scholarly journals Pharmacological Interventions to Treat Antipsychotic-Induced Dyslipidemia in Schizophrenia Patients: A Systematic Review and Meta Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pruntha Kanagasundaram ◽  
Jiwon Lee ◽  
Femin Prasad ◽  
Kenya A. Costa-Dookhan ◽  
Laurie Hamel ◽  
...  

Introduction: Antipsychotic-induced dyslipidemia represents a common adverse effect faced by patients with schizophrenia that increases risk for developing further metabolic complications and cardiovascular disease. Despite its burden, antipsychotic-induced dyslipidemia is often left untreated, and the effectiveness of pharmacological interventions for mitigating dyslipidemia has not been well-addressed. This review aims to assess the effectiveness of pharmacological interventions in alleviating dyslipidemia in patients with schizophrenia.Methods: Medline, PsychInfo, and EMBASE were searched for all relevant English articles from 1950 to November 2020. Randomized placebo-controlled trials were included. Differences in changes in triglycerides, HDL cholesterol, LDL cholesterol, and VLDL cholesterol levels between treatment and placebo groups were meta-analyzed as primary outcomes.Results: Our review identified 48 randomized controlled trials that comprised a total of 3,128 patients and investigated 29 pharmacological interventions. Overall, pharmacological interventions were effective in lowering LDL cholesterol, triglycerides, and total cholesterol levels while increasing the levels of HDL cholesterol. Within the intervention subgroups, approved lipid-lowering agents did not reduce lipid parameters other than total cholesterol level, while antipsychotic switching and antipsychotic add-on interventions improved multiple lipid parameters, including triglycerides, LDL cholesterol, HDL cholesterol, and total cholesterol. Off label lipid lowering agents improved triglycerides and total cholesterol levels, with statistically significant changes seen with metformin.Conclusion: Currently available lipid lowering agents may not work as well in patients with schizophrenia who are being treated with antipsychotics. Additionally, antipsychotic switching, antipsychotic add-ons, and certain off label interventions might be more effective in improving some but not all associated lipid parameters. Future studies should explore novel interventions for effectively managing antipsychotic-induced dyslipidemia.Registration: PROSPERO 2020 CRD42020219982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219982.

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yanqiu Wang ◽  
Qinglei Yin ◽  
Min Xu ◽  
Qicheng Ni ◽  
Weiqing Wang ◽  
...  

The impacts of thyroid hormones (TH) on lipid profile in euthyroid adults have gained much attention. It is currently unknown whether BMI influences such interaction. In the present study, we investigate the role of BMI in modulating the association between TH and lipid parameters in 1372 euthyroid healthy adults. Our results show that thyroid parameters are differentially associated with lipid profile. FT3 is positively correlated with total cholesterol (β=0.176±0.046, P<0.001) and LDL cholesterol levels (β=0.161±0.040, P<0.001). FT4 is negatively correlated with TG (β=−0.087±0.029, P<0.01) while positively correlated with HDL cholesterol levels (β=0.013±0.005, P<0.01). TSH is positively associated with TG (β=0.145±0.056, P<0.05) and total cholesterol levels (β=0.094±0.030, P<0.01). Importantly, BMI modulates the effect of TH on lipid profile: the interaction of FT4 and BMI and the interaction of FT3 and BMI reach statistical significance in predicting TG and HDL cholesterol levels, respectively. Stratified according to BMI levels, most associations between TH and lipid profile are significant only in normal-weight group. In conclusion, in euthyroid adults, high normal FT3, TSH levels, and low normal FT4 levels are associated with unfavorable lipid profile. BMI mediates the effect of thyroid function on lipid profile in euthyroid adults.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 227-232
Author(s):  
M. Thejaswini ◽  
Chandrashekar Udyavara Kudru ◽  
Shivashankara Kaniyoor Nagiri ◽  
Arpita Chakraborty ◽  
Vasudeva Guddattu

