A Pilot Study on the Effects of Medically Supervised, Water-Only Fasting and Refeeding on Cardiometabolic Risk

The Fasting for Brain and Heart Health Study was a prospective, single-center, observational study examining the effects of medically supervised, water-only fasting followed by an exclusively whole-plant-food refeeding diet on accepted measures of cardiovascular risk and metabolic health. The study enrolled 48 overweight/obese, non-diabetic participants of which 26 completed the full study protocol. The participants fasted according to an established protocol at an independent medical center that reported mean fast and refeed lengths of 17 and 7 days, respectively. The primary endpoint was to describe mean glucose tolerance as indicated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores at baseline, end-of-fast (EOF), and end-of-refeed (EOR) visits. Secondary endpoints were to describe the effects of fasting and refeeding on accepted markers of cardiovascular risk. Here we show that medically supervised, water-only fasting and/or whole-plant-food refeeding reduced resting systolic blood pressure (SBP), abdominal circumference, low-density lipoprotein (LDL), and high-sensitivity C-reactive protein (hsCRP) after refeeding. An increase in HOMA-IR scores at EOR was also observed.

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Metabolic Actions of a Supplement of Ilex Paraguariensis (An Extract of the Leaf Standardized to 2% I-Deoxinojirimcina), White Mulberry and Chromium Picolinate in Nondiabetic Subects with Dysglycemia: A Randomized Trial

Life ◽

10.3390/life11070709 ◽

2021 ◽

Vol 11 (7) ◽

pp. 709

Author(s):

Giuseppe Derosa ◽

Angela D’Angelo ◽

Pamela Maffioli

Keyword(s):

Low Density Lipoprotein ◽

Density Lipoprotein ◽

High Sensitivity ◽

Postprandial Glucose ◽

Chromium Picolinate ◽

Ilex Paraguariensis ◽

Model Assessment ◽

Glycemic Status ◽

Assessment Index ◽

White Mulberry

Aim: To prove if a nutraceutical containing Ilex paraguariensis (Ilex L. spp. Aquifoliales) (an extract of the leaf standardized to 2% I-deoxinojirimcina), white mulberry (Morus spp., Moraceae), and chromium picolinate can be effective in improving glycemic status in subject with dysglycemia. Methods: We randomized patients to consume placebo or the nutraceutical, self-administered once a day, one tablet at breakfast, for 3 months. Results: A reduction in fasting plasma glucose, postprandial glucose, and glycated hemoglobin was observed with the nutraceutical combination, both compared to baseline and placebo. Data suggested a decrease in the Homeostasis Model Assessment index with the nutraceutical, both compared to baseline and placebo. The M value, an index of insulin sensitivity, obtained after nutraceutical treatment was higher compared to baseline. We recorded a decrease in total cholesterol, low-density lipoprotein-cholesterol, and triglycerides with the nutraceutical combination compared to baseline and placebo. A decrease in high-sensitivity C-reactive protein was observed with the nutraceutical combination compared to baseline and placebo. Conclusions: A nutraceutical containing Ilex paraguariensis, white mulberry, and chromium picolinate can be helpful in improving glycemic status and lipid profile in dysglycemic subjects.

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The Effect of Testosterone on Cardiovascular Biomarkers in the Testosterone Trials

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-02243 ◽

2017 ◽

Vol 103 (2) ◽

pp. 681-688 ◽

Cited By ~ 36

Author(s):

Emile R Mohler ◽

Susan S Ellenberg ◽

Cora E Lewis ◽

Nanette K Wenger ◽

Matthew J Budoff ◽

...

Keyword(s):

