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The Impact of Egg Nutrient Composition and Its Consumption on Cholesterol Homeostasis. 鸡蛋营养成分及其消耗对胆固醇稳态的影响。
Pub Date : 2018-08-23 eCollection Date: 2018-01-01 DOI: 10.1155/2018/6303810
Heqian Kuang, Fang Yang, Yan Zhang, Tiannan Wang, Guoxun Chen

Nutrient deficiencies and excess are involved in many aspects of human health. As a source of essential nutrients, eggs have been used worldwide to support the nutritional needs of human societies. On the other hand, eggs also contain a significant amount of cholesterol, a lipid molecule that has been associated with the development of cardiovascular diseases. Whether the increase of egg consumption will lead to elevated cholesterol absorption and disruption of cholesterol homeostasis has been a concern of debate for a while. Cholesterol homeostasis is regulated through its dietary intake, endogenous biosynthesis, utilization, and excretion. Recently, some research interests have been paid to the effects of egg consumption on cholesterol homeostasis through the intestinal cholesterol absorption. Nutrient components in eggs such as phospholipids may contribute to this process. The goals of this review are to summarize the recent progress in this area and to discuss some potential benefits of egg consumption.

营养缺乏和营养过剩涉及人类健康的许多方面。鸡蛋作为基本营养素的来源,在全世界范围内被用来满足人类社会的营养需求。另一方面,鸡蛋中还含有大量的胆固醇,这是一种与心血管疾病发展有关的脂质分子。一段时间以来,鸡蛋消费量的增加是否会导致胆固醇吸收增加和胆固醇稳态的破坏一直是人们关注的问题。胆固醇稳态是通过饮食摄入、内源性生物合成、利用和排泄来调节的。近年来,人们对食用鸡蛋通过肠道胆固醇吸收对胆固醇稳态的影响产生了一些研究兴趣。鸡蛋中的营养成分,如磷脂,可能有助于这一过程。这篇综述的目的是总结这一领域的最新进展,并讨论食用鸡蛋的一些潜在好处。
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引用次数: 0
Update on the Benefits and Mechanisms of Action of the Bioactive Vegetal Alkaloid Berberine on Lipid Metabolism and Homeostasis. 植物活性生物碱小檗碱对脂质代谢和体内平衡的益处和作用机制研究进展。
Pub Date : 2018-07-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7173920
Yanwen Wang, Jeffrey A Zidichouski

Elevation of circulating levels of blood cholesterol, especially LDL cholesterol, and/or the decrease of HDL cholesterol levels have long been recognized as primary risk factors for developing atherosclerosis that leads to cardiovascular and cerebrovascular disease. Hypertriglyceridemia is an independent risk factor that is known to contribute to the development of atherosclerosis. Thus, various interventional efforts aimed at reducing hypercholesterolemia and hypertriglyceridemia have been practiced clinically for decades to reduce morbidity and mortality risk associated with deleterious cardiovascular and cerebrovascular events. As such, many drugs have been developed and clinically used to treat hypocholesteremia and/or hypertriglyceridemia; however, dietary approaches including supplements along with changes in nutrition and lifestyle have become increasingly attractive and acceptable methods used to control borderline or moderately increased levels of blood cholesterol and triacylglycerols. In this regard, the use of a plant/herbal bioactive compound, berberine (BBR), has recently been studied extensively in terms of its efficacy as well as its mechanisms of action and safety as an alternative intervention that beneficially modulates blood lipids. The aim of this review is to provide a comprehensive update on BBR research, new concepts and directions in terms of product development and current challenges, and future prospects of using BBR to manage diseases and complications associated with dyslipidemia.

