyl ester – 100 µM; indomethacin 10 µM and 1H-[1,2,4]-oxadiazolo[4,3,-a]quinoxalin-1-one, ODQ – 10 µM, respectively) was generally greater in WD-fed mice. Thus, vasculature from WD-fed mice with short-term dyslipidaemia do not exhibit reduced endothelium-dependent vasodilatation, but the WD is associated with changes in the overall endothelial-dependent relaxation and contractile responses thus suggesting an impact of diet rather than dyslipidaemia on cellular signalling pathways in vascular tissue. In contrast, acute hyperglycaemia resulted in endothelial dysfunction in both small mesenteric arteries and thoracic aorta. [Copyright &y& Elsevier]

Abstract: Background: Although ischemic preconditioning (PC) is known to confer cardioprotection in healthy subjects, it is unclear whether this phenomenon exists in the presence of hyperlipidaemia. The goal of this study was to determine whether the cardioprotective effect of PC is affected by hyperlipidaemia in a guinea pig model. Methods: We investigated the influence of preconditioning in normo- and hyperlipidaemic animals on papillary muscle contractility and myocardial damage as expressed by the percentage of apoptotic cells. Guinea pigs were fed a normal diet or a hyperlipidaemic diet for 5 weeks. Experiments were performed on papillary muscles subjected to experimental ischemia-reperfusion with or without prior PC. Results: The dietary treatment resulted in significant changes in lipid parameters, which had not affected the functionality of the right ventricle papillary muscle, both at basal conditions and in response to ischemia-reperfusion injury. However, it was found that the hyperlipidaemic diet had an effect on ischemia-induced apoptosis. Papillary muscles of hyperlipidaemic animals with higher HDL plasma concentrations were less susceptible to ischemia-reperfusion injury. Conclusions: This study demonstrates that hyperlipidaemia does not alter the benefits of ischemic preconditioning such as a reduction of apoptosis and preservation of myocardial contractility. Additionally, it has been shown that plasma HDL may protect cardiomyocytes against ischemia-induced apoptosis. [Copyright &y& Elsevier]

Abstract: Background: During the last decade, the evidence of beneficial effects of cholesterol lowering in patients with coronary heart disease (CHD) has been proven in several clinical trials. This has prompted international guidelines on prevention of CHD to include recommendations on dietary and pharmacological treatment of hyperlipidaemia with set goals on total- and LDL-cholesterol. Methods: The first EUROASPIRE survey performed in 1995/1996 showed poor adherence to the European recommendations on lipid-lowering in patients with CHD. The second survey was carried out in 1999/2000 in 15 European countries and enrolled 8181 patients with CHD. Medical records were assessed and clinical examinations of risk factors including serum lipids were performed. The aim of this survey is to describe the treatment of hyperlipidaemia among CHD patients in Europe. Results: The proportion of patients not reaching the target of 5.0mmol/l was 58.3% with significant variations between countries. The use of lipid-lowering drugs was relatively high (60.9%). However, the most frequently used doses of lipid-lowering agents were much lower than the doses of proven effect used in clinical trials. Conclusions: Although the treatment of hyperlipidaemia in CHD patients seems to be improving as compared to the first survey, a significant number of patients do not reach treatment goals. If the full potential of lipid-lowering therapy was utilised with all eligible patients treated and doses titrated correctly, more patients would benefit in terms of reduced morbidity and mortality of CHD. [Copyright &y& Elsevier]

Abstract: The present study aimed to compare the associations of postprandial glucose (ppGL) and postprandial triglycerides (ppTG) with carotid intima media thickness (cIMT) in women with normal glucose metabolism (NGM) and type 2 diabetes (DM2). Post-menopausal women (76 with NGM, 78 with DM2), received two consecutive fat-rich and two consecutive carbohydrate-rich meals on separate occasions. Blood samples were taken before and 1, 2, 4, 6 and 8h following breakfast; lunch was given at t =4. Ultrasound imaging of the carotid artery was performed to measure cIMT. In women with NGM, an increase of 1.0mmol/l glucose following the fat-rich meals was associated with a 50μm cIMT increase (p =0.04), and following the carbohydrate meals, an increase of 1.8mmol/l glucose was associated with a 50μm larger cIMT (p =0.08). These associations were not explained by classical cardiovascular risk factors. However, no association between ppGL and cIMT was found in women with DM2 and ppTG were not associated with cIMT. The association between ppGL and cIMT in normoglycaemic women suggests that ppGL in the normal range is a marker or a risk factor for atherosclerosis. Postprandial glucose levels might be a better indicator of risk than post-OGTT glucose levels or triglyceride levels. [Copyright &y& Elsevier]