Cardiovascular Risk ◽

Density Lipoprotein ◽

Older Men ◽

The United States ◽

Mean Difference ◽

Lipoprotein Cholesterol ◽

Model Assessment ◽

Testosterone Treatment ◽

Low Testosterone ◽

Cardiovascular Biomarkers

Abstract Context Studies of the possible cardiovascular risk of testosterone treatment are inconclusive. Objective To determine the effect of testosterone treatment on cardiovascular biomarkers in older men with low testosterone. Design Double-blind, placebo-controlled trial. Setting Twelve academic medical centers in the United States. Participants In all, 788 men ≥65 years old with an average of two serum testosterone levels <275 ng/dL who were enrolled in The Testosterone Trials. Intervention Testosterone gel, the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. Main Outcome Measures Serum markers of cardiovascular risk, including lipids and markers of glucose metabolism, fibrinolysis, inflammation, and myocardial damage. Results Compared with placebo, testosterone treatment significantly decreased total cholesterol (adjusted mean difference, −6.1 mg/dL; P < 0.001), high-density lipoprotein cholesterol (adjusted mean difference, −2.0 mg/dL; P < 0.001), and low-density lipoprotein cholesterol (adjusted mean difference, −2.3 mg/dL; P = 0.051) from baseline to month 12. Testosterone also slightly but significantly decreased fasting insulin (adjusted mean difference, −1.7 µIU/mL; P = 0.02) and homeostatic model assessment‒insulin resistance (adjusted mean difference, −0.6; P = 0.03). Testosterone did not change triglycerides, d-dimer, C-reactive protein, interleukin 6, troponin, glucose, or hemoglobin A1c levels more than placebo. Conclusions and Relevance Testosterone treatment of 1 year in older men with low testosterone was associated with small reductions in cholesterol and insulin but not with other glucose markers, markers of inflammation or fibrinolysis, or troponin. The clinical importance of these findings is unclear and requires a larger trial of clinical outcomes.

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A lipid lover’s guide to novel therapeutics for lipid and cardiovascular risk reduction

Future Cardiology ◽

10.2217/fca-2020-0216 ◽

2021 ◽

Vol 17 (3) ◽

pp. 507-520

Author(s):

Rama Hritani ◽

Aliza Hussain ◽

Anum Saeed ◽

Anandita Agarwala

Keyword(s):

Cardiovascular Risk ◽

Risk Reduction ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

High Sensitivity ◽

Cardiovascular Risk Reduction ◽

Apolipoprotein C3 ◽

Novel Therapeutics ◽

Reactive Protein ◽

Lipids And Lipoproteins

Lipids and lipoproteins are the target of many novel therapeutics and are an area with great potential for the prevention and treatment of cardiovascular disease (CVD). Reduction of low-density lipoprotein cholesterol has been the mainstay of reducing the burden of CVD, however, several other atherogenic particles have more recently come into the spotlight as potential avenues for primary and/or secondary prevention of CVD. These include triglycerides, high sensitivity C-reactive protein, apolipoprotein A, apolipoprotein C3 and lipoprotein(a). In this review, we showcase novel therapeutics to target lipid and cardiovascular risk reduction that are either in development or that have recently been approved for use. We discuss the mechanisms of action, data from clinical trials and expected effects of each therapy based on the current body of literature.

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A herbal premix containing Macrotyloma uniflorum, ginger, and whey curtails obesity in rats fed a high-fat diet by a novel mechanism

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2019-0139 ◽

2020 ◽

Vol 45 (1) ◽

pp. 24-34

Author(s):

Vandana S. Panda ◽

Taasin Shah ◽

Sudhamani S

Keyword(s):

High Fat Diet ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Abdominal Circumference ◽

Mentha Piperita ◽

Low Density ◽

Model Assessment ◽

High Fat ◽

Reference Drug ◽

Macrotyloma Uniflorum

The present study designed and evaluated a polyherbal premix comprising Macrotyloma uniflorum, whey protein, Zingiber officinale, and Mentha piperita. Animals were fed a high-fat diet (HFD) for 30 days and were daily administered the premix (1.5 g/kg) in milk (PM) and water (PW), aerobic exercise (AE), premix in milk and water along with AE (PMAE and PWAE), ferulic acid (100 mg/kg), and the reference drug fluoxetine (6 mg/kg). All treatments showed significant reduction in food intake, weight gain, abdominal circumference, and body mass index compared with their initial values. All treatments generated a faster peak of the satiety marker cholecystokinin compared with the HFD group and control groups; PMAE and PWAE exhibited sustained satiety. The HFD-elevated blood glucose levels were significantly attenuated on the 30th day by all treatments when compared with their 15th day and basal values; PMAE exhibited the best results. All treatments significantly attenuated the HFD-elevated serum insulin, homeostasis model assessment of insulin resistance, C-reactive protein, triglycerides, total cholesterol, very-low-density lipoprotein, and low-density lipoprotein levels and significantly restored the HFD-depleted high-density lipoprotein and adiponectin levels. HFD-elevated thiobarbituric acid reactive substances values were attenuated successfully and the HFD-depleted reduced glutathione, superoxide dismutase, and catalase levels were significantly restored by all treatments. The histological findings corroborated the biochemical results. Novelty The polyherbal premix brought about appetite regulation and induction of satiety to control obesity in HFD-fed rats through homeostasis of energy metabolism. The premix along with exercise is a complete way to combat obesity.

