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Zhao W, Wang Y, Li J, Chen T, Yin D, Dai H, Yao Z, Zhao S. Efficacy and safety of omega-3-acid ethyl acetate 90 capsules in severe hypertriglyceridemia: A randomized, controlled, multicenter study. Lipids 2024. [PMID: 38830807 DOI: 10.1002/lipd.12406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
Omega-3-acid ethyl acetate 90 capsules (containing 465 mg of eicosapentaenoic acid and 375 mg docosahexaenoic acid) is composed of highly purified omega-3 polyunsaturated fatty acid (PUFA) ethyl esters, whose lipid-lowering effect for severe hypertriglyceridemia (HTG) treatment is unclear. This study aimed to evaluate the efficacy and safety of omega-3-acid ethyl acetate 90 capsules in patients with severe HTG. In this randomized, double-blind, placebo-controlled, multicenter study, 239 patients with severe HTG were enrolled and randomized (1:1) into omega-3 group (N = 122) and placebo group (N = 117) to receive 12-week corresponding treatments. Lipid-related indexes were obtained at treatment initiation (W0), 4 weeks (W4), W8, and W12 after treatment. Adverse events and adverse drug reactions were recorded. Triacylglycerols (TAG), total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), very-low-density lipoprotein cholesterol (VLDL-C), and apolipoprotein C-III (Apo C-III) at W4, W8, and W12 were decreased in the omega-3 group versus the placebo group (all p < 0.05). Moreover, the percentage changes of TAG, TC, non-HDL-C, and VLDL-C from W0 to W4, W8, and W12, and the percentage change of Apo C-III from W0 to W4 and W8, were more obvious in the omega-3 group compared with the placebo group (all p < 0.05). However, no difference was observed in the percentage changes of HDL-C, low-density lipoprotein cholesterol (LDL-C), and LDL-C/HDL-C ratio during follow-up between groups (all p > 0.05). Additionally, there was no discrepancy in adverse events and adverse drug reactions between groups (all p > 0.05). Omega-3-acid ethyl acetate 90 capsules exhibit satisfied lipid-lowering effect with tolerable safety profile in patients with severe HTG.
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Affiliation(s)
- Wang Zhao
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yangang Wang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jin Li
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Tao Chen
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital of SiChuan University, Chengdu, Sichuan, China
| | - Delu Yin
- Department of Cardiology, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
| | - Hailong Dai
- Department of Cardiology, Yan'an Affiliated Hospital of Kunming Medical University, Yunnan Cardiovascular Hospital, Kunming, Yunnan, China
| | - Zhuhua Yao
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Shuiping Zhao
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Simental-Mendía LE, Simental-Mendía M, Sahebkar A, Atkin SL, Jamialahmadi T. Effect of Fibrate Treatment on Circulating Adipokine Levels: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Arch Med Res 2024; 55:102957. [PMID: 38266418 DOI: 10.1016/j.arcmed.2024.102957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Fibrates are widely used in the treatment of dyslipidemia and associated metabolic abnormalities; however, their effects on adipokines are unclear. AIM OF THE STUDY This meta-analysis of clinical trials aimed to evaluate the effect of fibrates on circulating adipokine levels. METHODS Only randomized controlled trials investigating the impact/effect of fibrate treatment on circulating adipokine levels were included from searches in PubMed-Medline, SCOPUS, ClinicalTrials.gov, Web of Science, and Google Scholar databases. A random effects model and the generic inverse variance method were used for the meta-analysis. Sensitivity analysis was conducted using the leave-one-out method. RESULTS This meta-analysis of 22 clinical trials showed a significant reduction on/in leptin (WMD: -1.58 ng/mL, 95% CI: -2.96, -0.20, p = 0.02, I2 = 0%), plasminogen activator inhibitor-1 (PAI-1) (WMD: -13.86 ng/mL, 95% CI: -26.70, -1.03, p = 0.03, I2 = 99%), and visfatin (WMD: -1.52 ng/mL, 95% CI: -2.49, -0.56, p = 0.002, I2 = 0%) after fibrate therapy; no significant effect was observed on adiponectin (WMD: -0.69 µg/ml, 95% CI: -1.40, 0.02, p = 0.06, I2 = 83%) and resistin (WMD: -2.27 ng/mL, 95% CI: -7.11, 2.57, p = 0.36, I2 = 0%). The sensitivity analysis was robust only for visfatin, while the effect size was sensitive to one arm for leptin, four for adiponectin, and two for PAI-1. CONCLUSION This meta-analysis showed that fibrate treatment significantly improves adipokine levels with a decrease in leptin, PAI-1, and visfatin, suggesting potential additional clinical therapeutic benefits through/of fibrate treatment on adipose tissue.
