BACKGROUNDMenopausal hormone therapy (MHT) has been proven to have beneficial effects on several components of metabolic syndrome. However, the effects vary according to different regimens, dosages, and duration of MHT. The aim of the study was to evaluate the effect of standard-dose 0.625 mg conjugated equine estrogen (CEE) and half-dose 0.3 mg CEE daily with different progestogens in a continuous sequential regimen on postmenopausal metabolic parameters in generally healthy postmenopausal women.

METHODSA prospective, open-label, randomized controlled clinical trial was conducted between February 2014 and December 2015. Totally 123 Chinese postmenopausal women with climacteric symptoms were included in this study and were randomly assigned to three groups: Group A received CEE 0.3 mg/micronized progesterone (MP) 100 mg daily; Group B received CEE 0.625 mg/MP 100 mg daily; and Group C received CEE 0.625 mg/dydrogesterone 10 mg daily. Drugs were given in a continuous sequential pattern. The duration of treatment was 12 months. Clinical, anthropometrical, and metabolic variables were measured. Data were analyzed according to intention-to-treat analysis, using Student's t-test and analysis of variance.

RESULTSA total of 107 participants completed the 12-month follow-up and were included in the data analysis. At 12 months of treatment, high-density lipoprotein cholesterol and apolipoprotein A significantly increased, and low-density lipoprotein cholesterol, fasting glucose, and glycosylated hemoglobin significantly decreased in Groups B and C, compared with baseline (all P < 0.05). Among the three groups, only Group C showed significantly increased triglycerides compared with baseline (1.61 ± 0.80 mmol/L vs. 1.21 ± 0.52 mmol/L, P = 0.026). Each group showed a neutral effect on total cholesterol, lipoprotein A, apolipoprotein B, and fasting insulin levels. No cardiovascular and venous thromboembolic events occurred in the three groups.

CONCLUSIONSAmong Chinese postmenopausal women, half-dose CEE was not sufficient to induce a favorable lipid and carbohydrate profile compared with standard-dose CEE. Adding natural MP may counterbalance the TG-increasing effect of CEE.

TRIAL REGISTRATIONClinicalTrials.gov, NCT01698164; https://clinicaltrials.gov/ct2/show/NCT01698164?term=NCT01698164&rank=1.

Apolipoproteins B ; blood ; Blood Pressure ; drug effects ; Body Composition ; drug effects ; Dydrogesterone ; administration & dosage ; therapeutic use ; Estrogens, Conjugated (USP) ; administration & dosage ; therapeutic use ; Female ; Humans ; Insulin ; blood ; Lipoprotein(a) ; blood ; Metabolic Syndrome ; blood ; drug therapy ; Middle Aged ; Postmenopause ; Progesterone ; administration & dosage ; therapeutic use ; Triglycerides ; blood

OBJECTIVETo investigate the effect and molecular mechanisms of different doses of 8-hydroxy dihydroberberine (Hdber) for the treatment of hyperlipidemia in rats.

METHODSA rat model of hyperlipidemia was established by feeding rats a high-fat diet for 4 weeks in 70 rats of 80 animals, and 10 rats were randomly selected as control group. The hyperlipidemic rats were then randomly divided into the following groups: a model group (MOD); a berberine group [BBR, 156 mg/(kg day)]; Hdber groups, which were treated with different doses of Hdber [78, 39 and 19.5 mg/(kg day)]; and a simvastatin group [SIM, 4 mg/(kg day)]. The corresponding therapy was administered to the rats of each treatment via gastric tubes. Normal animals were used as a control group. The blood levels of various lipids, including total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, free fatty acid (FFA), apolipoprotein AI(Apo-AI) and apolipoprotein B (Apo-B) were examined. The protein expressions of low-density lipoprotein receptor (LDL-R), sterol regulatory element-binding protein 2 (SREBP-2), 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) and proprotein convertase subtilisin/kexin type 9 (PCSK-9) in liver tissues were determined by Western blot analysis.