Introduction and Aim: Serum lipids play a pivotal role in the immune response of the host during dengue. The aim of this study was to evaluate the serum lipid abnormalities in dengue patients and to study the relationship between serum lipids with disease severity and platelet count.   Materials and Methods: This case control study was carried out in 75 cases of dengue of age group > 18 years divided into three groups namely dengue without warning symptoms (DNWS), dengue with warning symptoms (DWWS) and severe dengue (SD) and 75 age and gender matched healthy controls. Lipid parameters such as total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides were thereafter measured in all the subjects.   Results: Among 75 patients with dengue fever, 52 (69.4%) were classified as DNWS, 15 (20%) as DWWS and the remaining 8 (10.6%) as SD. Lower levels of serum total cholesterol (TC) levels (118.8 + 30.71) (p <0.0001) were observed among patients with DNWS when compared to controls. A strong significant positive correlation was seen between the platelets and serum HDL cholesterol levels among the subjects with SD (r = 0.712, p=.047*) and weak negative correlation was observed between the platelets and triglycerides in patients with dengue with warning signs (r = -0.275, p=.048*).   Conclusion: We observed a strong association of diminished TC, HDL and LDL cholesterol levels with the severity of dengue. Based on our findings, these three lipid parameters could be utilized as a simple laboratory tool to identify dengue severity in resource limited settings.


2020 ◽  
Vol 11 (5) ◽  
pp. 69-76
Author(s):  
Ngatchic Metsagang Therese Josiane ◽  
Douanla Nodem Forestine Nikaise ◽  
Ndjantou Elie Baudelaire ◽  
Njintang Yanou Nicolas

Background: Fruits of Dichrostachys glomerata have in the last ten years benefited from special attention as a lipid-lowering plant. Recent studies show that biological activities of some plants depend on granulometry of their powder particles. Aims and Objective: The purpose of this study was to assess antihyperlipidemic, hypolipidemic, and anti-lipase properties of powder fractions of the fruits of Dichrostachys glomerata. Materials and Methods: The groups of rats on which the antihyperlipidemic test was done were fed with High Fat Diet and supplemented with powder fractions: ≥180μm, 212–180μm, 315–212μm, ≥315 μm and unsieved powder of Dichrostachys glomerata fruits at dose of 250 mg/kg for four weeks. For the hypolipidemic test, the diet was changed to normal diet and the powder fraction: 212 – 180μm, was given to rats for four weeks. Lipase inhibitory activity was determined using olive oil as substrate. Results: The antihyperlipidemic test showed that powder fractions reduced levels of total cholesterol, LDL-Cholesterol and triglycerides, groups taken powder fractions 212 –180µm and <180µm, presented the lowest values. HDL-Cholesterol levels increased, significant increases were observed in groups fed with powder fractions 315–212µm, 212–180µm, <180µm and unsieved powder. Concerning hypolipidemic test, powder fraction 212–180 µm decreased levels of total cholesterol, LDL-Cholesterol and triglycerides. 86.43% of the activity of pancreatic lipase was reduced to a concentration of 25mg/ml with an IC50 of 5mg/ml. Conclusion: Antihyperlipidemic properties of Dichrostachys glomerata fruits depended on powder fractions. Fraction 180-212μm exhibits hypolipidemic effects. The inhibition of pancreatic lipase is one of the mechanisms which could explain lipid- lowering properties of Dichrostachys glomerata fruits.


2001 ◽  
Vol 86 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Robert Volpe ◽  
Leena Niittynen ◽  
Riitta Korpela ◽  
Cesare Sirtori ◽  
Antonello Bucci ◽  
...  

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.


2018 ◽  
Vol 54 (1) ◽  
pp. 16 ◽  
Author(s):  
Wiwik Werdiningsih ◽  
Suhartati Suhartati

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.


2011 ◽  
Vol 152 (8) ◽  
pp. 296-302 ◽  
Author(s):  
Győző Dani ◽  
László Márk ◽  
András Katona