血液循环胆固醇水平的升高,尤其是低密度脂蛋白胆固醇,和/或高密度脂蛋白胆固醇水平的降低,长期以来被认为是导致心脑血管疾病的动脉粥样硬化的主要危险因素。高甘油三酯血症是一个独立的危险因素,已知有助于动脉粥样硬化的发展。因此,旨在降低高胆固醇血症和高甘油三酯血症的各种干预措施已经在临床上实践了几十年,以降低与有害心脑血管事件相关的发病率和死亡率风险。因此,许多药物已经开发出来并用于临床治疗低胆固醇血症和/或高甘油三酯血症;然而,包括补充营养和改变生活方式在内的饮食方法已变得越来越有吸引力和可接受的方法,用于控制血液中胆固醇和甘油三酯水平的边缘性或中度升高。在这方面,使用植物/草药生物活性化合物小檗碱(BBR)作为有益调节血脂的替代干预手段,其有效性、作用机制和安全性最近得到了广泛的研究。本综述的目的是提供BBR研究的全面更新,产品开发的新概念和方向,当前的挑战,以及使用BBR治疗与血脂异常相关的疾病和并发症的未来前景。
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引用次数: 36
Association between HDL Cholesterol Levels and the Consumption of Vitamin A in Metabolically Healthy Obese Lebanese: A Cross-Sectional Study among Adults in Lebanon. 代谢健康的黎巴嫩肥胖者高密度脂蛋白胆固醇水平与维生素 A 摄入量之间的关系:黎巴嫩成人横断面研究》。
Pub Date : 2018-06-03 eCollection Date: 2018-01-01 DOI: 10.1155/2018/8050512
J Zalaket, L Hanna-Wakim, J Matta

Objectives: Previous studies show the association between vitamin A and elevation of plasma triglyceride concentrations. However, limited information exists on the association between vitamin A and plasma HDL cholesterol concentrations. The aim of this study is to investigate the association between plasma HDL cholesterol levels and vitamin A intake in 57 metabolically healthy obese (MHO) Lebanese.

Methods: Out of the 112 adult obese participants who had completed anthropometric and biochemical data, 57 (22 males and 35 females) aged 18-62 years old are metabolically healthy and their data are included in this study. A valid semiquantitative food frequency questionnaire (SQFFQ) was used to test vitamin A intake among other antioxidants. The participants were recruited from the database of three dietary clinics across Lebanon.

Results: Pearson's correlation coefficient was used to measure the strength of the relationship between vitamin A and plasma HDL cholesterol levels. There was a significant positive correlation (P value = 0.0225) between vitamin A consumption and HDL cholesterol serum levels in obese participants; when vitamin A levels decrease, HDL levels decrease more in female than in male participants.

Conclusion: The association between dietary vitamin A, a powerful antioxidant, and high HDL levels is shown in MHO but should be further exploited in future studies.

研究目的以往的研究表明,维生素 A 与血浆甘油三酯浓度升高之间存在关联。然而,关于维生素 A 与血浆高密度脂蛋白胆固醇浓度之间关系的信息却很有限。本研究旨在调查 57 名代谢健康的黎巴嫩肥胖者(MHO)的血浆高密度脂蛋白胆固醇水平与维生素 A 摄入量之间的关系:在 112 名填写了人体测量和生化数据的成年肥胖参与者中,有 57 人(22 名男性和 35 名女性)年龄在 18-62 岁之间,代谢健康,他们的数据被纳入本研究。研究采用有效的半定量食物频率问卷(SQFFQ)来检测维生素 A 和其他抗氧化剂的摄入量。参与者是从黎巴嫩全国三家饮食诊所的数据库中招募的:皮尔逊相关系数用于测量维生素 A 与血浆高密度脂蛋白胆固醇水平之间的关系强度。肥胖参与者的维生素 A 摄入量与高密度脂蛋白胆固醇血清水平之间存在明显的正相关(P 值 = 0.0225);当维生素 A 水平下降时,女性参与者的高密度脂蛋白水平下降幅度大于男性参与者:结论:膳食维生素 A(一种强效抗氧化剂)与高密度脂蛋白水平之间的关系在 MHO 中有所体现,但在今后的研究中应进一步加以探讨。
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引用次数: 0
Cereal-Based Snack Bar with Added Plant Stanol Ester (Benecol®) Consumed between Meals Lowers Serum Total and LDL Cholesterol Effectively in Mildly to Moderately Hypercholesterolemic Subjects. 在两餐之间食用添加了植物赤霉醇酯(Benecol®)的谷物零食棒能有效降低轻度至中度高胆固醇血症受试者的血清总胆固醇和低密度脂蛋白胆固醇。
Pub Date : 2018-05-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/1463628
Essi Sarkkinen, Mari Lyyra, Sakari Nieminen, Päivi Kuusisto, Ingmar Wester