RESULTSCompared with the control group of rats, the model group demonstrated a deteriorated blood lipid profile and exhibited increased expression levels of PCSK-9 protein in their liver tissues (P<0.01). In addition, the high-fat diet decreased the expression levels of LDL-R, SREBP-2 and HMGCR proteins in murine liver tissues. However, the addition of berberine or Hdber reversed the blood lipid profile changes (P<0.05 or P<0.01), decreased the expression levels of PCSK-9 proteins (P<0.01), and increased the expression levels of LDL-R proteins in the hyperlipidemic rats (P<0.01). These compounds did not significantly influence the expression levels of SREBP-2 and HMGCR proteins in the hyperlipidemic rats.

CONCLUSIONSHdber is effective in the treatment of hyperlipidemia in rats. The therapeutic mechanisms of Hdber may be associated with increasing the expression of LDL-R protein and decreasing the expression of PCSK-9 protein in liver tissues.

Animals ; Apolipoprotein A-I ; blood ; Apolipoproteins B ; blood ; Berberine ; analogs & derivatives ; pharmacology ; therapeutic use ; Hydroxymethylglutaryl CoA Reductases ; metabolism ; Hyperlipidemias ; blood ; drug therapy ; Lipids ; blood ; Liver ; drug effects ; metabolism ; Male ; Proprotein Convertase 9 ; Rats, Wistar ; Receptors, LDL ; metabolism ; Serine Endopeptidases ; metabolism ; Sterol Regulatory Element Binding Protein 2 ; metabolism

OBJECTIVETo study the effects of ApoE gene polymorphism on anti-inflammatory action of Xuezhikang Capsule.

METHODSOne hundred and two patients with hyperlipidemia (as the treated group) and one hundred healthy volunteers (as the control group) were enrolled in the case-control study. Total DNA of the peripheral blood was extracted and ApoE genotypes were determined by PCR sequence analysis. The serum levels of tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), and high sensitivity C reactive protein (hs-CRP)were measured in all subjects. The changes of TNF-alpha, IL-6, and hs-CRP were detected before and after 6-week Xuezhikang Capsule treatment, thus analyzing the correlation between ApoE gene polymorphism and changes of each inflammatory factor.

RESULTSThe frequency of E3/3 genotype was 86% (86/100 cases)in the control group, significantly higher than that of the treated group (62.7%, 64/102 cases). The frequency of E3/4 genotype was 6% (6/100 cases) in the control group, significantly lower than that of the treated group (21.6%, 22/102 cases; both P < 0.05). Compared with the control group, the serum levels of TNF-alpha, IL-6, and hs-CPR were higher in the treated group before treatment (P < 0.05). In hyperlipidemia patients with E3/4 + E4/4 genotype, the serum level of TNF-alpha was higher than that of E3/3 genotype (P < 0.05); the serum level of IL-6 was higher than that of E2/E2 + E2/E3 genotype (P < 0.05); the serum level of hs-CRP was higher than that of E2/E2 + E2/E3 and E3/E3 genotype (P < 0.05). But there was no statistical difference in the serum levels of TNF-alpha, IL-6, or hs-CPR between E3/3 and E2/E2 + E2/E3 genotype. After 6-week intervention of Xuezhikang Capsule, the serum levels of TNF-alpha, IL-6, and hs-CRP were lower in the treated group (P < 0.05), but the serum levels of TNF-alpha and IL-6 were still higher than those of the control group (P < 0.05). But there was no statistical difference in the decrement of TNF-alpha, IL-6, or hsCRP among E2/E2 + E2/E3, E3/E3, or E3/4 + E4/4 genotypes (P > 0.05).

CONCLUSIONSThe distribution of ApoE gene polymorphism is different between the hyperlipidemia patients and the healthy people. Chronic inflammatory reactions exist in hyperlipidemia patients, especially in those with e4 allele. Xuezhikang Capsule showed anti-inflammatory effects, but ApoE gene polymorphism did not affect its effects.