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Affiliation(s)
- Luis E Simental-Mendía
- Biomedical Research Unit, Delegación Durango, Instituto Mexicano del Seguro Social, Mexico.
| | - Mario Simental-Mendía
- Department of Orthopedics and Traumatology, Hospital Universitario Dr. José E. González, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Stephen L Atkin
- Research Department, Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
| | - Tannaz Jamialahmadi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Reijnders E, van der Laarse A, Jukema JW, Cobbaert CM. High residual cardiovascular risk after lipid-lowering: prime time for Predictive, Preventive, Personalized, Participatory, and Psycho-cognitive medicine. Front Cardiovasc Med 2023; 10:1264319. [PMID: 37908502 PMCID: PMC10613690 DOI: 10.3389/fcvm.2023.1264319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
As time has come to translate trial results into individualized medical diagnosis and therapy, we analyzed how to minimize residual risk of cardiovascular disease (CVD) by reviewing papers on "residual cardiovascular disease risk". During this review process we found 989 papers that started off with residual CVD risk after initiating statin therapy, continued with papers on residual CVD risk after initiating therapy to increase high-density lipoprotein-cholesterol (HDL-C), followed by papers on residual CVD risk after initiating therapy to decrease triglyceride (TG) levels. Later on, papers dealing with elevated levels of lipoprotein remnants and lipoprotein(a) [Lp(a)] reported new risk factors of residual CVD risk. And as new risk factors are being discovered and new therapies are being tested, residual CVD risk will be reduced further. As we move from CVD risk reduction to improvement of patient management, a paradigm shift from a reductionistic approach towards a holistic approach is required. To that purpose, a personalized treatment dependent on the individual's CVD risk factors including lipid profile abnormalities should be configured, along the line of P5 medicine for each individual patient, i.e., with Predictive, Preventive, Personalized, Participatory, and Psycho-cognitive approaches.
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Affiliation(s)
- E. Reijnders
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - A. van der Laarse
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - J. W. Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Heart Institute, Utrecht, Netherlands
| | - C. M. Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands
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Taha HSED, Kandil H, Farag N, Oraby A, Sharkawy ME, Fawzy F, Mahrous H, Bahgat J, Samy M, Aboul M, Abdrabou M, Shaker MM. Egyptian practical guidance in hypertriglyceridemia management 2021. Egypt Heart J 2021; 73:107. [PMID: 34928475 PMCID: PMC8688602 DOI: 10.1186/s43044-021-00235-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
Hypertriglyceridemia (HTG) is a very common, yet underappreciated problem in clinical practice. Elevated triglyceride (TG) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD) risk. Furthermore, severe HTG may lead to acute pancreatitis. Although LDL-guided statin therapy has improved ASCVD outcomes, residual risk remains. Recent trials have demonstrated that management of high TG levels, in patients already on statin therapy, reduces the rate of major vascular events. Few guidelines were issued, providing important recommendations for HTG management strategies. The goal of treatment is to reduce the risk of ASCVD and acute pancreatitis. The management stands on lifestyle modification, detection of secondary causes of HTG and pharmacological therapy, when indicated. In this guidance we review the causes and classification of HTG and summarize the current methods for risk estimation, diagnosis and treatment. The present guidance provides a focused update on the management of HTG, outlined in a simple user-friendly format, with an emphasis on the latest available data.