The cholesterol-lowering effect of foods with added plant sterols or stanols consumed as snacks might be compromised. The purpose of this study was to confirm the cholesterol-lowering efficacy of a specially formulated cereal-based snack bar with added plant stanol ester (1.6 g plant stanols/day) when consumed between meals twice a day. In a double-blind, placebo-controlled, 4-week parallel-design study, 71 mildly to moderately hypercholesterolemic subjects were randomized into one of two groups, stanol or placebo group. Subjects were advised to replace their ordinary snacks with test products in an isocaloric manner and otherwise keep their habitual diet unchanged. The study showed that a snack bar product with added plant stanol ester lowered LDL and non-HDL cholesterol by 8.6% and 9.2% (mean%-change), respectively, as compared to the placebo product. The change in LDL cholesterol was statistically significantly different (P = 0.001) between the groups while the change in HDL cholesterol or triglycerides did not differ between the groups. In conclusion, the cereal-based snack bar with added plant stanol ester ingested without a meal reduced LDL cholesterol significantly without affecting HDL cholesterol or triglyceride concentrations in mildly hypercholesterolemic men and women. The study is registered as NCT03284918.

作为零食食用添加了植物固醇或甾醇的食品,其降低胆固醇的效果可能会受到影响。本研究的目的是确认一种添加了植物甾醇酯(1.6 克植物甾醇/天)的特殊配方谷物类零食棒在每天两餐之间食用时的降胆固醇效果。在一项双盲、安慰剂对照、为期 4 周的平行设计研究中,71 名轻度至中度高胆固醇血症受试者被随机分为两组,即石蒜醇或安慰剂组。研究人员建议受试者以等热量的方式用试验产品代替普通零食,其他饮食习惯保持不变。研究结果表明,与安慰剂产品相比,添加了植物甾醇酯的零食棒产品可将低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇分别降低 8.6% 和 9.2%(平均变化%)。各组之间低密度脂蛋白胆固醇的变化在统计学上有显著差异(P = 0.001),而各组之间高密度脂蛋白胆固醇或甘油三酯的变化则没有差异。总之,轻度高胆固醇血症男性和女性在不进餐的情况下摄入添加了植物甾醇酯的谷物类零食棒可明显降低低密度脂蛋白胆固醇,而不会影响高密度脂蛋白胆固醇或甘油三酯的浓度。该研究已注册为 NCT03284918。
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引用次数: 0
Effect of Anthocyanin Supplementations on Lipid Profile and Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 补充花青素对血脂和炎症标志物的影响:随机对照试验的系统回顾和荟萃分析。
Pub Date : 2018-04-22 eCollection Date: 2018-01-01 DOI: 10.1155/2018/8450793
Komal Shah, Pratik Shah

Purpose: To assess combined data from seventeen randomized controlled trials studying effect of anthocyanin consumption on levels of various lipids and inflammatory markers with meta-analysis approach.

Methods: Various databases, namely, PubMed, MEDLINE, EMBASE, and Cochrane Trial Register were used to identify randomized controlled trials (RCTs) investigating an association between anthocyanins and lipid profile and inflammatory markers. Heterogeneity was assessed using Q and I2 statistics and data was expressed using mean difference with 95% confidence interval.

Results: Statistically significant reduction in triglyceride [mean difference (MD) = -9.16, 95% CI: -14.02 to -4.31 mg/dL, I2 = 33.54%, P = 0.149], low density lipoprotein [MD = -8.86, 95% CI: -11.17 to -20.02 mg/dL, I2 = 37.75%, P = 0.098], and apolipoprotein B [MD = -7.13, 95% CI: -8.66 to -5.59 mg/dL, I2 = 20.42%, P = 0.287] levels and increase in high-density lipoprotein [MD = 1.67, 95% CI: 0.8 to 2.54 mg/dL, I2 = 44.88%, P = 0.053] and apolipoprotein A-1 [MD = 6.1, 95% CI: 4.51 to 7.69 mg/dL, I2 = 6.95%, P = 0.358] levels were observed with anthocyanin supplementation. Levels of inflammatory markers were found to reduce [TNF-∞ - MD = -1.98, 95% CI: -2.40 to -1.55 pg/mL, I2 = 0%, P = 0.975; IL-6 - MD = 1.17, 95% CI: 0.8 to 1.53 pg/mL, I2 = 0%, P = 0.825; hs-CRP - MD = 0.164, 95% CI: -0.06 to 0.39 mg/dL, I2 = 0%, P = 0.569]. Though the effect on TC, IL-6, and hs-CRP was positive, it was nonsignificant in nature.