Adult ; Aged ; Anti-Inflammatory Agents ; therapeutic use ; Apolipoproteins E ; genetics ; C-Reactive Protein ; metabolism ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Genotype ; Humans ; Hyperlipidemias ; drug therapy ; genetics ; Interleukin-6 ; blood ; Male ; Middle Aged ; Phytotherapy ; Polymorphism, Genetic ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: To investigate the effect of administration of rosiglitazone, an artificial ligand of PPARγ, on the expression and secretion of apolipoprotein (apoM) in fat-fed, streptozotocin-treated rats, an animal model for type 2-like diabetes. METHODS: Healthy male SD rats were divided into 4 groups: a control group (n=7), a high-fat chow group (HF group, n=8), a diabetes mellitus group (DM group, n=7), and a diabetes mellitus group with rosiglitazone intervention group (RSG group, n=7). Fasting blood glucose (FBG), fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC) were measured at the beginning of the study. The diabetic rats model was established by feeding high fat chow and intraperitoneal injection of streprozotocin. Then the randomly selected treatment group was given rosiglitazone by daily gavage for 8 weeks. All the rats were killed at the fifteenth week, at which time blood and tissues (liver, kidney, adipose) were collected and prepared. The levels of FBG, FINS, TG and TC were assayed. The level of apoM in serum was measured by enzyme-linked immunosorbent assay (ELISA). Reverse transcription polymerase chain reaction (RT-PCR) was used to determine apoM mRNA expression in liver, kidney, and adipose tissues. RESULTS: Compared with either control group or HF group, serum apoM concentration in the DM group was reduced significantly (P<0.05); compared with the DM group, however, serum apoM concentrations in RSG group were increased (P<0.05). The expression of apoM mRNA in liver was highest, in kidney medium, and in adipose tissue extremely low (P<0.05). ApoM mRNA expression in liver and kidney was decreased in both DM and HF groups compared to control group (P<0.05). But, as with serum apoM concentration, apoM mRNA in the liver, kidney and adipose tissues of the RSG group were all increased markedly (P<0.05). The level of serum apoM in SD rats correlated negatively with TG (r=-0.466, P=0.011), TC (r=-0.568, P= 0.001), FBS (r =-0.371, P<0.001), and FINS(r=-0.768, P= 0.048 ). CONCLUSION These results suggest that apoM may participate in the glucose and lipid metabolism by the regulation of PPARγ.
Animals ; Apolipoproteins ; blood ; genetics ; metabolism ; Apolipoproteins M ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Dietary Fats ; administration & dosage ; Lipocalins ; blood ; genetics ; metabolism ; Male ; PPAR gamma ; agonists ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rosiglitazone ; Thiazolidinediones ; therapeutic use

The aim of this study was to test the susceptibility of mice to Trypanosoma evansi treated with human plasma containing different concentrations of apolipoprotein L-1 (APOL1). For this experiment, a strain of T. evansi and human plasma (plasmas 1, 2, and 3) from 3 adult males clinically healthy were used. In vivo test used 50 mice divided in 5 groups (A to E) with 10 animals in each group. Animals of groups B to E were infected, and then treated with 0.2 ml of human plasma in the following outline: negative control (A), positive control (B), treatment with plasma 1 (C), treatment with plasma 2 (D), and treatment with plasma 3 (E). Mice treated with human plasma showed an increase in longevity of 40.9+/-0.3 (C), 20+/-9.0 (D) and 35.6+/-9.3 (E) days compared to the control group (B) which was 4.3+/-0.5 days. The number of surviving mice and free of the parasite (blood smear and PCR negative) at the end of the experiment was 90%, 0%, and 60% for groups C, D, and E, respectively. The quantification of APOL1 was performed due to the large difference in the treatments that differed in the source plasma. In plasmas 1, 2, and 3 was detected the concentration of 194, 99, and 115 mg/dl of APOL1, respectively. However, we believe that this difference in the treatment efficiency is related to the level of APOL1 in plasmas.
Adult ; Animals ; Apolipoproteins/blood/*therapeutic use ; DNA, Protozoan/genetics ; Female ; Humans ; Lipoproteins, HDL/blood/*therapeutic use ; Male ; Mice ; Polymerase Chain Reaction ; Trypanocidal Agents/blood/*therapeutic use ; Trypanosoma/drug effects/genetics/*pathogenicity ; Trypanosomiasis/drug therapy/mortality/*parasitology ; Young Adult

OBJECTIVETo explore the correlation between Fc γ RIII A (CD16A) and aortic atherosclerotic plaque destabilization in apoE knockout (apoE KO) mice and the intervention effects of effective components of chuanxiong rhizome and red peony root.

