Atherosclerosis ; prevention & control ; Cholesterol, LDL ; blood ; Humans ; Hypercholesterolemia ; drug therapy ; United States

OBJECTIVE: To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia, and preliminarily explore its lipid-lowering mechanism. METHODS: A total of 90 early menopausal women with hypercholesterolemia were enrolled from December, 2014 to May, 2016 from Beijing Anzhen Hospital, Capital Medical University, who were randomly allocated to receive Xuezhikang (1200 mg/d, orally) or atorvastatin (10 mg/d, orally) according to a random number table. Serum levels of some related biomarkers, including cholesterol synthesis markers (squalene, dihydrocholesterol, dehydrocholesterol, and lathosterol), and absorption markers (campesterol, stigmasterol, and sitosterol) as well as safety indices were obtained at baseline and after 8 weeks of the intervention. RESULTS: Eight weeks after treatment, both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol, triglycerides, low density cholesterol compared to baseline (all P<0.01). Xuezhikang significantly reduced the levels of squalene, dehydrocholesterol and lathosterol compared to baseline (all P<0.01), but atorvastatin only significantly reduced the level of squalene (P<0.01), compared to baseline. All cholesterol absorption markers showed no significant differences before and after treatment (P>0.05), however, a more obvious downward trend was shown in the Xuezhikang group. In addition, all the safety indices showed no significant differences between the two groups. Although the creatinekinase level in the Xuezhikang group was significantly higher, it remained within the safe range. CONCLUSIONS Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its "natural polypill."
Biomarkers ; Cholesterol ; Drugs, Chinese Herbal ; Female ; Humans ; Hypercholesterolemia/drug therapy* ; Menopause

Atherosclerosis ; blood ; prevention & control ; Cardiovascular Diseases ; blood ; drug therapy ; prevention & control ; Cholesterol ; blood ; Humans ; Hypercholesterolemia ; drug therapy ; Practice Guidelines as Topic

BACKGROUND: The ciprofibrate, 3rd generation fibrate derivative, is known as an effective hypolipidemic drug in both hypercholesterolemia and hypertriglyceridemia. We studied the efficacy and side effects of ciprofibrate dmonotherapy in patients with primary type II and type IV hyperlipidemia. METHOD: Patients who showed 12-hours fasting serum total cholesterol level more than 240mg% and/or serum triglyceride level more than 250mg% were enrolled to diet therapy. After 12 weeks of diet therapy serum lipid profiles were checked and the drug therapy was considered according to the above mentioned guidelines. The ciprofibrate 100mg p.o qd was administrated and the patients had regular follow-up every 6 weeks for 12 weeks. RESULTS: The total study population was 32 patients. Fifteen patients were type II hyperlipidemia and seventeen patients were type IV hyperlipidemia. The drug was well tolerated in all patients. There was mild gastrointestinal side effects in 9% of study patients but no patients discontinued ciprofibrate due to side effects. There was mild and transient serum CK elevation less than 3 times of baslines in 5(15%) patients. The LFT, serum uric acid, BUN and creatinine level did not show any significant changes during therapy. Serum total cholesterol and apolipoprotein B level in patients with type II hyperlipidemia showed significant reduction after 6week of therapy. The mean reduction was 25% and 32% respectively. Serum triglyceride level in patients with type IV hyperlipidemia decreased by 55%. The reduction of total cholesterol more than 25% could be achieved in 50% of type II hyperlipidemia and the reduction of triglyceride more than 25% could be achieved in 93% of type IV hyperlipidemia. CONCLUSION: The ciprofibrate is effective and sage hypolidipemic drug in patients with primary type II and type IV hyperlipidemia.
Apolipoproteins ; Cholesterol ; Creatinine ; Diet Therapy ; Drug Therapy ; Fasting ; Follow-Up Studies ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Hypertriglyceridemia ; Triglycerides ; Uric Acid

OBJECTIVETo determine the percentage of hypercholesterolemic patients who had met the criteria as total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), defined by the Chinese National Recommendations for Prevention and Treatment of Dyslipidemia.

METHODSAdult patients with hypercholesterolemia, who had been receiving the same lipid-lowering therapy for at least 2 months, were enrolled. Lipid levels were determined at the time of enrollment, to assess whether the patients' lipid levels had reached the criteria for treatment. Patients' cardiovascular risk factors and lipid-lowering treatments were also collected.

RESULTSOne hundred and eighty patients with mean age of 65.8 were studied. Of these, 6.7% had no risk factors and no definite disease of atherosclerosis (low-risk group), 65.5% had risk factors but no documented atherosclerosis (high-risk group), and 27.8% had established atherosclerosis diseases or diabetes mellitus. Overall, only 44% of patients achieved both TC and LDL-C target levels. The success rates were higher among low and high-risk groups than that among patients with atherosclerosis or diabetes mellitus. The relationship between four different lipid-lowering drug therapies and successful patient outcome was also investigated. The success rates were 51.8% for simvastatin, 42.9% for pravastatin, 31.6% for fluvastatin, 12.5% for other drugs respectively.