Conclusion: Anthocyanin supplementation significantly improves lipid profile and inflammatory status. However, future trials with sufficient sample size are recommended to substantiate the findings especially for the parameters showing nonsignificant improvement.

目的:采用荟萃分析方法评估17项随机对照试验的综合数据,研究花青素摄入对各种脂质和炎症标志物水平的影响。方法:利用PubMed、MEDLINE、EMBASE和Cochrane Trial Register等数据库,对花青素与血脂和炎症标志物之间关系的随机对照试验(rct)进行分析。采用Q和I2统计量评估异质性,数据采用95%置信区间的平均差值表示。结果:显著降低甘油三酸酯(平均差(MD) = -9.16, 95%置信区间CI: -14.02 - -4.31 mg / dL, I2 = 33.54%, P = 0.149),低密度脂蛋白(MD = -8.86, 95%置信区间CI: -11.17 - -20.02 mg / dL, I2 = 37.75%, P = 0.098),载脂蛋白B (MD = -7.13, 95%置信区间CI: -8.66 - -5.59 mg / dL, I2 = 20.42%, P = 0.287)水平和增加高密度脂蛋白(MD = 1.67, 95%置信区间CI: 0.8 - 2.54 mg / dL, I2 = 44.88%, P = 0.053),载脂蛋白a - 1 (MD = 6.1, 95%置信区间CI:添加花青素组的水平为4.51 ~ 7.69 mg/dL, I2 = 6.95%, P = 0.358]。炎症标志物水平降低[TNF-∞- MD = -1.98, 95% CI: -2.40 ~ -1.55 pg/mL, I2 = 0%, P = 0.975;IL-6 - MD = 1.17, 95% CI: 0.8 ~ 1.53 pg/mL, I2 = 0%, P = 0.825;hs-CRP - MD = 0.164, 95% CI: -0.06 ~ 0.39 mg/dL, I2 = 0%, P = 0.569]。虽然对TC、IL-6、hs-CRP的影响是阳性的,但在本质上是不显著的。结论:补充花青素可显著改善血脂和炎症状态。然而,建议未来有足够样本量的试验来证实这些发现,特别是那些显示无显著改善的参数。
{"title":"Effect of Anthocyanin Supplementations on Lipid Profile and Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Komal Shah,&nbsp;Pratik Shah","doi":"10.1155/2018/8450793","DOIUrl":"https://doi.org/10.1155/2018/8450793","url":null,"abstract":"<p><strong>Purpose: </strong>To assess combined data from seventeen randomized controlled trials studying effect of anthocyanin consumption on levels of various lipids and inflammatory markers with meta-analysis approach.</p><p><strong>Methods: </strong>Various databases, namely, PubMed, MEDLINE, EMBASE, and Cochrane Trial Register were used to identify randomized controlled trials (RCTs) investigating an association between anthocyanins and lipid profile and inflammatory markers. Heterogeneity was assessed using <i>Q</i> and <i>I</i><sup>2</sup> statistics and data was expressed using mean difference with 95% confidence interval.</p><p><strong>Results: </strong>Statistically significant reduction in triglyceride [mean difference (MD) = -9.16, 95% CI: -14.02 to -4.31 mg/dL, <i>I</i><sup>2</sup> = 33.54%, <i>P</i> = 0.149], low density lipoprotein [MD = -8.86, 95% CI: -11.17 to -20.02 mg/dL, <i>I</i><sup>2</sup> = 37.75%, <i>P</i> = 0.098], and apolipoprotein B [MD = -7.13, 95% CI: -8.66 to -5.59 mg/dL, <i>I</i><sup>2</sup> = 20.42%, <i>P</i> = 0.287] levels and increase in high-density lipoprotein [MD = 1.67, 95% CI: 0.8 to 2.54 mg/dL, <i>I</i><sup>2</sup> = 44.88%, <i>P</i> = 0.053] and apolipoprotein A-1 [MD = 6.1, 95% CI: 4.51 to 7.69 mg/dL, <i>I</i><sup>2</sup> = 6.95%, <i>P</i> = 0.358] levels were observed with anthocyanin supplementation. Levels of inflammatory markers were found to reduce [TNF-∞ - MD = -1.98, 95% CI: -2.40 to -1.55 pg/mL, <i>I</i><sup>2</sup> = 0%, <i>P</i> = 0.975; IL-6 - MD = 1.17, 95% CI: 0.8 to 1.53 pg/mL, <i>I</i><sup>2</sup> = 0%, <i>P</i> = 0.825; hs-CRP - MD = 0.164, 95% CI: -0.06 to 0.39 mg/dL, <i>I</i><sup>2</sup> = 0%, <i>P</i> = 0.569]. Though the effect on TC, IL-6, and hs-CRP was positive, it was nonsignificant in nature.</p><p><strong>Conclusion: </strong>Anthocyanin supplementation significantly improves lipid profile and inflammatory status. However, future trials with sufficient sample size are recommended to substantiate the findings especially for the parameters showing nonsignificant improvement.</p>","PeriodicalId":72589,"journal":{"name":"Cholesterol","volume":"2018 ","pages":"8450793"},"PeriodicalIF":0.0,"publicationDate":"2018-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8450793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36177993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 33
Double-Blind Randomized Placebo Controlled Trial Demonstrating Serum Cholesterol Lowering Efficacy of a Smoothie Drink with Added Plant Stanol Esters in an Indonesian Population. 双盲随机安慰剂对照试验证明添加了植物赤霉醇酯的冰沙饮料对降低印度尼西亚人血清胆固醇的功效
Pub Date : 2018-02-04 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4857473
Lanny Lestiani, Dian Novita Chandra, Kirsi Laitinen, Fransisca Diah Ambarwati, Päivi Kuusisto, Widjaja Lukito