Authors aimed to assess how target values in serum lipid concentrations (LDL- and HDL-cholesterol, triglyceride) can be achieved in patients with a history of acute coronary syndrome during follow up in an outpatient cardiology clinic. Methods: 201 patients with a history of acute coronary syndrome were included and were followed up between January 1 and May 31, 2007.Authors analyzed serum lipid parameters of the patients and the lipid-lowering medications at the time of the first meeting and during follow up lasting two years. Results: During the enrollment visit only 26.4% of the patients had serum LDL cholesterol at target level, whereas high triglycerides and low HDL cholesterol levels were observed in 40.3% and 33.3% of the patients, respectively. Only 22 patients (10.9%) achieved the target levels in all three lipid parameters. Of the 201 patients, 179 patients participated in the follow up, and data obtained from these patients were analyzed. There was a positive trend toward better lipid parameters; 42.5% of the patients reached the desired LDL-cholesterol target value and 17.3% of the patients had HDL-cholesterol and triglycerides target values. Conclusions: These findings are consistent with those published in the literature. Beside the currently used therapeutic options for achieving optimal LDL-cholesterol, efforts should be made to reduce the so-called “residual cardiovascular risk” with the use of a widespread application of combination therapy. Orv. Hetil., 2011, 152, 296–302.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1940-1940
Author(s):  
M.-L. Ancelin ◽  
I. Carrière ◽  
J.-P. Boulenger ◽  
A. Malafosse ◽  
R. Stewart ◽  
...  

BackgroundLipids appear to mediate depressive vulnerability in the elderly, however, sex differences and genetic vulnerability have not been taken into account in previous prospective studies.MethodsDepression was assessed in a population of 1040 women and 752 men aged 65 years and over at baseline and after 7-year follow-up. Clinical level of depression (DEP) was defined as having either a score of 16 and above on the Centre for Epidemiology Studies Depression scale or a diagnosis of current major depression on the Mini International Neuropsychiatric Interview. Lipid levels, apolipoprotein E and serotonin transporter linked promoter region (5-HTTLPR) genotypes were evaluated at baseline.ResultsMultivariate analyses adjusted by socio-demographic and behavioral variables, measures of physical health including ischemic pathologies, and genetic vulnerability indicated gender-specific associations between dyslipidemia and DEP, independent of the use of lipid lowering agents or apolipoprotein E status. Men with low LDL-cholesterol levels had twice the risk of prevalent and incident DEP whereas in women low HDL-cholesterol levels were found to be significantly associated with increased prevalent DEP (OR = 1.5) only. A significant interaction was observed between low LDL-cholesterol and 5-HTTLPR genotype, men with s/s or s/l genotype being at increased risk of DEP (OR = 6.0 and 2.7, respectively). No significant gene-environment interaction was observed for women.ConclusionsDEP is associated with higher atherogenic risk in women (low HDL-cholesterol), whereas the reverse is observed in men (low LDL-cholesterol). Late-life depression may have a complex gender-specific etiology involving genetic vulnerability in men.


2012 ◽  
Vol 8 (3) ◽  
pp. 106
Author(s):  
Krisnansari Diah ◽  
Ariadne Tiara Hapsari ◽  
Evy Sulistyoningrum ◽  
Agus Prastowo

Background: Nowadays, cardiovascular disease caused by hypercholesterolemia has become the main cause of death. Propolis has been used widely to reduce plasma cholesterol levels.Objective: The aims of this research was to study the effect of propolis on lipid profile of hypercholesterolemic Sprague Dawley rats.Method: This was an experimental study with pre-post test. Twenty four (24) male Sprague Dawley rats aged 12-16 week old, weighing 125-200 g were allocated into 4 groups. Group I received standard meal + aquadest-gavage; group II received high cholesterol meal + PTU 0,01 + aquadest gavage; group III received high cholesterol meal + PTU 0,01 + 0,027 g propolis gavage; group IV received high cholesterol meal + PTU 0,01 + 0,054 g propolis gavage. Total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol levels before and after treatment were measured. The data were then analyzed with One Way Anova.Results: The study showed that there were no significant differences in changes of body weight. There were significant differences in total cholesterol levels between all groups of treatment. Triglyceride levels were significantly different among all groups, except between group I and IV. Furthermore, the HDL cholesterol levels of group I vs III and group I vs IV were significantly different. However, there were no differences found in LDL cholesterol levels among all groups of treatment.Conclusion: Provision of 0,027 g and 0,054 g propolis improve lipid profile (total cholesterol, triglyceride and HDL cholesterol levels) of hypercholesterolemic rats.