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Affiliation(s)
- Hesham Salah El Din Taha
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt.
| | - Hossam Kandil
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | | | | | | | - Fouad Fawzy
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Hossam Mahrous
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Juliette Bahgat
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Mina Samy
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Mohamed Aboul
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Mostafa Abdrabou
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
| | - Mirna Mamdouh Shaker
- Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt
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So HC, Chau CKL, Cheng YY, Sham PC. Causal relationships between blood lipids and depression phenotypes: a Mendelian randomisation analysis. Psychol Med 2021; 51:2357-2369. [PMID: 32329708 DOI: 10.1017/s0033291720000951] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The etiology of depression remains poorly understood. Changes in blood lipid levels were reported to be associated with depression and suicide, however study findings were mixed. METHODS We performed a two-sample Mendelian randomisation (MR) analysis to investigate the causal relationship between blood lipids and depression phenotypes, based on large-scale GWAS summary statistics (N = 188 577/480 359 for lipid/depression traits respectively). Five depression-related phenotypes were included, namely major depression (MD; from PGC), depressive symptoms (DS; from SSGAC), longest duration and number of episodes of low mood, and history of deliberate self-harm (DSH)/suicide (from UK Biobank). MR was conducted with inverse-variance weighted (MR-IVW), Egger and Generalised Summary-data-based MR (GSMR) methods. RESULTS There was consistent evidence that triglyceride (TG) is causally associated with DS (MR-IVW β for one-s.d. increase in TG = 0.0346, 95% CI 0.0114-0.0578), supported by MR-IVW and GSMR and multiple r2 clumping thresholds. We also observed relatively consistent associations of TG with DSH/suicide (MR-Egger OR = 2.514, CI 1.579-4.003). There was moderate evidence for positive associations of TG with MD and the number of episodes of low mood. For HDL-c, we observed moderate evidence for causal associations with DS and MD. LDL-c and TC did not show robust causal relationships with depression phenotypes, except for weak evidence that LDL-c is inversely related to DSH/suicide. We did not detect significant associations when depression phenotypes were treated as exposures. CONCLUSIONS This study provides evidence to a causal relationship between TG, and to a lesser extent, altered cholesterol levels with depression phenotypes. Further studies on its mechanistic basis and the effects of lipid-lowering therapies are warranted.
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Affiliation(s)
- Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
- KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology and The Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Shenzhen, China
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carlos Kwan-Long Chau
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yu-Ying Cheng
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Pak C Sham
- Depeartment of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
- Center for Genomic Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
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Luçardo JDC, Monk GF, Dias MDS, Martins-Silva T, Fernandes MP, Maia JC, Valle SC, Vaz JDS. Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder. J Pediatr (Rio J) 2021; 97:103-108. [PMID: 32087108 PMCID: PMC9432298 DOI: 10.1016/j.jped.2020.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. METHODS Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. RESULTS Sixty patients were evaluated. The average age was 8.6±3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. CONCLUSION Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.
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Affiliation(s)
- Josiane da Cunha Luçardo
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil.
| | - Giliane Fraga Monk
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil
| | - Mariane da Silva Dias
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Thais Martins-Silva
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Mayra Pacheco Fernandes
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Juliana Costa Maia
- Universidade Federal de Pelotas, Faculdade de Medicina, Neuropediatria, Pelotas, RS, Brazil
| | - Sandra Costa Valle
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Faculdade de Nutrição, Pelotas, RS, Brazil
| | - Juliana Dos Santos Vaz
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentação, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Faculdade de Nutrição, Pelotas, RS, Brazil.
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Huang X, Li G, Xu B, Zhang J, Wang X, Cheng X, Jayachandran M, Huang Y, Qu S. Lower Baseline Serum Triglyceride Levels Are Associated With Higher Decrease in Body Mass Index After Laparoscopy Sleeve Gastrectomy Among Obese Patients. Front Endocrinol (Lausanne) 2021; 12:633856. [PMID: 33692759 PMCID: PMC7937917 DOI: 10.3389/fendo.2021.633856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/07/2021] [Indexed: 12/23/2022] Open
Abstract
AIMS To investigate the predictive value of baseline serum triglyceride (TG) levels for improvements of metabolism after laparoscopic sleeve gastrectomy (LSG). METHODS 112 obese patients [body mass index (BMI) ≥ 35 kg/m2] underwent LSG and with complete information of anthropometric and metabolic parameters were divided into normal TG group (group A) and high TG group (group B), while group A had TG levels ≤ 1.7 mmol/L, and group B had TG levels > 1.7 mmol/L. The post-operative changes (Δ) in metabolic parameters between the two groups were compared. RESULTS In the whole cohort, the metabolic parameters were significantly improved at 6 months after LSG. BMI and waist circumference (WC) decreased significantly in the two groups. The ΔBMI among group A and group B were 11.42±3.23 vs 9.13±2.77 kg/m2 (p<0.001), respectively. ΔBMI was positively correlated with ΔWC (r=0.696, p<0.001), Δfasting insulin level (r=0.440, p=0.002), Δfasting serum C peptide level (r=0.453, p=0.002), and Δhomeostasis model assessment insulin resistance index (r=0.418, p=0.004) in group A. Compared with group B, group A had a significantly higher odds ratio (OR) of 2.83 (95% confidence interval [CI]1.25-6.38, p=0.012)and 2.73 (95% CI 1.11-6.72, p=0.029) for ΔBMI and ΔWC after adjustment for age and gender, respectively. CONCLUSIONS Obese patients with baseline TG levels under 1.7 mmol/L had greater loss of weight at six months follow-up later LSG. This finding suggests that baseline TG level may have a predictive value for weight loss, at least in the short-term follow-up.