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Circulating proinflammatory peptides related to abdominal adiposity and cardiometabolic risk factors in healthy prepubertal children

Acta Endocrinologica ◽

10.1530/eje-10-1124 ◽

2011 ◽

Vol 164 (4) ◽

pp. 553-558 ◽

Cited By ~ 36

Author(s):

Sonya V Galcheva ◽

Violeta M Iotova ◽

Yoto T Yotov ◽

Sergio Bernasconi ◽

Maria E Street

Keyword(s):

Risk Factors ◽

Abdominal Obesity ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

High Sensitivity ◽

Cardiometabolic Risk Factors ◽

Model Assessment ◽

Cross Sectional ◽

Prepubertal Children ◽

Tnf Α

ObjectivesTo analyze the circulating levels of proinflammatory peptides in healthy prepubertal children in relation to abdominal obesity, measured by waist circumference (WC), and to investigate their interactions with cardiometabolic risk factors.Design and methodsA cross-sectional study of 137 healthy prepubertal children with a mean age of 8.0±0.1 years divided into three groups according to their WC as a measure of abdominal obesity: ‘normal-WC’ children (25th–75th percentile, n=48), ‘children at risk’ (75th–90th percentile, n=39), and ‘abdominally obese’ (≥90th percentile, n=50) children. Auxological measurements and blood pressure (BP) were taken. Fasting levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL6), tumor necrosis factor-α (TNF-α), glucose, insulin, and lipid profile were measured. Insulin resistance (IR) was assessed by homeostasis model assessment of IR (HOMA-IR).ResultsAbdominally obese children had significantly higher BP, insulin, HOMA-IR, total cholesterol and triglycerides (TG) compared with their normal-WC counterparts (P<0.05). HsCRP concentrations increased proportionally with the degree of abdominal obesity (r=0.443, P<0.0001), whereas IL6 and TNF-α were not significantly associated with any of the adiposity variables. After controlling for adiposity, hsCRP was significantly correlated with systolic BP (r=0.257, P=0.004), TNF-α levels were related to high-density lipoprotein cholesterol (HDL-C; r=−0.216, P=0.016) and TG (r=0.196, P=0.029), whereas the relationship between IL6 and HDL-C reduced its magnitude to an insignificant level (r=−0.173, P=0.055).ConclusionsHealthy prepubertal children with abdominal obesity have associated inflammatory and cardiometabolic alterations, interacting with each other.

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Lower than average HDL cholesterol efflux capacity in Lithuanian population

Lipids in Health and Disease ◽

10.1186/s12944-019-1124-2 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Sandra Kutkiene ◽

Zaneta Petrulioniene ◽

Dovile Karciauskaite ◽

Aleksandras Laucevicius ◽

Gabija Matuzevicienė ◽

...

Keyword(s):

Cardiovascular Risk ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Normal Weight ◽

Abdominal Circumference ◽

Control Group ◽

Residual Cardiovascular Risk ◽

Cross Sectional ◽

Hdl Function ◽

Lipid Panel

Abstract Background The aim of our study was to evaluate high-density lipoprotein cholesterol (HDL-C) efflux capacity in healthy controls and patients with severe dyslipidemia. Evaluation of HDL function may be beneficial for better understanding of cardiovascular diseases, as well as for taking actions to minimize residual cardiovascular risk. Methods During 2016–2017 a total of 93 participants – 48 (51.6%) women and 45 (48.4%) men – were included in this cross-sectional study. Data of 45 (48.4%) participants with severe dyslipidemia (SD) and 48 (51.6%) controls without dyslipidemia was used for statistical analysis. Total lipid panel, concentration of lipoprotein (a) and apolipoproteins were measured, data about cardiovascular risk factors were collected and detailed evaluation of HDL-C quality was performed for all patients. Results Increased HDL-C concentration was associated with higher ApoA1 (r = 0.866 in controls, r = 0.63 in SD group), ApoA2 (r = 0.41 in controls, r = 0.418 in SD group) and LDL-C concentrations (r = − 0.412 in SD group), lower ApoE (r = − 0.314 in SD group) and TG concentrations (r = − 0.38 in controls, r = − 0.608 in SD group), lower ApoB/ApoA1 ratio (r = − 0.567 in control group), below average HDL-C efflux capacity (r = − 0.335 in SD group), lower BMI (r = − 0.327 in controls, r = − 0.531 in SD group) and abdominal circumference (r = − 0.309 in women with SD). Below-average HDL-C efflux capacity was found in 67.7% (N = 63) of participants. It was more often found among patients with normal weight or BMI 30–31 kg/m2. HDL-C efflux capacity was inversely associated with HDL-C concentration (r = − 0.228). Conclusion Abnormal HDL function may be associated with residual cardiovascular risk in Lithuanian population.

