Relative Efficacy of Antilipemic Agents in Non–High-Density Lipoprotein Cholesterol Reduction

2012 ◽  
Vol 25 (4) ◽  
pp. 447-456
Author(s):  
Jennifer Santee ◽  
Cameron Lindsey ◽  
Heather Pace

The investigators sought to summarize the percentage reduction in non–high-density lipoprotein cholesterol (non-HDL-C) achieved with various antilipemic regimens and to determine whether certain antilipemic regimens have been proven more effective in lowering non-HDL-C. A search of MEDLINE, International Pharmaceutical Abstracts, and Iowa Drug Information Service Database from 1970 to May 2011 was performed. Criteria were used to exclude studies not published in English, studies with methodology limitations, and studies with variables that may affect efficacy beyond the antilipemic agent administered. Only randomized, controlled trials comparing medications approved by the Food and Drug Administration were reviewed to determine whether significant differences in percentage reduction in non-HDL-C had been observed between different medication regimens. A total of 51 trials reported data that could be used to determine the range of percentage reduction in non-HDL-C achieved by select antilipemic regimens. Of these 51 trials, 38 provided head-to-head comparisons of antilipemic regimens. Rosuvastatin and atorvastatin are the most potent 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in lowering non-HDL-C. Adding ezetimibe, fibric acid derivatives, and omega-3 fatty acids to antilipemic monotherapy may result in further reduction in non-HDL-C. Subjects with certain characteristics (eg, nonwhite) were not prevalent in these studies.

2007 ◽  
Vol 32 (3) ◽  
pp. 473-480 ◽  
Author(s):  
Tom R. Thomas ◽  
Ying Liu ◽  
Melissa A. Linden ◽  
R. Scott Rector

The effect of combining omega-3 fatty acid (n-3 FA) supplementation and exercise training treatment on postprandial lipemia (PPL) has not been studied. The purpose of this study was to examine the interaction of n-3 FA and exercise training in attenuating PPL after a high-fat meal. Previously sedentary, overweight, subjects (n = 22; 12 women, 10 men, BMI 26.6 ±0.7 kg/m2) were randomly assigned to one of two treatment groups: n-3 FA supplementation alone (FO, n = 10) or n-3 FA supplementation plus exercise training (FO+ExTr, n = 12). Both groups consumed 4 g/d n-3 FA, and one group also exercise trained for 45 min/d, 5d/week of brisk walking and (or) jogging at 60% VO2 max. Before and after 4 weeks of treatment, subjects performed a baseline PPL and a PPL following a single session of exercise (ExPPL). PPL was assessed by triglyceride (TG) area under the curve (AUC) and peak TG response (TGpeak). A two-way analysis of variance (ANOVA) with repeated measures was used to compare results from treatments for baseline and exercise trials. FO alone reduced PPL and Ex PPL, and FO+ExTr attenuated the ExPPL response measured as total AUC and TGpeak. There was no significant main effect for group or group by time interaction for baseline PPL or ExPPL. Fasting high-density lipoprotein cholesterol (HDL-C) and HDL2-C (i.e., subfraction 2) concentrations were significantly increased in the FO+ExTr group after the treatments. These results suggest that n-3 FA supplementation reduced PPL in sedentary subjects. Exercise training has no interference or additive effects with n-3 FA supplementation in attenuating PPL, but combined treatments may be additive in raising high-density lipoprotein cholesterol.


2004 ◽  
Vol 34 (1) ◽  
pp. 103-112 ◽  
Author(s):  
S. SOBCZAK ◽  
A. HONIG ◽  
A. CHRISTOPHE ◽  
M. MAES ◽  
R. W. C. HELSDINGEN ◽  
...  

Background. Lower serum high-density lipoprotein cholesterol and increased ratio of omega-6/omega-3 fatty acids have been reported in unipolar and bipolar depressed patients. Changes in cholesterol and fatty acids have been suggested to affect membrane viscosity and consequently serotonergic neurotransmitter expression.The goal of this study was to investigate whether lower baseline cholesterol and increased omega-6 and lower omega-3 fatty acids are present in healthy first-degree relatives of bipolar patients compared with controls and whether these changes were associated with neuroendocrine responses to an i.v. tryptophan challenge or mood.Method. Baseline cholesterol, fatty acids and mood were determined in healthy first-degree relatives of patients with bipolar disorders (N=30) and healthy matched controls (N=15) (parallel-group design). Prolactin and cortisol were measured following tryptophan infusion.Results. First-degree relatives showed significantly lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids. Lower total omega-3 and higher total omega-6 fatty acids in phospholipids were positively correlated with peak prolactin response to tryptophan. Lower total omega-3 fatty acids in phospholipids and cholesteryl esters were associated with lower mood.Conclusions. Abnormalities of lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids in these subjects are in agreement with findings in bipolar and major depressed patients. Changes in fatty acids show an association with central serotonergic parameters. It is suggested that these abnormalities in cholesterol and fatty acids may constitute a trait marker for bipolar disorders.


VASA ◽  
2014 ◽  
Vol 43 (3) ◽  
pp. 189-197 ◽  
Author(s):  
Yiqiang Zhan ◽  
Jinming Yu ◽  
Rongjing Ding ◽  
Yihong Sun ◽  
Dayi Hu

Background: The associations of triglyceride (TG) to high-density lipoprotein cholesterol ratio (HDL‑C) and total cholesterol (TC) to HDL‑C ratio and low ankle brachial index (ABI) were seldom investigated. Patients and methods: A population based cross-sectional survey was conducted and 2982 participants 60 years and over were recruited. TG, TC, HDL‑C, and low-density lipoprotein cholesterol (LDL-C) were assessed in all participants. Low ABI was defined as ABI ≤ 0.9 in either leg. Multiple logistic regression models were applied to study the association between TG/HDL‑C ratio, TC/HDL‑C ratio and low ABI. Results: The TG/HDL‑C ratios for those with ABI > 0.9 and ABI ≤ 0.9 were 1.28 ± 1.20 and 1.48 ± 1.13 (P < 0.0001), while the TC/HDL‑C ratios were 3.96 ± 1.09 and 4.32 ± 1.15 (P < 0.0001), respectively. After adjusting for age, gender, body mass index, obesity, current drinking, physical activity, hypertension, diabetes, lipid-lowering drugs, and cardiovascular disease history, the odds ratios (ORs) with 95 % confidence intervals (CIs) of low ABI for TG/HDL‑C ratio and TC/HDL‑C ratio were 1.10 (0.96, 1.26) and 1.34 (1.14, 1.59) in non-smokers. When TC was further adjusted, the ORs (95 % CIs) were 1.40 (0.79, 2.52) and 1.53 (1.21, 1.93) for TG/HDL‑C ratio and TC/HDL‑C ratio, respectively. Non-linear relationships were detected between TG/HDL‑C ratio and TC/HDL‑C ratio and low ABI in both smokers and non-smokers. Conclusions: TC/HDL‑C ratio was significantly associated with low ABI in non-smokers and the association was independent of TC, TG, HDL‑C, and LDL-C. TC/HDL‑C might be considered as a potential biomarker for early peripheral arterial disease screening.


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