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Affiliation(s)
- Xiu Huang
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Guifang Li
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Bei Xu
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Junyi Zhang
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Xingchun Wang
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
- Shanghai Center of Thyroid Disease, Shanghai, China
| | - Xiaoyun Cheng
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Muthukumaran Jayachandran
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
| | - Yueye Huang
- Shanghai Center of Thyroid Disease, Shanghai, China
- *Correspondence: Shen Qu, ; Yueye Huang,
| | - Shen Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine Tongji University, Shanghai, China
- Shanghai Center of Thyroid Disease, Shanghai, China
- *Correspondence: Shen Qu, ; Yueye Huang,
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Hubacek JA, Dlouha D, Adamkova V, Schwarzova L, Lanska V, Ceska R, Satny M, Vrablik M. The Gene Score for Predicting Hypertriglyceridemia: New Insights from a Czech Case-Control Study. Mol Diagn Ther 2020; 23:555-562. [PMID: 31222479 DOI: 10.1007/s40291-019-00412-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Plasma triglyceride (TG) values are significant predictors of cardiovascular and total mortality. The plasma levels of TGs have an important genetic background. We analyzed whether 32 single nucleotide polymorphisms (SNPs) identified in genome-wide association studies are discriminators of hypertriglyceridemia (HTG) in the Czech population. OBJECTIVES The objective of this study was to replicate and test the original findings in an independent study and to re-analyze the gene score leading to HTG. METHODS In total, we analyzed 32 SNPs in 209 patients with plasma TG levels over 10 mmol/L (HTG group) and compared them in a case-control design with 524 treatment-naïve controls (normotriglyceridemic [NTG] group) with plasma TG values below 1.8 mmol/L. RESULTS Sixteen SNPs were significantly associated with an increased risk of HTG development, with odds ratios (ORs) (95% confidence interval [CI]) varying from 1.40 (1.01-1.95) to 4.69 (3.29-6.68) (rs964184 within the APOA5 gene). Both unweighted (sum of the risk alleles) and weighted gene scores (WGS) (log of the achieved ORs per individual genotype) were calculated, and both gene scores were significantly different between groups. The mean score of the risk alleles was significantly increased in the HTG group compared to the NTG group (18.5 ± 2.5 vs. 15.7 ± 2.3, respectively; P < 0.00001). Subjects with a WGS over 9 were significantly more common in the HTG group (44.5%) than in the NTG group, in which such a high score was observed in only 4.7% of subjects (OR 16.3, 95% CI 10.0-36.7; P < 0.0000001). CONCLUSIONS An increased number of risk genetic variants, calculated both in a weighted or unweighted manner, significantly discriminates between the subjects with HTG and controls. Population-specific sets of SNPs included into the gene score seem to yield better discrimination power.
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Affiliation(s)
- Jaroslav A Hubacek
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM-DEM-LAR), Videnska 1958/9, 140 21, Prague 4, Czech Republic.