Indonesians have a high intake of saturated fats, a key contributing dietary factor to elevated blood cholesterol concentrations. We investigated the cholesterol lowering efficacy of a smoothie drink with 2 grams of plant stanols as esters to lower serum total and LDL-cholesterol concentrations in hypercholesterolemic Indonesian adults. The double-blind randomized placebo controlled parallel design study involved 99 subjects. Fifty subjects received control drink and dietary advice, and 49 subjects received intervention drink (Nutrive Benecol®) and dietary advice. Baseline, midline (week 2), and endline (week 4) assessments were undertaken for clinical, anthropometric, and biochemical variables. Compared to control, the smoothie drink with plant stanols reduced serum LDL-cholesterol concentration by 7.6% (p < 0.05) and 9.0% (p < 0.05) in two and four weeks, respectively. Serum total cholesterol was reduced by 5.7% (p < 0.05 compared to control) in two weeks, and no further reduction was detected after four weeks (5.6%). Compared to baseline habitual diet, LDL-cholesterol was reduced by 9.3% (p < 0.05) and 9.8% (p < 0.05) in the plant stanol ester group in two and four weeks, respectively. We conclude that consumption of smoothie drink with added plant stanol esters effectively reduces serum total and LDL-cholesterol of hypercholesterolemic Indonesian subjects already in two weeks. Trial is registered as NCT02316808.