2019 ◽  
Vol 18 (3) ◽  
pp. 5-10
Author(s):  
A. S. Safaryan ◽  
T. V. Kamyshova ◽  
D. V. Nebieridze ◽  
V. D. Sargsyan

Aim. To assess the efficacy and safety of plant stanols in patients with arterial hypertension (AH) and disorders of lipid metabolism, without clinical manifestations of atherosclerosis.Material and methods. The study included 40 patients — men at the age of 50-55 years, with AH (stage 1) and cholesterol above 5,0 mmol/l and LDL cholesterol above 3,0 mmol/l with low and medium risk (SCORE — 1-4%). Patients with coronary artery disease and other clinical manifestations of atherosclerosis, secondary hypertension, liver diseases, diabetes mellitus, secondary dyslipoproteinemia, cardiovascular diseases requiring constant therapy, bronchial asthma were excluded from the study. Patients were randomized into 2 groups of 20 people. In the study group of patients within 3 months received plant stanols (2 tab./day), in the control group — only healthy diet. In addition, patients with high blood pressure received antihypertensive therapy. Assessment of lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides) was performed at baseline and after 3 months. At the beginning of the study, after 3 months of the study patients underwent a full medical examination. Safety control of plant stanols was carried out by determination of liver enzymes (aspartic transaminase (AST), alanine transaminase (ALT)), before and after the completion of the study.Results. Patients of two groups were comparable in baseline characteristics (lipid parameters, blood pressure level). After 3 months of research beginning patients from study group have statistically significant decrease of total cholesterol and LDL cholesterol. The average level of total cholesterol before treatment was 5,8±0,32 mmol/l, and after treatment — 5,3±0,32 mmol/l, p<0,001. The average level of LDL cholesterol before treatment was 3,6±0,26 mmol/l, and after treatment — 3,3±0,25 mmol/l, p<0,001. According to other lipid parameters (HDL cholesterol, triglycerides) significant differences are not obtained. As a result, there was a significant reduction in the total risk from 4% to 3,1%. As for the control group, the dynamics of lipid parameters were practically not observed. For example, the average level of total cholesterol before treatment was 5,7±0,39 mmol/l, and after treatment — 5,6±0,42 mmol/l. The average level of LDL cholesterol before treatment was 3,6±0,21 mmol/l, and after treatment — 3,6±0,21 mmol/l. The differences between the study and control groups in the reduction of total and LDL cholesterol were highly significant (p<0,001). The study did not reveal the dynamics of liver enzymes. The level of AST before treatment in the study group was 28,4±6,54, and after treatment — 29,5±5,56. ALT levels were 32,3±7,38 and 33,9±5,65, before and after the study, respectively.Conclusion. The study shows the high efficacy and safety of plant stanols. We found a significant decrease of the two most important parameters of lipid metabolism — total cholesterol and LDL cholesterol.


Author(s):  
Nela Maksimovic ◽  
Vanja Vidovic ◽  
Tatjana Damnjanovic ◽  
Biljana Jekic ◽  
Nada Majkic Singh ◽  
...  

IntroductionPositive regulatory domain containing 16 (PRDM16) protein represents the key regulator of brown adipose tissue (BAT) development. It induces brown fat phenotype and represses white adipose tissue specific genes through the association with C-terminal binding co-repressor proteins (CtBP1 and CtBP2). In healthy adults presence of BAT has been associated with lower glucose, total cholesterol and LDL (low-density lipoprotein) cholesterol levels. Our aim was to analyze the association of PRDM16 gene (rs12409277) and CtBP2 gene (rs1561589) polymorphisms with body mass index (BMI), fasting glucose level and lipid profile of adolescents.Material and methodsOur study included 295 healthy school children, 145 boys (49.2%) and 150 girls (50.8%), 15 years of age. Genotypes for the selected polymorphisms were detected by the real-time PCR method. Age, gender, height, weight, lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and fasting glucose levels were recorded.ResultsWe did not find a statistically significant association of rs12409277 and rs1561589 polymorphisms with BMI, fasting glucose and lipid profile of adolescents. We further analyzed the combined effect of the two SNPs and the statistical analysis showed that carriers of CT genotype of rs12409277 polymorphism and GG genotype of rs1561589 polymorphism had significantly lower total cholesterol (p = 0.001) and LDL cholesterol (p = 0.008) levels compared to all other groups of genotypes.ConclusionsOur study suggests that rs12409277 and rs1561589 polymorphism might have an influence on total and LDL cholesterol levels in adolescents. Larger studies should be performed in order to confirm our results.


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