| | - Dana Dlouha
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM-DEM-LAR), Videnska 1958/9, 140 21, Prague 4, Czech Republic
| | - Vera Adamkova
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lucie Schwarzova
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vera Lanska
- Statistical Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Richard Ceska
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Satny
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Vrablik
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Schubert M, Becher S, Wallert M, Maeß MB, Abhari M, Rennert K, Mosig AS, Große S, Heller R, Grün M, Lorkowski S. The Peroxisome Proliferator-Activated Receptor (PPAR)- γ Antagonist 2-Chloro-5-Nitro-N-Phenylbenzamide (GW9662) Triggers Perilipin 2 Expression via PPAR δ and Induces Lipogenesis and Triglyceride Accumulation in Human THP-1 Macrophages. Mol Pharmacol 2019; 97:212-225. [PMID: 31871304 DOI: 10.1124/mol.119.117887] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022] Open
Abstract
Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear hormone receptor family, playing pivotal roles in regulating glucose and lipid metabolism as well as inflammation. While characterizing potential PPARγ ligand activity of natural compounds in macrophages, we investigated their influence on the expression of adipophilin [perilipin 2 (PLIN2)], a well-known PPARγ target. To confirm that a compound regulates PLIN2 expression via PPARγ, we performed experiments using the widely used PPARγ antagonist 2-chloro-5-nitro-N-phenylbenzamide (GW9662). Surprisingly, instead of blocking upregulation of PLIN2 expression in THP-1 macrophages, expression was concentration-dependently induced by GW9662 at concentrations and under conditions commonly used. We found that this unexpected upregulation occurs in many human and murine macrophage cell models and also primary cells. Profiling expression of PPAR target genes showed upregulation of several genes involved in lipid uptake, transport, and storage as well as fatty acid synthesis by GW9662. In line with this and with upregulation of PLIN2 protein, GW9662 elevated lipogenesis and increased triglyceride levels. Finally, we identified PPARδ as a mediator of the substantial unexpected effects of GW9662. Our findings show that: 1) the PPARγ antagonist GW9662 unexpectedly activates PPARδ-mediated signaling in macrophages, 2) GW9662 significantly affects lipid metabolism in macrophages, 3) careful validation of experimental conditions and results is required for experiments involving GW9662, and 4) published studies in a context comparable to this work may have reported erroneous results if PPARγ independence was demonstrated using GW9662 only. In light of our findings, certain existing studies might require reinterpretation regarding the role of PPARγ SIGNIFICANCE STATEMENT: Peroxisome proliferator-activated receptors (PPARs) are targets for the treatment of various diseases, as they are key regulators of inflammation as well as lipid and glucose metabolism. Hence, reliable tools to characterize the molecular effects of PPARs are indispensable. We describe profound and unexpected off-target effects of the PPARγ antagonist 2-chloro-5-nitro-N-phenylbenzamide (GW9662) involving PPARδ and in turn affecting macrophage lipid metabolism. Our results question certain existing studies using GW9662 and make better experimental design of future studies necessary.
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Affiliation(s)
- Martin Schubert
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Stefanie Becher
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Maria Wallert
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Marten B Maeß
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Masoumeh Abhari
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Knut Rennert
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Alexander S Mosig
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Silke Große
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Regine Heller
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Michael Grün
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
| | - Stefan Lorkowski
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany (M.S., S.B., M.W., M.B.M., M.A., M.G., S.L.); Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany (M.S., M.W., M.G., S.L.); Institute of Biochemistry II, Jena University Hospital, Jena, Germany (K.R., A.S.M.); and Institute of Molecular Cell Biology, Center for Molecular Biomedicine (CMB), Jena University Hospital and Friedrich Schiller University Jena, Jena, Germany (S.G., R.H.)
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Chmelík Z, Šnejdrlová M, Vrablík M. Amaranth as a potential dietary adjunct of lifestyle modification to improve cardiovascular risk profile. Nutr Res 2019; 72:36-45. [PMID: 31757630 DOI: 10.1016/j.nutres.2019.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 08/25/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
The aim of this review was to summarize data regarding amaranth as a potential component of lifestyle modification to improve cardiovascular risk profiles by modifying cardiovascular risk factors such as cholesterol, diabetes, and hypertension. PubMed was searched for appropriate articles. The main inclusion criteria for articles were as follows: interventions with amaranth; conducted in humans or animals or in vitro; and reported serum lipids and lipoprotein levels, and antidiabetic, antihypertensive, and antioxidant abilities. The outcome measures were changes in serum lipids and the presence of antidiabetic, antihypertensive, and antioxidant activity. A total of 33 articles were included herein. Regarding hypolipidemic activity, most studies investigated the effect of intervention with amaranth in animals, and fewer studies were performed in humans. Most studies in animal models demonstrated the ability of amaranth to decrease total cholesterol and low-density lipoprotein cholesterol. Pilot studies in humans were not convincing regarding amaranth's lipid-lowering activity. Based on this search, it is not clear which constituents are potentially responsible for the hypocholesterolemic effect of amaranth. Some authors tend to think that squalene can play a role in this effect, whereas others suggest that different components of amaranth are of greater importance (eg, sterols, oil fractions rich in fatty acids, proteins, amino acids, or fiber) for its hypocholesterolemic effect. It is possible that several constituents are jointly responsible for this action. Regarding the antidiabetic, antihypertensive, and antioxidant activities, most studies were performed in vitro and showed good potential for all three biological effects. Future research should focus on clarifying the effect of amaranth on high-density lipoprotein cholesterol, identifying the constituents responsible for these beneficial effects, and providing more data regarding its use in humans, ideally using randomized controlled trials. The antidiabetic, antihypertensive, and antioxidant activities found in vitro should be confirmed further in animal or human models.