METHODSEight 8-week-old male C57BL/6J mice were selected as the control group. Forty 8-week-old male apoE KO mice were randomly divided into the model group, apoE KO + intraperitoneal injection immunoglobulin group (IVIG), apoE KO + simvastatin group (Sm), apoE KO + high dosage of xiongshao capsule (XSC) group (XSCH), and apoE KO + low dosage of XSC group (XSCL), 8 mice in each group. Mice in the control group were put on a normal diet, and others were fed with a high-fat diet. After 10-week different interventions, monocyte CD16 expression was detected by flow cytometry, aortic matrix metalloproteinase-9 (MMP-9) mRNA expression was detected using reverse transcription polymerase chain reaction, and serum tumor necrosis factor (TNF)-α level was detected using enzyme-linked immunosorbent assay.

RESULTSCompared with the control group, monocyte CD16 expression, aortic MMP-9 mRNA expression, and serum TNF-α level in the model group increased obviously (P<0.01). Injections of apoE KO mice with intraperitoneal immunoglobulin during a 5-day period significantly reduced the monocyte CD16 expression, aortic MMP-9 mRNA expression, and serum TNF-α level (P<0.01 or 0.05) over a 10-week period of high-fat diet. Indices above in the Sm group, XSCH group, and XSCL group decreased in a different degree. Of them, the aortic MMP-9 mRNA expression in XSCH group was lower than that in Sm group (P<0.05) and the monocyte CD16 expression and serum TNF-α level showed no significant difference between XSCH group and Sm group (P>0.05). Correlation analyses suggested positive correlation between monocyte CD16 expression and aortic MMP-9 mRNA expression or serum TNF-α level in IVIG group, XSCH group, and XSCL group.

CONCLUSIONSFcγR III A mediates systemic inflammation in the progression of coronary heart disease with blood stasis syndrome. XSC could stabilize atherosclerotic plaque by suppressing inflammation and its target was relative with FcγRIII A.

Animals ; Aorta ; drug effects ; enzymology ; pathology ; Apolipoproteins E ; deficiency ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Flow Cytometry ; Gene Expression Regulation, Enzymologic ; drug effects ; Lipopolysaccharide Receptors ; metabolism ; Male ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Monocytes ; drug effects ; metabolism ; Paeonia ; chemistry ; Phytotherapy ; Plant Roots ; chemistry ; Plaque, Atherosclerotic ; blood ; drug therapy ; enzymology ; pathology ; RNA, Messenger ; genetics ; metabolism ; Receptors, IgG ; metabolism ; Tumor Necrosis Factor-alpha ; blood

BACKGROUNDAtherosclerosis is an important cardiovascular disease, becoming a major and increasing health problem in developed countries. However, the possible underlying mechanisms were not completely clear. In 2009, our research group first discovered that hydrogen sulfide (H(2)S) as a novel gastrotransmitter played an important anti-atherosclerotic role. The study was designed to examine the regulatory effect of hydrogen sulfide (H(2)S) on endoplasmic reticulum stress (ERS) in apolipoprotein E knockout (apoE(-/-)) mice fed a Western type diet.