印度尼西亚人的饱和脂肪摄入量很高,这是导致血液中胆固醇浓度升高的一个关键饮食因素。我们研究了含有 2 克植物甾醇酯的冰沙饮料对降低高胆固醇血症印尼成年人血清总胆固醇和低密度脂蛋白胆固醇浓度的功效。这项双盲随机安慰剂对照平行设计研究涉及 99 名受试者。50 名受试者接受对照组饮料和饮食建议,49 名受试者接受干预组饮料(Nutrive Benecol®)和饮食建议。对临床、人体测量和生化变量进行了基线、中线(第2周)和终点(第4周)评估。与对照组相比,含有植物甾醇的冰沙饮料在两周和四周内分别降低了 7.6% (p < 0.05)和 9.0% (p < 0.05)的血清低密度脂蛋白胆固醇浓度。血清总胆固醇在两周内降低了 5.7%(与对照组相比,p < 0.05),四周后没有进一步降低(5.6%)。与基线习惯饮食相比,植物甾醇酯组的低密度脂蛋白胆固醇在两周和四周内分别降低了 9.3%(p < 0.05)和 9.8%(p < 0.05)。我们的结论是,饮用添加了植物甾醇酯的冰沙饮料可在两周内有效降低高胆固醇血症印尼受试者的血清总胆固醇和低密度脂蛋白胆固醇。试验已注册为 NCT02316808。
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引用次数: 0
Identification of Quantitative Trait Loci That Determine Plasma Total-Cholesterol and Triglyceride Concentrations in DDD/Sgn and C57BL/6J Inbred Mice. DDD/Sgn和C57BL/6J近交系小鼠血浆总胆固醇和甘油三酯浓度定量性状位点的鉴定
Pub Date : 2017-01-01 Epub Date: 2017-05-31 DOI: 10.1155/2017/3178204
Jun-Ichi Suto, Misaki Kojima

DDD/Sgn mice have significantly higher plasma lipid concentrations than C57BL/6J mice. In the present study, we performed quantitative trait loci (QTL) mapping for plasma total-cholesterol (CHO) and triglyceride (TG) concentrations in reciprocal F2 male intercross populations between the two strains. By single-QTL scans, we identified four significant QTL on chromosomes (Chrs) 1, 5, 17, and 19 for CHO and two significant QTL on Chrs 1 and 12 for TG. By including cross direction as an interactive covariate, we identified separate significant QTL on Chr 17 for CHO but none for TG. When the large phenotypic effect of QTL on Chr 1 was controlled by composite interval mapping, we identified three additional significant QTL on Chrs 3, 4, and 9 for CHO but none for TG. QTL on Chr 19 was a novel QTL for CHO and the allelic effect of this QTL significantly differed between males and females. Whole-exome sequence analysis in DDD/Sgn mice suggested that Apoa2 and Acads were the plausible candidate genes underlying CHO QTL on Chrs 1 and 5, respectively. Thus, we identified a multifactorial basis for plasma lipid concentrations in male mice. These findings will provide insight into the genetic mechanisms of plasma lipid metabolism.

DDD/Sgn小鼠血浆脂质浓度显著高于C57BL/6J小鼠。在本研究中,我们对两个品系之间F2雄性互交群体的血浆总胆固醇(CHO)和甘油三酯(TG)浓度进行了数量性状位点(QTL)定位。通过单QTL扫描,我们在染色体1、5、17和19上鉴定出CHO的4个显著QTL,在染色体1和12上鉴定出TG的2个显著QTL。通过将交叉方向作为交互协变量,我们在Chr 17上发现了CHO的独立显著QTL,而TG没有。当QTL在Chr 1上的巨大表型效应被复合区间作图控制时,我们在Chr 3、4和9上发现了3个与CHO相关的显著QTL,而与TG相关的QTL则没有。Chr 19上的QTL是CHO的一个新QTL,该QTL的等位效应在雄性和雌性之间存在显著差异。DDD/Sgn小鼠的全外显子组序列分析表明,Apoa2和Acads分别是Chrs 1和5上CHO QTL的可能候选基因。因此,我们确定了雄性小鼠血浆脂质浓度的多因素基础。这些发现将有助于深入了解血浆脂质代谢的遗传机制。
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引用次数: 7
The Interpretation of Cholesterol Balance Derived Synthesis Data and Surrogate Noncholesterol Plasma Markers for Cholesterol Synthesis under Lipid Lowering Therapies. 降脂治疗下胆固醇合成的胆固醇平衡衍生合成数据和替代非胆固醇血浆标志物的解释。
Pub Date : 2017-01-01 Epub Date: 2017-02-22 DOI: 10.1155/2017/5046294
Frans Stellaard, Dieter Lütjohann