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Affiliation(s)
- Zdeněk Chmelík
- Third Department of Internal Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital in Prague, U Nemocnice 1, 128 08, Prague 2, Czech Republic.
| | - Michaela Šnejdrlová
- Third Department of Internal Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital in Prague, U Nemocnice 1, 128 08, Prague 2, Czech Republic.
| | - Michal Vrablík
- Third Department of Internal Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital in Prague, U Nemocnice 1, 128 08, Prague 2, Czech Republic.
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Gene Expression Profiles Induced by a Novel Selective Peroxisome Proliferator-Activated Receptor α Modulator (SPPARMα) Pemafibrate. Int J Mol Sci 2019; 20:ijms20225682. [PMID: 31766193 PMCID: PMC6888257 DOI: 10.3390/ijms20225682] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 12/16/2022] Open
Abstract
Pemafibrate is the first clinically-available selective peroxisome proliferator-activated receptor α modulator (SPPARMα) that has been shown to effectively improve hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C) levels. Global gene expression analysis reveals that the activation of PPARα by pemafibrate induces fatty acid (FA) uptake, binding, and mitochondrial or peroxisomal oxidation as well as ketogenesis in mouse liver. Pemafibrate most profoundly induces HMGCS2 and PDK4, which regulate the rate-limiting step of ketogenesis and glucose oxidation, respectively, compared to other fatty acid metabolic genes in human hepatocytes. This suggests that PPARα plays a crucial role in nutrient flux in the human liver. Additionally, pemafibrate induces clinically favorable genes, such as ABCA1, FGF21, and VLDLR. Furthermore, pemafibrate shows anti-inflammatory effects in vascular endothelial cells. Pemafibrate is predicted to exhibit beneficial effects in patients with atherogenic dyslipidemia and diabetic microvascular complications.
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Sahebkar A, Simental-Mendía LE, Katsiki N, Reiner Ž, Banach M, Pirro M, Atkin SL. Effect of fenofibrate on plasma apolipoprotein C-III levels: a systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open 2019; 8:e021508. [PMID: 30798284 PMCID: PMC6278807 DOI: 10.1136/bmjopen-2018-021508] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism. MATERIALS AND METHODS Randomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders. RESULTS Meta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) -4.78 mg/dL, 95% CI -6.95 to -2.61, p<0.001; I266.87%). Subgroup analysis showed that fenofibrate reduced plasma apo C-III concentrations in subgroups of trials with treatment durations of either <12 weeks (WMD -4.50 mg/dL, p=0.001) or ≥12 weeks (WMD: -4.73 mg/dL, p=0.009) and doses of fenofibrate <200 mg/day (WMD -6.33 mg/dL, p<0.001) and >200 mg/day (p=0.006), with no significant difference between the subgroups. CONCLUSION This meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day.
