Update on the Benefits and Mechanisms of Action of the Bioactive Vegetal Alkaloid Berberine on Lipid Metabolism and Homeostasis

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.

Download Full-text

A Randomized, Double-Blinded, Placebo-Controlled, Clinical Study of the Effects of a Nutraceutical Combination (LEVELIP DUO®) on LDL Cholesterol Levels and Lipid Pattern in Subjects with Sub-Optimal Blood Cholesterol Levels (NATCOL Study)

Nutrients ◽

10.3390/nu12103127 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3127

Author(s):

Arrigo F.G. Cicero ◽

Sergio D’Addato ◽

Claudio Borghi

Keyword(s):

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Blood Cholesterol ◽

Controlled Clinical Trial ◽

Red Yeast Rice ◽

Double Blind ◽

Cholesterol Levels ◽

Red Yeast ◽

Significant Difference ◽

Double Blinded

Phytosterols and red yeast rice are largely studied cholesterol-lowering nutraceuticals, respectively inhibiting the bowel absorption and liver synthesis of cholesterol. Our aim was to test the effect of combined nutraceutical-containing phytosterols and red yeast rice vs. a placebo on the lipid profile. We performed a parallel arms, double-blind, placebo-controlled clinical trial, randomizing 88 moderately hypercholesterolemic subjects to treatment with a combined nutraceutical containing phytosterols (800 mg) and red yeast rice, standardized to contain 5 mg of monacolins from Monascus purpureus, with added niacin (27 mg) and policosanols (10 mg) (LEVELIP DUO®), or placebo. The mean LDL-Cholesterol (LDL-C) change at Week 8 was −32.5 ± 30.2 mg/dL (−19.8%) in the combined nutraceutical group and 2.5 ± 19.4 mg/dL (2.3%) in the placebo group. The estimated between-group difference of −39.2 mg/dL (95% CI: −48.6; −29.8) indicates a statistically significant difference between treatments in favor of the combined nutraceutical (p < 0.0001). Total Cholesterol (TC), non-HDL cholesterol (non-HDL-C), Apolipoprotein B, TC/HDL-C and LDL-C/HDL-C improved in a similar way in the combined nutraceutical group only. No significant changes in other clinical and laboratory parameters were observed. In conclusion, the tested combined nutraceutical was well tolerated, while significantly reducing the plasma levels of LDL-C, TC, non-HDL-C, ApoB, TC/HDL-C and LDL-C/HDL-C ratios in mildly hypercholesterolemic patients. Trial registration (ClinicalTrials.gov): NCT03739242.

Download Full-text

Cholesterol lowering in pigs through enhanced bacterial bile salt hydrolase activity

British Journal Of Nutrition ◽

10.1079/bjn19980030 ◽

1998 ◽

Vol 79 (2) ◽

pp. 185-194 ◽

Cited By ~ 108

Author(s):

I. De Smet ◽

P. De Boever ◽

W. Verstraete

Keyword(s):

Bile Salt ◽

Ldl Cholesterol ◽

Lactobacillus Reuteri ◽

Plasma Cholesterol ◽

Hdl Cholesterol ◽

Blood Cholesterol ◽

Cholesterol Concentration ◽

Control Group ◽

Bile Salt Hydrolase ◽

Cholesterol Levels

The effect of feeding liveLactobacillus reutericells containing active bile salt hydrolase (BSH) on plasma cholesterol levels was studied in pigs. During an experiment lasting 13 weeks, twenty pigs were fed on a high-fat, high-cholesterol, low-fibre diet for the first 10 weeks, and a regular pig diet for the last 3 weeks. One group of animals received, twice daily, 11·25 (SD 0·16) log10colony forming units of the potential probiotic bacteria for 4 weeks (from week 3 until week 7). From week 8 onwards, the treated group was again fed on the same diet as the control group without additions. The total faecalLactobacilluscounts were only significantly higher in the treated pigs during the first 2 weeks ofL. reuterifeeding. Based on limited data, it was suggested that the administeredLactobacillusspecies had caused a temporary shift within the indigenousLactobacilluspopulation rather than permanently colonizing the intestinal tract. The probiotic feeding brought about significant lowering (P≤ 0·05) of total and LDL-cholesterol concentrations in the treated pigs compared with the control pigs, while no change in HDL-cholesterol concentration was observed. The data for faecal output of neutral sterols and bile salts were highly variable between the animals of each group, yet they indicated an increased output in the treated pigs. Although the blood cholesterol levels went up in both groups during the 3 weeks following theLactobacillusadministration period, significantly lower serum total and LDL-cholesterol levels were observed in the treated pigs. During the final 3 weeks of normalization to the regular diet, cholesterol concentrations significantly decreased in both animal groups and the differences in total and LDL-cholesterol concentrations between the groups largely disappeared.