CONCLUSIONMore than half of the hypercholesterolemic patients receiving lipid-lowering therapy had not achieved TC and LDL-C target levels. Data from this study indicated that a significant gap still existed between dyslipidemia prevention principles and clinical practices, suggesting that more aggressive treatment of dyslipidemia is needed.

Aged ; Anticholesteremic Agents ; therapeutic use ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Female ; Humans ; Hypercholesterolemia ; blood ; drug therapy ; Male ; Middle Aged

OBJECTIVETo investigate the effect of the Mortierella isabellina lipid-soluble extracts on improving hyperlipidemia and renal damage in lipid-induced renal injury rats.

METHODSThirty two male Wistar rats were divided into four groups: normal group (N), model group (M), the group treated with Mortierella isabellina lipid-soluble extracts (T) and Simvastatin (S). N group was fed a standard diet and the other groups were fed a high-fat diet. T and S groups were orally administered by Mortierella isabellina lipid-soluble extracts and Simvastatin respectively for 12 weeks. N and M groups were orally administered by the normal saline. Twenty four-hour urinary protein excretion was detected. The levels of serum ALB, TP, BUN, Scr, TG, TC, LDL and TG, TC, LDL in the kidney were measured at week 12. The histological change, ultrastructural change and lipid deposits in kidney were evaluated.

RESULTSAt the 12th week, compared with M group, twenty four hour urinary protein excretion and the levels of TC, LDL in serum and renal tissue in T and S group decreased (P < 0.01 or P < 0.05), but the levels of ALB and TP in T and S group increased markedly (P < 0.01). There was no significant difference of the levels of BUN, Scr, and TG among the four groups. The protein casts in renal tubules, inflammatory cell infiltration in tubulointerstitium as well as mild mesangial cell proliferation and expanded mesangial matrix were obseverd in M group. Electron micrograph demonstrated massive fusion of foot process of podocytes accompanied with rich lipid droplets in proximal tubular epithelial cells in M group.

CONCLUSIONThe lipid-soluble extracts of Mortierella isabellina has beneficial effect on improving hypercholesterolemia and kidney damage in lipid-induced renal injury rat.

Animals ; Biological Products ; therapeutic use ; Hypercholesterolemia ; drug therapy ; Kidney Diseases ; chemically induced ; drug therapy ; Lipids ; analysis ; Male ; Mortierella ; chemistry ; Rats ; Rats, Wistar

OBJECTIVETo study the effect of Lycium ruthenicum anthocyanins on atherosclerosis (AS) in mice.

METHODNormal mice were taken as the control group, and hyperlipemia mice were divided into the model group, Lycium ruthenicum anthocyanins low, medium and high dose groups, and the simvastatin drug control group. After the oral administration, blood lipid indicators were detected by enzymatic analysis. The histomorphological changes in aortas, hearts and livers were observed, and liver-related indicators were determined by using hematoxylin-eosin (HE) staining.

RESULTCompared with the high-fat group, L. ruthenicum anthocyanins low, medium and high dose groups showed significant decrease in total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and atherosclerotic index (AI) (P < 0.05). However, high-density lipoprotein cholesterol (HDL-C) level showed a trend of higher than the model group. Liver's total antioxidant capacity (T-AOC), Glutathione peroxidase (GSH-PX), lipoprotein lipase (LPL) were significantly increased (P < 0.05), malondialdehyde (MDA) was markedly decreased (P < 0.01); the percentage of aortic plaque area of each anthocyanins dose group in the total area was significantly lower than the model group (P < 0.05); severity of aorta, heart and liver were significantly lighter than the high-fat group. But the media dose group was similar with the simvastatin group.

CONCLUSIONL. ruthenicum anthocyanins can interfere the formation of AS, while lowering blood lipid levels in mice.

Animals ; Anthocyanins ; therapeutic use ; Atherosclerosis ; prevention & control ; Body Weight ; drug effects ; Glutathione Peroxidase ; metabolism ; Hypercholesterolemia ; blood ; drug therapy ; pathology ; Lipids ; blood ; Liver ; pathology ; Lycium ; chemistry ; Male ; Mice ; Phytotherapy