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Waist-to-height ratio as a clinical predictor for cardiovascular risks and insulin resistance in children and adolescents with exogenous obesity

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00085-9 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Hend Soliman ◽

Samah Ahmed ◽

Amany Ibrahim

Keyword(s):

Insulin Resistance ◽

Cardiovascular Risk ◽

Lipid Profile ◽

Children And Adolescents ◽

Density Lipoprotein ◽

Model Assessment ◽

Height Ratio ◽

Clinical Predictor ◽

Waist To Height Ratio ◽

Risk Ratios

Abstract Background Obesity is one of the most challenging clinical syndromes associated with deleterious health problems. Waist-to-height ratio (WHtR), a newer index for abdominal fat assessment, can be a superior tool in the evaluation of cardiometabolic risk. This study aimed to determine the relation between WHtR and lipid cardiovascular risk ratios and insulin resistance (IR) in children and adolescents with exogenous obesity. Results This analytical cross-sectional study included 80 children and adolescents with exogenous obesity, compared to 80 age- and sex-matched healthy non-overweight non-obese controls. Fasting lipid profile (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL)), fasting insulin, and fasting blood glucose were done and lipoprotein risk ratios were calculated; TC/HDL, LDL/HDL, non-HDL/HDL, and TG/HDL). In addition, homeostatic model assessment for IR (HOMA IR), triglyceride glucose index (TyG), TyG-BMI, and TyG-WC were calculated. The study group included 55 (34.4%) males and 105 (65.6%) females with a mean age of 13.6 ± 2.22 years. Obese group had significantly higher TC, TG, LDL, non-HDL, LDL/HDL, TC/HDL, non-HDL/HDL, and TG/HDL, with significantly lower HDL. In addition, they had significantly higher FBG, HOMA IR, TyG, TyG-BMI, and TyG-WC indices compared to the control group. There were statistically significant correlations between WHtR and lipid profile, lipid risk ratios and indices of IR. WHtR was found to be an independent predictor of IR by linear regression analysis. Conclusion WHtR can be an excellent, easy, and reliable clinical predictor for cardiovascular risk and IR in children and adolescents with exogenous obesity.

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AB0974 ANALYSIS OF DYSLIPIDEMIA IN SYSTEMIC LUPUS ERYTHEMATOSUS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5742 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1782.2-1782

Author(s):

A. S. H. Chen ◽

J. H. Lee ◽

H. Ya-Chiao ◽

H. H. Yu ◽

L. C. Wang ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cardiovascular Risk ◽

Total Cholesterol ◽

Lupus Erythematosus ◽

Density Lipoprotein ◽

High Sensitivity ◽

Systemic Lupus ◽

Mean Values ◽

The Mean ◽

Pediatric Sle

Background:Systemic lupus erythematosus (SLE) is an autoimmune disease and is characterized by multiple autoantibodies associated with a multisystem illness. However, studies of dyslipidemia in pediatric SLE patients are limited.Objectives:The aim of our study is to describe the lipid profiles associated with disease activity and organ damage and their correlation with laboratory parameters in pediatric SLE patients.Methods:We retrospectively reviewed medical records from a single tertiary hospital in Taipei, Taiwan from 2002 to 2018. One hundred and twenty-four patients diagnosed with SLE were included. Dyslipidemia is defined as elevations in total cholesterol (TC), low-density lipoprotein (LDL), and triglyceride (TG) levels, and a reduction in high-density lipoprotein (HDL) levels. We gathered all of the lipid profiles, clinical characteristics, and laboratory parameters from each patient. Pediatric SLE patients participated in this study, based on their lipid profile, were classified as dyslipidemic or not. The mean values of each evaluated parameters were calculated and analyzed with generalized estimating equation (GEE) method.Results:Total thirty-one SLE patients were enrolled; twenty-four (77%) patients had dyslipidemia. The levels of total cholesterol, TG, and LDL in the dyslipidemic group are significantly higher than those of non-dyslipidemia (214.0 mg/dLvs145.0 mg/dL, 130.1 mg/dLvs76.4 mg/dL, 138.7 mg/dLvs82.0 mg/dL; respectively). The mean values of white blood cell count (6726/µL) in dyslipidemia group are significantly higher than non-dyslipidemia group (4521/µL;p=0.0157). In contrast, the level of high-sensitivity CRP in the non-dyslipidemia group (0.2 mg/dL) are significantly lower than those of patients with dyslipidemia (0.49 mg/dL;p=0.0486).Conclusion:It has been well known that CRP could suppress HDL and increase TG and that elevation of CRP might indicate increased cardiovascular risk. Our results demonstrated that elevated high sensitivity CRP levels were noted in SLE patients with dyslipidemia. It is suggested that routine monitoring of cardiovascular risk factors, such as dyslipidemia, should be recommended for pediatric SLE patients.References:[1]Szabó, M.Z., Szodoray, P. & Kiss, E. Immunol Res (2017) 65: 543.[2]Atta, A.M., Silva, J.P.C.G., Santiago, M.B. et al. Clin Rheumatol (2018) 37: 1539.[3]Yu, H.H., Chen, P.C., Yang, Y.H. Atherosclerosis. 2015; 243(1): 11–18.Acknowledgments:The authors acknowledge statistical assistance provided by the Center of Statistical Consultation and Research in the Department of Medical Research, National Taiwan University HospitalDisclosure of Interests:None declared