METHODSC57BL/6 mice and homozygous apoE(-/-) mice were fed a Western type diet. C57BL/6 mice were injected intraperitoneally with normal saline (5 ml/kg per day) as control group. The apoE(-/-) mice were treated with the same dose of normal saline as the apoE(-/-) group, injected intraperitoneally with sodium hydrosulfide (NaHS, an H(2)S donor, 56 µmol/kg per day) as the apoE(-/-) + NaHS group and injected intraperitoneally with DL-propargylglycine (PPG, a cystathionine-γ-lyase inhibitor, 50 mg/kg, per day) as the apoE(-/-) + PPG group. After 10 weeks, the mice were sacrificed and the plasma lipids were detected. Sections of aortic root from these animals were examined for atherosclerotic lesions by HE and oil red O staining. The aortic ultrastructure and microstructure were analyzed with the help of light and electronic microscope. Glucose-regulated protein 78 (GRP78), caspase-12, copper-andzinc-containing superoxide dismutase (Cu/ZnSOD) and Mn-containing superoxide dismutase (MnSOD) protein expression in aortic tissues were detected with immunohistochemistry. The level of intracellular reactive oxygen species (ROS) were measured by using a commercial assay kit.

RESULTSCompared with control mice, apoE(-/-) mice showed increased plasma levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL), decreased high density lipoprotein (HDL), increased aortic plaque size, destroyed ultra-structure of aortic tissue, and increased expression of GRP78 and caspase-12 proteins. Compared with apoE(-/-) mice, H(2)S donor-treated apoE(-/-) mice showed a decreased plasma LDL level, lessened plaque necrosis and attenuated aortic ultra-structural disorder. H(2)S donor-treatment induced GRP78 expression but suppressed caspase-12 expression in aortic lesions. However, compared with apoE(-/-) mice, PPG treated apoE(-/-) mice showed enlarged plaque size, more severe ultrastructural disorder of the aortic tissue and reduced GRP78 staining in aortic lesions. The plasma lipids and the staining of caspase-12 in apoE(-/-) + PPG rats did not significantly differ from those in the apoE-/-mice. Consistently, H(2)S induced SOD expression, accompanied by a reduced level of ROS.

CONCLUSIONH(2)S plays a regulatory role in aortic ERS and reduces atherosclerotic lesions in apoE(-/-) mice fed with a Western type diet.

Animals ; Apolipoproteins E ; genetics ; metabolism ; Atherosclerosis ; blood ; Body Weight ; drug effects ; Cholesterol ; blood ; Endoplasmic Reticulum Stress ; drug effects ; Hydrogen Sulfide ; metabolism ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Microscopy, Electron, Transmission ; Reactive Oxygen Species ; metabolism ; Sulfides ; pharmacology ; therapeutic use ; Triglycerides ; blood

BACKGROUNDCholesterol-lowering therapy with statins has been reported to reduce the morbidity and mortality of cardiovascular diseases. This study aimed to investigate the effects of combined application of extended-release niacin and atorvastatin on lipid profile modification and the risks of adverse events in patients with coronary artery disease.

METHODSConsecutive 108 patients with coronary artery disease and serum total cholesterol (TC) > or = 3.5 mmol/L were randomized into two groups: group A using atorvastatin and group B using extended-release niacin (niacin ER) and atorvastatin. Plasma lipid profile, glucose, and adverse events were assessed at the hospitalization, and 6 and 12 months after treatment. In addition, clinical cardiovascular events were evaluated after 12 months of treatment.

RESULTSThe levels of TC, low density lipoprotein cholesterol (LDL-C) were significantly decreased (P < 0.05) in groups A and B, but the levels of high density lipoprotein cholesterol (HDL-C) and ApoA increased by 29.36% and 40.81% respectively after 12 months of treatment in group B (P < 0.01). The medications were generally well tolerated in the two groups. No significant difference of adverse events was found between the two groups (group A: 3.2% vs group B 5.1%, P > 0.05).

CONCLUSIONSCombined use of extended-release niacin with atorvastatin was superior to atorvastatin monotherapy alone in lipid profile regulation. Combination therapy with niacin ER and atorvastatin was well tolerated and safe in patients with coronary artery disease.