Download Full-text

The Effects of L-Carnitine Supplementation on Serum Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Current Pharmaceutical Design ◽

10.2174/1381612825666190830154336 ◽

2019 ◽

Vol 25 (30) ◽

pp. 3266-3281 ◽

Cited By ~ 1

Author(s):

Hadis Fathizadeh ◽

Alireza Milajerdi ◽

Željko Reiner ◽

Fariba Kolahdooz ◽

Maryam Chamani ◽

...

Keyword(s):

Serum Lipids ◽

Ldl Cholesterol ◽

Meta Analysis ◽

Hdl Cholesterol ◽

Health Conditions ◽

Carnitine Supplementation ◽

Randomized Controlled ◽

Cholesterol Levels ◽

Vldl Cholesterol ◽

Subgroup Analyses

Background: The findings of trials investigating the effects of L-carnitine administration on serum lipids are inconsistent. This meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effects of L-carnitine intake on serum lipids in patients and healthy individuals. Methods: Two authors independently searched electronic databases including MEDLINE, EMBASE, Cochrane Library, Web of Science, PubMed and Google Scholar from 1990 until August 1, 2019, in order to find relevant RCTs. The quality of selected RCTs was evaluated using the Cochrane Collaboration risk of bias tool. Cochrane’s Q test and I-square (I2) statistic were used to determine the heterogeneity across included trials. Weight mean difference (SMD) and 95% CI between the two intervention groups were used to determine pooled effect sizes. Subgroup analyses were performed to evaluate the source of heterogeneity based on suspected variables such as, participant’s health conditions, age, dosage of L-carnitine, duration of study, sample size, and study location between primary RCTs. Results: Out of 3460 potential papers selected based on keywords search, 67 studies met the inclusion criteria and were eligible for the meta-analysis. The pooled results indicated that L-carnitine administration led to a significant decrease in triglycerides (WMD: -10.35; 95% CI: -16.43, -4.27), total cholesterol (WMD: -9.47; 95% CI: - 13.23, -5.70) and LDL-cholesterol (LDL-C) concentrations (WMD: -6.25; 95% CI: -9.30, -3.21), and a significant increase in HDL-cholesterol (HDL-C) levels (WMD: 1.39; 95% CI: 0.21, 2.57). L-carnitine supplementation did not influence VLDL-cholesterol concentrations. When we stratified studies for the predefined factors such as dosage, and age, no significant effects of the intervention on triglycerides, LDL-C, and HDL-C levels were found. Conclusion: This meta-analysis demonstrated that L-carnitine administration significantly reduced triglycerides, total cholesterol and LDL-cholesterol levels, and significantly increased HDL-cholesterol levels in the pooled analyses, but did not affect VLDL-cholesterol levels; however, these findings were not confirmed in our subgroup analyses by participant’s health conditions, age, dosage of L-carnitine, duration of study, sample size, and study location.

Download Full-text

Effects of yoghurt enriched with plant sterols on serum lipids in patients with moderate hypercholesterolaemia

British Journal Of Nutrition ◽

10.1079/bjn2001395 ◽

2001 ◽

Vol 86 (2) ◽

pp. 233-239 ◽

Cited By ~ 84

Author(s):

Robert Volpe ◽

Leena Niittynen ◽

Riitta Korpela ◽

Cesare Sirtori ◽

Antonello Bucci ◽

...

Keyword(s):

Total Cholesterol ◽

Serum Lipids ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Plant Sterols ◽

Dependent Manner ◽

Low Fat ◽

Treatment Groups ◽

Cholesterol Levels ◽

Dose Dependent

The objective of the present study was to assess the effect of consumption of a yoghurt-based drink enriched with 1–2 g plant sterols/d on serum lipids, transaminases, vitamins and hormone status in patients with primary moderate hypercholesterolaemia. Thirty patients were randomly assigned to one of two treatment groups: a low-fat low-lactose yoghurt-based drink enriched with 1 g plant sterol extracted from soyabean/dv.a low-fat low-lactose yoghurt, for a period of 4 weeks. After a 2-week wash-out period, patients were crossed over for an additional 4-week period. Second, after a 4-week wash-out period, eleven patients were treated with 2 g plant sterols/d in a second open part of the study for a period of 8 weeks. The yoghurt enriched with plant sterols significantly reduced, in a dose-dependent manner, serum total cholesterol and LDL-cholesterol levels and LDL-cholesterol:HDL-cholesterol (P<0·001), whereas no changes were observed in HDL-cholesterol and triacylglycerol levels, either in the first or the second part of the study. There were only slight, not statistically significant, differences in serum transaminase, vitamin and hormone levels. To conclude, a low-fat yoghurt-based drink moderately enriched with plant sterols may lower total cholesterol and LDL-cholesterol effectively in patients with primary moderate hypercholesterolaemia.