BACKGROUND: Previous studies indicated that a recently approved synthetic HMG-CoA reductase inhibitor, atorvastatin, reduces LDL cholesterol and triglyceride. To assess the efficacy on the level of serum LDL cholesterol and other lipoprotein fractions and its safety, we investigated 59 patients for lipid and side effect profile. METHOD: In patients with hypercholesterolemia, who showed 12-hours fasting serum LDL cholesterol>145 mg/dl and <250 mg/dl and triglyceride levels<400 mg/dl were enrolled to diet therapy for 4 weeks. After 4 weeks of diet therapy, serum lipid profile were reevaluated and patients with LDL cholesterol > or =130 mg/dl were assigned to receive 10 mg dose of atorvastatin once daily for 4weeks. After 4 weeks of drug therapy, serum lipid profile were rechecked, if showed LDL cholesterol level> or =130 mg/dl, assigned to receive 20 mg dose of atorvastatin once daily until 8 weeks. RESULTS: Of the 59 patients were assigned to receive atorvastatin therapy, 52 patients completed the study. Among lipid profiles, total cholesterol, triglyceride, LDL-cholesterol and apolipoprotein B levels showed significant reduction with mean reduction rate of 28%, 13%, 38%, 32% respectively after 4 weeks and 31%, 13%, 41% and 34% respectively after 8 weeks. HDL-Cholesterol and lipoprotein (a) level did not show significant change after 8 weeks of therapy. Nine patients had mild adverse events, such as elevated ALT, epigastric pain, insomnia, thumb pain. postural hypotension, palpitation and constipation. Only three patients of fifty-nine withdrew from the study due to adverse events related to drug treatment. CONCLUSION: The atorvastatin was highly effective and generally well tolerated with an acceptable safety profile in patients with primary hypercholestelemia.
Apolipoproteins ; Cholesterol ; Cholesterol, LDL ; Constipation ; Diet Therapy ; Drug Therapy ; Fasting ; Humans ; Hypercholesterolemia* ; Hypotension, Orthostatic ; Lipoprotein(a) ; Lipoproteins ; Oxidoreductases ; Sleep Initiation and Maintenance Disorders ; Thumb ; Triglycerides ; Atorvastatin Calcium

OBJECTIVETo assess the current status in dietary treatment of hypercholesterolemia and its effects on control of this disease in China.

METHODSTwenty five Tertiary-A hospitals from 12 provinces in China were selected, in which 2136 patients were recruited who had had hypercholesterolemia and had been receiving lipid lowering treatment for at least 2 months. Serum lipids level was determined for each patient at the time of enrollment, and using a simplified food frequency method carried out dietary intake survey. Patients who take meat of less than 75 g per day and eggs of less than 5 per week, and fried foods of less than 5 times per week, and butter cakes and pastry of less than 5 times per week were considered as having their diet controlled.

RESULTSAmong 1746 responded patients, 68.3% reported having controlled diet. Among those reported "controlled", 75% had a diet meeting the requirements suggested by the Chinese Recommendations on Prevention and Treatment of Hypercholesterolemia (CRPTH). The percentage of patients having their serum total cholesterol under control in diet controlled group, according to the CRPTH, was significantly higher than that in diet uncontrolled group (28.8% vs 13.6%, P < 0.01). After adjustment for drug treatment and other covariates, the diet controlled group showed a significantly higher rate in control of hypercholesterolemia than the diet uncontrolled group (OR = 2.7, 95% CI: 1.4 approximately 5.2).

CONCLUSIONDiet control significantly improves the status in control of hypercholesterolemia and thus should be reinforced in routine clinical practice.

Anticholesteremic Agents ; therapeutic use ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Humans ; Hypercholesterolemia ; blood ; diet therapy ; drug therapy ; Hypolipidemic Agents ; therapeutic use ; Treatment Outcome

BACKGROUND: The HMG-CoA reductase inhibitor is the most powerful cholesterol lowering drug and lovastatin, simvastatin and pravastatin are used clinically. We studied the efficacy and side effects of pravastatin monotherapy in patients with hypercholesterolemia(type IIa or IIb). METHODS: Patients who showed 12-hours fasting serum total cholesterol level more than 240mg% were enrolled to diet therapy. After 4weeks of diet therapy, serum lipid profiles were checked and the drug therapy was considered according to NCEP guidelines. The pravastatin 5mg po bid was administrated and the patients had regular follow-up every 2weeks for 8week. RESULTS: The total study population was 20 patients and the mean age of them was 55 years old (55+/-18, M : F=6 : 14). There were a few side effects in 5% of study patients and no patient discontinued pravastatin due to side effects.The side effect was G-I trouble and there were not other side effects. Serum CK was elevated in only one patient but the elevation was mild(less than 3 times) and transient. The LFT, serum uric acid, BUN and creatinine level did not show any significant changes during therapy. Among lipid profiles, total cholesterol, LDL-cholesterol and apolipoprotein B level showed significant reduction after therapy and the maximum reduction was achieved after 2week of therapy. The mean reduction was 20%, 33% and 23% respectively. HDL-cholesterol and apolipoprotein A1 11% and 17% respectively. The triglyceride level did not show any changes during therapy but in one type IIb patient, the triglyceride level decreased significantly. CONCLUSIONS: The pravastatin is effective and safe in patients with hypercholesterolemia.
Apolipoprotein A-I ; Apolipoproteins ; Cholesterol ; Creatinine ; Diet Therapy ; Drug Therapy ; Fasting ; Follow-Up Studies ; Humans ; Hypercholesterolemia* ; Lovastatin ; Middle Aged ; Oxidoreductases ; Pravastatin* ; Simvastatin ; Triglycerides ; Uric Acid