Aged ; Anticholesteremic Agents ; pharmacology ; therapeutic use ; Apolipoproteins A ; blood ; Atorvastatin Calcium ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Coronary Artery Disease ; drug therapy ; Female ; Heptanoic Acids ; pharmacology ; therapeutic use ; Humans ; Lipid Metabolism ; drug effects ; Male ; Middle Aged ; Niacin ; pharmacology ; therapeutic use ; Pyrroles ; pharmacology ; therapeutic use

OBJECTIVETo explore the influence of apolipoprotein E (ApoE) gene polymorphism on the lipid metabolism regulatory effect of Xuezhikang Capsule (XZKC).

METHODSApoE polymorphism of 74 patients with hyperlipidemia was detected by gene sequencing method, and their plasma levels of total cholesterol (TC), triglyceride (TG), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C) were determined before and after they received a 6-week treatment of XZKC, for analyzing the relationship between ApoE gene polymorphism and the changes of various blood lipids associated indices.

RESULTSThe effect of XZKC on reducing TG in the epsilon2 allele (E2/E2 and E2/E3 genotypes) was higher than that in the E3/E3 genotypes and epsilon4 allele (E3/E4 and E4/E4 genotypes), while on increasing HDL-C, it showed more effect in the epsilon4 allele (E3/E4 and E4/E4 genotypes) than that in the epsilon2 allele (E2/E2 and E2/E3 genotypes) and E3/E3 genotypes.

CONCLUSIONPatients' ApoE gene polymorphism could influence the lipid regulatory effect of XZKC, embodying mainly by raising HDL-C and reducing TG in patients with different ApoE genotypes to different extents.

Adult ; Aged ; Apolipoproteins E ; genetics ; Cholesterol, HDL ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Genotype ; Humans ; Hyperlipidemias ; blood ; drug therapy ; genetics ; Lipid Metabolism ; drug effects ; Male ; Middle Aged ; Polymorphism, Genetic ; Triglycerides ; blood

It has been hypothesized that blood infusion of reconstituted HDL (rHDL) is a possible therapeutic strategy for the treatment of coronary artery disese. To compare short-term anti-inflammatory activity of wildtype (WT) apoA-I and point mutants, each rHDL containing WT, V156K, or R173C was infused into apo-E deficient atherosclerotic mice. Each rHDL was injected via the tail vein at a dosage of 120 mg/kg of body weight in 0.4 ml of tris-buffered saline (TBS), and blood was then collected at 24 and 48 h post-injection. Although regression activity was observed in each of the rHDL infused groups, a 30% reduction in the lipid-stained area of the aortic sinus was observed in the V156K and R173C-rHDL groups when compared to that of the WT-rHDL group, and this reduction was well correlated with an approximately 60% reduction in the accumulation of macrophages in the lesion area. Additionally, the groups that received the V156K and R173C-rHDL treatments showed smaller increases in the GOT, GPT, interleukin-6, myeloperoxidase (MPO) and lipid hydroperoxide (LPO) serum levels than those that received the WT-rHDL treatment. In addition, the strongest serum paraoxonase and ferric reducing ability was observed in the V156K and R173C-rHDL groups. In vitro nitration and chlorination of apoA-I by MPO treatment revealed that V156K-rHDL and R173C-rHDL were less susceptible to chlorination. Furthermore, rHDL treatment inhibited cellular uptake of oxidized LDL by macrophage cells and the production of proatherogenic species in culture media. In conclusion, blood infusions of the rHDLs exerted in vivo regression activity with anti-inflammatory and antioxidant activity in apo-E deficient mice and THP-1 cells, especially in those that were treated with V156K and R173C apoA-I.
Animals ; Anti-Inflammatory Agents/immunology/*therapeutic use ; Apolipoprotein A-I/blood/genetics/immunology/*therapeutic use ; Apolipoproteins E/genetics ; Aryldialkylphosphatase/blood/metabolism ; Atherosclerosis/*drug therapy ; Cell Line ; Cell Membrane Permeability ; Cholesterol/blood/metabolism ; Humans ; Lipoproteins, HDL/genetics/immunology/*therapeutic use ; Lipoproteins, LDL/metabolism ; Macrophages/cytology ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Oxidation-Reduction/*drug effects ; Peroxidase/blood/metabolism ; Point Mutation