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Obesity, dyslipidemia, and high blood pressure are associated with cardiovascular risk, determined using high-sensitivity C-reactive protein concentration, in young adults

Journal of International Medical Research ◽

10.1177/0300060520980596 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052098059

Author(s):

Luz Elena Ramos-Arellano ◽

Ines Matia-Garcia ◽

Linda Anahi Marino-Ortega ◽

Natividad Castro-Alarcón ◽

José Francisco Muñoz-Valle ◽

...

Keyword(s):

Blood Pressure ◽

Young Adults ◽

Cardiovascular Risk ◽

High Blood Pressure ◽

Density Lipoprotein ◽

High Sensitivity ◽

High Cardiovascular Risk ◽

Apo B ◽

High Waist Circumference ◽

Hs Crp

Objective Few studies have investigated the relationships between high-sensitivity C-reactive protein (hs-CRP) concentration and conventional cardiometabolic markers in young adults. The aim of this study was to characterize the cardiometabolic profile of young adults who are at high cardiovascular risk, according to hs-CRP concentration. Methods A cross-sectional study was conducted in 300 young adults (18 to 30 years old) from southern Mexico (n = 150 normal-weight and n = 150 obese). Their circulating lipid and glucose concentrations were measured using colorimetric enzymatic assays, and their hs-CRP, ApoA, and ApoB concentrations were measured using turbidimetric assays. Results The most prevalent abnormalities in the participants with high cardiovascular risk, determined using an hs-CRP >28.57 nmol/L, were high waist circumference (85.7%), obesity (83.9%), high low-density lipoprotein-cholesterol (64.3%), low high-density lipoprotein-cholesterol (50%), Apo B in the highest tertile (39.3%), hypertriglyceridemia (35.7%), and high blood pressure (30.4%). In addition, there were strong associations between hs-CRP >28.57 nmol/L and obesity (odds ratio [OR] = 13.9), high waist circumference (OR = 8.0), hypertriglyceridemia (OR = 4.0), high blood pressure (OR = 3.4), hypercholesterolemia (OR = 2.8), and Apo B in the highest tertile (OR = 2.4). Conclusion The principal cardiometabolic alterations associated with high cardiovascular risk, determined using hs-CRP, are obesity, dyslipidemia, and high blood pressure in young adults.

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Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intima-media complex in men

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2014.1322490 ◽

2014 ◽

Vol 132 (2) ◽

pp. 97-104 ◽

Cited By ~ 2

Author(s):

Priscilla Lopes da Fonseca Abrantes Sarmento ◽

Frida Liane Plavnik ◽

Andrea Scaciota ◽

Joab Oliveira Lima ◽

Robson Barbosa Miranda ◽

...

Keyword(s):

Risk Factors ◽

Uric Acid ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Fasting Glucose ◽

Density Lipoprotein ◽

High Sensitivity ◽

Cross Sectional Study ◽

Cross Sectional ◽

Arterial Blood

CONTEXT AND OBJECTIVE: The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an "abnormal" C-IMC. DESIGN AND SETTING: Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo. METHODS: Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated. RESULTS: The following were discriminating variables: fasting glucose (r2 = 0.036; P = 0.013), uric acid (r2 = 0.08; P = 0.03), IM-SD (r2 = 0.43; P < 0.001), IM-GSM (r2 = 0.35; P < 0.001) and thickness of the C-IMC (r2 = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007). CONCLUSION: IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC.

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