Download Full-text

Effects of Red Pitaya (Hylocereus polyrhizus) on Lipid Profile of Male White Rats (Rattus norvegicus) Receiving High Fat Diet

Folia Medica Indonesiana ◽

10.20473/fmi.v54i1.8046 ◽

2018 ◽

Vol 54 (1) ◽

pp. 16 ◽

Cited By ~ 1

Author(s):

Wiwik Werdiningsih ◽

Suhartati Suhartati

Keyword(s):

Lipid Profile ◽

Total Cholesterol ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Fruit Peel ◽

Cholesterol Levels ◽

White Rats ◽

Wistar Strain ◽

Dragon Fruit ◽

Pap Method

Red dragon fruit (Hylocereus polyrhizus) peel contains anthocyanin, fiber and vitamin C, so it can be used to improve lipid profile in dyslipidemia. The peel of the dragon fruit is not durable, so in this study we used freeze-dried dragon fruit peel. The aim of this study was to prove that the administration of the red dragon fruit peel in a dose of 0.72 g/200 g BW, 1.08 g/200 g BW, and 1.44 g/200 g BW of rat per day for 28 days may improve lipid profile in male wistar strain white rats with high-fat diet. Lipid profiles were studied by examining of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. This was a pure experimental study using randomized post test only control group design. This study used experimental animal of 30 male wistar strain white rats which were divided into five groups. Measurements of total, LDL, and HDL cholesterol levels were done by CHOD-PAP method, while triglyceride level was measured with GPO-PAP method. Data were analyzed statistically by One Way Anova test. The results of this study indicated that giving the peel of red dragon fruit as much as 0.72 g lowered total cholesterol levels, 1.08 g lowered total and LDL cholesterol levels, and 1.44 g lowered total cholesterol, LDL cholesterol, triglyceride levels, and raised HDL cholesterol level. Red dragon fruit peel can be used alternatively to improve lipid profile in dyslipidemia.

Download Full-text

Lipid abnormalities in elderly patients with subclinical hyperthyroidism

Medicinski pregled ◽

10.2298/mpns0312564c ◽

2003 ◽

Vol 56 (11-12) ◽

pp. 564-567 ◽

Cited By ~ 2

Author(s):

Zorica Caparevic ◽

Dragos Stojanovic ◽

Vesna Ilic ◽

Gradimir Bojkovic ◽

Mirjana Stojanovic

Keyword(s):

Atrial Fibrillation ◽

Thyroid Hormone ◽

Elderly Patients ◽

Cardiac Hypertrophy ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Antithyroid Drugs ◽

Subclinical Hyperthyroidism ◽

Cholesterol Levels ◽

Lipid Abnormalities

Introduction Sensitive thyroid-stimulating hormone (TSH) assays provide identification of many patients with subclinical hyperthyroidism resulting from excessive production or excessive replacement of thyroid hormone. Subclinical hyperthyroidism is defined by a TSH below normal (suppressed) with normal serum T3 and T4 levels. Subclinical hyperthyroidism is the goal of thyroid hormone therapy in patients with thyroid cancer, solitary thyroid nodules, multinodular or diffuse goiters, or a history of head and neck irradiation. Benefits of TSH suppression in these patients, were thought to exceed the risks of subclinical hyperthyroidism. Subclinical hyperthyroidism also occurs in patients with thyroiditis and those with autoimmune thyroid disease. Other causes of TSH suppression, such as use of glucocorticoids, severe illness and pituitary dysfunction should be excluded. Material and methods This investigation included 55 elderly patients with subclical hyperthyroidism in order to establish the type and degree of lipid abnormalities and effects of therapy with antithyroid drugs (methimazole 10 mg/day) during three months. These patients presented with no or minimal symptoms of thyroid hormone excess, but 56% of patients experienced atrial fibrillation and cardiac hypertrophy. Results Levels of serum cholesterol, LDL-cholesterol and HDL-cholesterol were decreased. We found a significant increase of serum cholesterol, LDL-cholesterol and HDL-cholesterol levels after treatment. Discussion and Conclusion Subclinical hyperthyroidism in elderly individuals is difficult to diagnose because it may present only with cardiac manifestations including atrial fibrillation and cardiac hypertrophy. There is general agreement that measurement of serum TSH is the most sensitive indicator of thyroid hormone activity in its target tissues. Patients with subclinical hyperthyroidism tend to have low serum total cholesterol, LDL-cholesterol anf HDL-cholesterol levels. These values increase after treatment. Most patients with subclinical hyperthyroidism should be treated with antithyroid drugs to prevent cardiovascular complications and bone loss, particulary among postmenopausal women.