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Affiliation(s)
- Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Željko Reiner
- Department of Internal medicine, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
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Kleess LE, Janicic N. SEVERE HYPERTRIGLYCERIDEMIA IN PREGNANCY: A CASE REPORT AND REVIEW OF THE LITERATURE. AACE Clin Case Rep 2018; 5:e99-e103. [PMID: 31967011 DOI: 10.4158/accr-2018-0168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Severe gestational hypertriglyceridemia is a rare disease, and there are no published guidelines to assist the clinician in management. However, due to the elevations in lipids that occur during pregnancy, this condition is encountered in clinical practice and presents a therapeutic dilemma. We report the successful management and treatment of a patient with severe gestational hypertriglyceridemia and conducted a review of the literature regarding treatment modalities. Methods We conducted a search in PubMed from 1990 to 2018 for the following terms: "severe hypertriglyceridemia in pregnancy;" "management of hypertriglyceridemia in pregnancy;" "apheresis for severe gestational hypertriglyceridemia;" "TPN for severe gestational hypertriglyceridemia;" "insulin for severe gestational hypertriglyceridemia;" and "heparin for treatment of severe hypertriglyceridemia." We then reviewed the literature. Results Given the risks to the mother and fetus of severe hypertriglyceridemia, aggressive therapy should be initiated within a multidisciplinary team. There are multiple treatment modalities, including restrictive diet, various medications such as niacin, fibrates, intravenous heparin, insulin, and apheresis. Choice of treatment will depend on the patient's comorbidities, clinical status, and if there are any associated complications. Conclusion Treatment for severe gestational hypertriglyceridemia should be initiated immediately and aggressively to avoid risk to the mother and infant, including pancreatitis, hyperviscosity syndrome, preeclampsia, fetal death, and preterm labor.
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Masson W, Rossi E, Siniawski D, Damonte J, Halsband A, Barolo R, Scaramal M. Severe hypertriglyceridemia. Clinical characteristics and therapeutic management. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2018; 30:217-223. [PMID: 29789213 DOI: 10.1016/j.arteri.2018.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/14/2018] [Accepted: 03/27/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The therapeutic management of severe hypertriglyceridaemia represents a clinical challenge. OBJECTIVES The objectives of this study were 1) to identify the clinical characteristics of patients with severe hypertriglyceridaemia, and 2) to analyse the treatment established by the physicians in each case. METHODS A cross-sectional study was carried out using the computerised medical records of all patients>18 years of age with a blood triglyceride level≥1,000mg/dL between 1 January 2011 and 31 December 2016. Clinical and laboratory variables were collected. The behaviour of the physicians in the 6 months after the lipid finding was analysed. RESULTS A total of 420 patients were included (mean age 49.1±11.4 years, males 78.8%). The median of triglycerides was 1,329mg/dL (interquartile range 1,174-1,658). No secondary causes were found in 34.1% of the patients. The most frequent secondary causes were obesity (38.6%) and diabetes (28.1%). Physical activity was recommended and a nutritionist was referred to in 49.1% and 44.2% of the patients, respectively. Secondary causes were identified and attempts were made to correct them in 40.7% of cases. The most indicated pharmacological treatments were fenofibrate 200mg/day (26.5%) and gemfibrozil 900mg/day (19.3%). Few patients received the indication of omega 3 fatty acids or niacin. CONCLUSION This study showed, for the first time in our country, the characteristics of a population with severe hypertriglyceridaemia. The therapeutic measures instituted by the physicians were insufficient. Knowing the characteristics in this particular clinical scenario could improve the current approach of these patients.
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Affiliation(s)
- Walter Masson
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Emiliano Rossi
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniel Siniawski
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan Damonte
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Halsband
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ramiro Barolo
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Miguel Scaramal
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Effect of fibrates on glycemic parameters: A systematic review and meta-analysis of randomized placebo-controlled trials. Pharmacol Res 2017; 132:232-241. [PMID: 29292213 DOI: 10.1016/j.phrs.2017.12.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 12/26/2017] [Accepted: 12/27/2017] [Indexed: 12/26/2022]
Abstract
AIMS The aim of this meta-analysis of randomized placebo-controlled clinical trials was to assess the effect of fibrates on glycemic parameters. MATERIALS AND METHODS Only randomized placebo-controlled trials investigating the impact of fibrate treatment on glucose homeostasis markers were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (from inception to April 11, 2017). A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate the impact of potential confounders on glycemic parameters. RESULTS This meta-analysis of data from 22 randomized placebo-controlled clinical trials involving a total of 11,402 subjects showed that fibrate therapy significantly decreased fasting plasma glucose (WMD: -0.28 mmol/L, 95% CI: -0.42, -0.14, p < 0.001), insulin levels (WMD: -3.87 pmol/L, 95% CI: -4.97, -2.78, p < 0.001) and insulin resistance (HOMA-IR, WMD: -1.09, 95% CI: -1.71, -0.47, p = 0.001), but with no effect on HbA1c (WMD: 0.01%, 95% CI: -0.18, 0.19, p = 0.955). All analyses were robust in the leave-one-out sensitivity analysis except for insulin levels that showed a non-significant result (WMD: -0.84 pmol/L, 95% CI: -6.36, 4.68, p = 0.766) following omission of one of the included trials. CONCLUSION This meta-analysis has shown that fibrate treatment significantly decreases fasting plasma glucose, insulin levels, and HOMA-IR indicating additional clinical therapeutic benefits.