The cholesterol balance procedure allows the calculation of cholesterol synthesis based on the assumption that loss of endogenous cholesterol via fecal excretion and bile acid synthesis is compensated by de novo synthesis. Under ezetimibe therapy hepatic cholesterol is diminished which can be compensated by hepatic de novo synthesis and hepatic extraction of plasma cholesterol. The plasma lathosterol concentration corrected for total cholesterol concentration (R_Lath) as a marker of de novo cholesterol synthesis is increased during ezetimibe treatment but unchanged under treatment with ezetimibe and simvastatin. Cholesterol balance derived synthesis data increase during both therapies. We hypothesize the following. (1) The cholesterol balance data must be applied to the hepatobiliary cholesterol pool. (2) The calculated cholesterol synthesis value is the sum of hepatic de novo synthesis and the net plasma-liver cholesterol exchange rate. (3) The reduced rate of biliary cholesterol absorption is the major trigger for the regulation of hepatic cholesterol metabolism under ezetimibe treatment. Supportive experimental and literature data are presented that describe changes of cholesterol fluxes under ezetimibe, statin, and combined treatments in omnivores and vegans, link plasma R_Lath to liver function, and define hepatic de novo synthesis as target for regulation of synthesis. An ezetimibe dependent direct hepatic drug effect cannot be excluded.

胆固醇平衡程序允许计算胆固醇合成的假设,通过粪便排泄和胆汁酸合成的内源性胆固醇的损失是由重新合成补偿。依折替米贝治疗肝胆固醇降低,可通过肝脏重新合成和肝脏提取血浆胆固醇来补偿。经总胆固醇浓度校正的血浆胆甾醇浓度(R_Lath)作为新生胆固醇合成的标志,在依泽替米治疗期间升高,但在依泽替米和辛伐他汀治疗期间不变。在两种治疗期间,胆固醇平衡衍生的合成数据增加。我们假设如下。(1)胆固醇平衡数据必须应用于肝胆胆固醇库。(2)计算出的胆固醇合成值为肝脏新生合成与血浆-肝脏净胆固醇交换率之和。(3)胆道胆固醇吸收率降低是依折替米贝治疗下肝脏胆固醇代谢调节的主要触发因素。支持性的实验和文献数据描述了依zetimibe、他汀和综合治疗对杂食动物和素食者胆固醇通量的变化,将血浆R_Lath与肝功能联系起来,并将肝脏新生合成定义为调节合成的靶点。不能排除依折麦布依赖的直接肝药物作用。
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引用次数: 9
Cholesterol Levels in Genetically Determined Familial Hypercholesterolaemia in Russian Karelia. 俄罗斯卡累利阿地区遗传决定的家族性高胆固醇血症中的胆固醇水平。
Pub Date : 2017-01-01 Epub Date: 2017-03-28 DOI: 10.1155/2017/9375818
V A Korneva, T Yu Kuznetsova, T Yu Bogoslovskaya, D S Polyakov, V B Vasilyev, A V Orlov, M Yu Mandelshtam

Familial hypercholesterolaemia (FH) is a rare disease that tends to be diagnosed lately. In Russia, the genetic and phenotypic characteristics of the disease are not well defined. We investigated 102 patients with definite FH. In 52 of these patients (50.9%) genetic analysis was performed, revealing pathogenic mutations of the low density lipoprotein (LDL) receptor gene in 22 patients. We report here five mutations of the LDL receptor gene found in the Karelian FH sample for the first time. The detection rate of mutations in definite FH patients was 42.3%. Two groups of patients with a definite diagnosis of FH according to the Dutch Lipid Clinic Network criteria were compared: the first group had putatively functionally important LDL receptor gene mutations, while in the second group LDL receptor gene mutations were excluded by single-strand conformation polymorphism analysis. Total and LDL cholesterol levels were higher in the group with LDL receptor mutations compared to the mutation-free population. The frequency of mutations in patients with LDL cholesterol > 6.5 mmol/L was more than 3 times higher than that in patients with LDL < 6.5 mmol/L. Total and LDL cholesterol levels and the frequency of coronary heart disease and myocardial infarction were higher in the group with definite FH compared to groups with probable and possible FH. Cholesterol figures in FH patients of different age and sex from the Karelian population were comparable.