Download Full-text

PENGARUH SINBIOTIK KEFIR PISANG BATU TERHADAP KADAR KOLESTEROL-LDL DAN KOLESTEROL-HDL TIKUS MODEL SINDROM METABOLIK

Jurnal Bioteknologi & Biosains Indonesia (JBBI) ◽

10.29122/jbbi.v7i2.3781 ◽

2020 ◽

Vol 7 (2) ◽

pp. 280-288

Author(s):

Dina Khoiriyah ◽

Taufik Maryusman ◽

Santi Herlina

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Positive Control ◽

Negative Control ◽

Sprague Dawley ◽

Musa Balbisiana ◽

Cholesterol Levels ◽

Sprague Dawley Rats

Effect of Banana Kefir Synbiotic on LDL-Cholesterol and HDL-Cholesterol of Metabolic Syndrome Rats Metabolic syndrome (SM) is characterized by several risk factors including dyslipidemia. This study aims to analyze the effect of kefir synbiotic produced from banana stone flour (Musa balbisiana) on LDL-cholesterol and HDL-cholesterol of metabolic syndrome rat model. The 24 Sprague Dawley rats were divided into four groups, namely negative control (healthy rats fed standard feed), positive control (metabolic syndrome rats fed standard feed), treatment I and treatment II (metabolic syndrome rats each given synbiotic kefir banana stone flour 1.8 mL/200 g mouse BW/day and 3.6 mL/200 g mouse BW/day, respectively). The intervention was carried out for three weeks. After the intervention, the levels of LDL-cholesterol in treatment I and II experienced a decrease of 44.66% and 56.94%, respectively, while the-HDL-cholesterol levels in treatment I and II experienced an increase of 104.5% and 172.71%, respectively. The biggest change occurred in treatment II. Synbiotic kefir banana stone flour improved lipid profile in metabolic syndrome rats. Sindrom metabolik (SM) ditandai dengan beberapa faktor risiko termasuk dislipidemia. Penelitian ini bertujuan untuk menganalisis pengaruh sinbiotik kefir tepung pisang batu (Musa balbisiana) terhadap kadar kolesterol-LDL dan kolesterol-HDL tikus model SM. Subjek menggunakan 24 ekor tikus Sprague Dawley yang dibagi menjadi empat kelompok, yaitu kontrol negatif (tikus sehat yang diberi pakan standar), kontrol positif (tikus model SM yang diberi pakan standar), perlakuan I dan perlakuan II (tikus model SM yang masing-masing diberi sinbiotik kefir tepung pisang batu 1,8 mL/200 g BB tikus/hari dan 3,6 mL/200 g BB tikus/hari). Proses intervensi dilakukan selama tiga minggu. Setelah intervensi, kadar kolesterol-LDL perlakuan I dan II mengalami penurunan sebesar 44,66% dan 56,94%, sedangkan kadar kolesterol-HDL perlakuan I dan II mengalami peningkatan sebesar 104,5% dan 172,71%. Perubahan terbesar terjadi pada perlakuan II. Sinbiotik kefir tepung pisang batu memperbaiki profil lipid tikus sindrom metabolik.

Download Full-text

Familial Hypercholesterolemia: Three “under” (Understood, Underdiagnosed, and Undertreated) Disease

Cardiovascular Risk Factors in Pathology ◽

10.5772/intechopen.93042 ◽

2021 ◽

Author(s):

Vladimir O. Konstantinov

Keyword(s):