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Fermented green tea extract exhibits hypolipidaemic effects through the inhibition of pancreatic lipase and promotion of energy expenditure. Br J Nutr 2017; 117:177-186. [PMID: 28132656 DOI: 10.1017/s0007114516004621] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hyperlipidaemia is a major cause of atherosclerosis and related CVD and can be prevented with natural substances. Previously, we reported that a novel Bacillus-fermented green tea (FGT) exerts anti-obesity and hypolipidaemic effects. This study further investigated the hypotriglyceridaemic and anti-obesogenic effects of FGT and its underlying mechanisms. FGT effectively inhibited pancreatic lipase activity in vitro (IC50, 0·48 mg/ml) and ameliorated postprandial lipaemia in rats (26 % reduction with 500 mg/kg FGT). In hypertriglyceridaemic hamsters, FGT administration significantly reduced plasma TAG levels. In mice, FGT administration (500 mg/kg) for 2 weeks augmented energy expenditure by 22 % through the induction of plasma serotonin, a neurotransmitter that modulates energy expenditure and mRNA expressions of lipid metabolism genes in peripheral tissues. Analysis of the gut microbiota showed that FGT reduced the proportion of the phylum Firmicutes in hamsters, which could further contribute to its anti-obesity effects. Collectively, these data demonstrate that FGT decreases plasma TAG levels via multiple mechanisms including inhibition of pancreatic lipase, augmentation of energy expenditure, induction of serotonin secretion and alteration of gut microbiota. These results suggest that FGT may be a useful natural agent for preventing hypertriglyceridaemia and obesity.
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Kohno M. Soybean Protein and Peptide as Complementation Medical Food Materials for Treatment of Dyslipidemia and Inflammatory Disorders. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2017. [DOI: 10.3136/fstr.23.773] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Autosomal dominant familial dysbetalipoproteinemia: A pathophysiological framework and practical approach to diagnosis and therapy. J Clin Lipidol 2017; 11:12-23.e1. [DOI: 10.1016/j.jacl.2016.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/26/2016] [Accepted: 10/02/2016] [Indexed: 11/18/2022]
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Piťha J, Kovář J, Blahová T. Fasting and nonfasting triglycerides in cardiovascular and other diseases. Physiol Res 2016; 64:S323-30. [PMID: 26680665 DOI: 10.33549/physiolres.933196] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Moderately elevated plasma/serum triglycerides (2-10 mmol/l) signalize increased risk for cardiovascular disease or presence of non-alcoholic steatohepatitis. Extremely elevated triglycerides (more than 10 mmol/l) signalize increased risk for pancreatitis and lipemia retinalis. The concentration of triglycerides is regulated by many genetic and nongenetic factors. Extremely elevated triglycerides not provoked by nutritional factors, especially inappropriate alcohol intake are more likely to have a monogenic cause. On the contrary, mildly to moderately elevated triglycerides are often caused by polygenic disorders; these could be also associated with central obesity, insulin resistance, and diabetes mellitus. Concentration of triglycerides is also closely interconnected with presence of atherogenic remnant lipoproteins, impaired reverse cholesterol transport and more atherogenic small LDL particles. In general, there is tight association between triglycerides and many other metabolic factors including intermediate products of lipoprotein metabolism which are frequently atherogenic. Therefore, reliable evaluation of the independent role of triglycerides especially in atherosclerosis and cardiovascular disease is difficult. In individual cases values of HDL cholesterol, non-HDL cholesterol (total minus HDL cholesterol), non-HDL/nonLDL cholesterol (total minus HDL minus LDL cholesterol, especially in nonfasting status), atherogenic index of plasma and/or apolipoprotein B could help in decisions regarding aggressiveness of treatment.
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Affiliation(s)
- J Piťha
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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