家族性高胆固醇血症(FH)是一种罕见的疾病,最近才被诊断出来。在俄罗斯,该病的遗传和表型特征尚未明确。我们调查了102例确诊的FH患者。其中52例(50.9%)患者进行了遗传分析,22例患者显示低密度脂蛋白(LDL)受体基因的致病性突变。我们在这里报告了首次在卡累利阿FH样本中发现的LDL受体基因的五个突变。确诊FH患者的突变检出率为42.3%。比较两组根据荷兰脂质临床网络标准明确诊断为FH的患者:第一组推定具有重要功能的LDL受体基因突变,第二组通过单链构象多态性分析排除LDL受体基因突变。与无突变人群相比,LDL受体突变组的总胆固醇和LDL胆固醇水平更高。LDL胆固醇> 6.5 mmol/L患者的突变频率是LDL < 6.5 mmol/L患者的3倍以上。确诊FH组的总胆固醇和低密度脂蛋白胆固醇水平以及冠心病和心肌梗死的发生率高于可能和可能FH组。卡累利阿人口中不同年龄和性别的FH患者的胆固醇数据具有可比性。
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引用次数: 6
Premature Valvular Heart Disease in Homozygous Familial Hypercholesterolemia. 纯合子家族性高胆固醇血症的早发性瓣膜性心脏病。
Pub Date : 2017-01-01 Epub Date: 2017-07-06 DOI: 10.1155/2017/3685265
Akl C Fahed, Kamel Shibbani, Rabih R Andary, Mariam T Arabi, Robert H Habib, Denis D Nguyen, Fady F Haddad, Elie Moubarak, Georges Nemer, Sami T Azar, Fadi F Bitar

Valvular heart disease frequently occurs as a consequence of premature atherosclerosis in individuals with familial hypercholesterolemia (FH). Studies have primarily focused on aortic valve calcification in heterozygous FH, but there is paucity of data on the incidence of valvular disease in homozygous FH. We performed echocardiographic studies in 33 relatively young patients (mean age: 26 years) with homozygous FH (mean LDL of 447 mg/dL, 73% on LDL apheresis) to look for subclinical valvulopathy. Twenty-one patients had evidence of valvulopathy of the aortic or mitral valves, while seven subjects showed notable mitral regurgitation. Older patients were more likely to have aortic valve calcification (>21 versus ≤21 years: 59% versus 12.5%; p = 0.01) despite lower LDL levels at the time of the study (385 versus 513 mg/dL; p = 0.016). Patients with valvulopathy were older and had comparable LDL levels and a lower carotid intima-media thickness. Our data suggests that, in homozygous FH patients, valvulopathy (1) is present across a wide age spectrum and LDL levels and (2) is less likely to be influenced by lipid-lowering treatment. Echocardiographic studies that focused on aortic root thickening and stenosis and regurgitation are thus likely an effective modality for serial follow-up of subclinical valvular heart disease.

家族性高胆固醇血症(FH)患者的早发动脉粥样硬化常导致瓣膜性心脏病。研究主要集中在杂合子FH的主动脉瓣钙化,但缺乏纯合子FH的瓣膜疾病发生率的数据。我们对33例相对年轻的纯合子FH患者(平均LDL为447 mg/dL, 73%采用LDL分离)进行了超声心动图研究,以寻找亚临床瓣膜病变。21例有主动脉瓣或二尖瓣病变,7例有明显的二尖瓣返流。老年患者更容易发生主动脉瓣钙化(>21岁vs≤21岁:59% vs 12.5%;p = 0.01),尽管研究时LDL水平较低(385 vs 513 mg/dL;P = 0.016)。瓣膜病变患者年龄较大,LDL水平相当,颈动脉内膜-中膜厚度较低。我们的数据表明,在纯合子FH患者中,瓣膜病变(1)存在于广泛的年龄谱和低密度脂蛋白水平,(2)不太可能受到降脂治疗的影响。超声心动图研究的重点是主动脉根部增厚、狭窄和反流,因此可能是亚临床瓣膜性心脏病系列随访的有效方式。
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引用次数: 17
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Cholesterol
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