Familial Hypercholesterolemia ◽

Time Course ◽

Ldl Cholesterol ◽

Genetic Disorders ◽

Receptor Gene ◽

Ldl Receptor ◽

Hdl Cholesterol ◽

Blood Cholesterol ◽

Healthy Population ◽

Loss Of Function

Familial hypercholesterolemia (FH) is one of the most prevalent genetic disorders leading to premature atherosclerosis and coronary heart disease. The main cause of FH is a mutation in the LDL-receptor gene that leads to loss of function of these receptors causing high levels of blood cholesterol. The diagnosis of FH is not very easy. Wide screenings are needed to reveal high levels of LDL cholesterol among “healthy” population. If the patient has MI or stroke at an early age, high levels of LDL cholesterol, and tendon xanthomas, the diagnosis of FH becomes much more clear. Genetic testing is a gold standard in the diagnosis of FH. There are several factors, influencing the time course of FH. Smoking males with low levels of HDL cholesterol have an extremely higher risk of death than nonsmoking females with high HDL cholesterol. Management of FH includes low cholesterol diet, statin and ezetimibe treatment, PCSK inhibitors, and LDL aphaeresis. Early and effective treatment influences much the prognosis in FH patients.

Download Full-text

Dyslipidaemia

The ESC Handbook on Cardiovascular Pharmacotherapy ◽

10.1093/med/9780198759935.003.0002 ◽

2019 ◽

pp. 33-48

Author(s):

Heinz Drexel

Keyword(s):

Cardiovascular Disease ◽

Randomized Clinical Trials ◽

Ldl Cholesterol ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Epidemiological Studies ◽

Residual Risk ◽

Atherosclerotic Cardiovascular Disease ◽

Cholesterol Levels

Lipid metabolism has gained cardiological interest only after statins were demonstrated to reduce cardiovascular disease in secondary and primary prevention. Therefore, this chapter first introduces the physiological and atherogenic properties of lipoproteins, before focusing on interventions. Both the efficacy and safety of statins have been proven in numerous randomized clinical trials. Because there is a considerable residual risk in statin-treated patients, additional approaches have been investigated. The focus is now on further reductions in low-density lipoprotein (LDL) cholesterol levels. First, high-intensity statin regimens were shown to reduce residual risk. Subsequently, ezetimibe was demonstrated, for the first time, to have a beneficial effect as a non-statin lipid intervention. More recently, inhibitors of the enzyme PCSK9 have demonstrated a very high efficacy in reducing LDL cholesterol levels. Although the causality of LDL for atherosclerotic cardiovascular disease has been proven in epidemiological studies, including Mendelian randomization studies, as well as interventional trials, adherence to statins and other therapies is far from optimal. In contrast, interventions to increase high-density lipoprotein (HDL) cholesterol levels could not proven to have further benefits when combined with statins.

Download Full-text

Study of Lipid Profile in Shift Workers

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v2i0.982 ◽

1970 ◽

Vol 2 ◽

pp. 34-37

Author(s):

Md Abedur Rahman ◽

Md Ruhul Amin ◽

Momotaj Begum ◽

Firoza Khatun ◽

Montasir Islam ◽

...

Keyword(s):

Blood Pressure ◽

Circadian Rhythm ◽

Lipid Profile ◽

Serum Lipid ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Shift Workers ◽

Shift Worker ◽

Cholesterol Levels ◽

Apparently Healthy

Background: The present study was undertaken to evaluate the changes of serum lipid profile in apparently healthy shift workers and non shift workers to identify the possible high risk factors for developing atherosclerotic changes. Methods: Serum Total Cholesterol, Triglyceride, HDL-Cholesterol and LDL-Cholesterol levels were estimated and blood pressure was measured in apparently healthy adult shift worker and non shift worker participants. Total 60 subjects age ranged from 20-50 years were selected, of whom 30 were shift workers (Study) for at least one year and 30 were non shift workers (control). Height, weight and resting blood pressure of all the subjects were recorded before collection of blood. Blood samples were collected after over night fasting for estimation of serum lipid and lipoprotein levels and were measured by standard laboratory technique. Data were analyzed by unpaired ‘t' test. Results: The mean serum Total Cholesterol and LDL-Cholesterol levels were significantly higher in shift workers compared to those of non shift workers. Again mean serum Triglyceride and HDL-Cholesterol levels in the shift workers did not differ significantly from that of non shift workers. These changes may be related to internal desynchronization due to disruption of circadian rhythm. Conclusion: The changes in serum lipid and lipoprotein levels with the exception of HDL-Cholesterol and Triglyceride in the subjects engaged in shift work may put them at increased risk for coronary artery disease. Keywords: Circadian Rhythm; Lipid Profile; Shift-work DOI:10.3329/jbsp.v2i0.982 J Bangladesh Soc Physiol. 2007 Dec;(2): 34-37.

Download Full-text