| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Attaining United Kingdom-European Atherosclerosis Society low-density lipoprotein cholesterol guideline target values in the Greek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) Study Athyros, V. G., D. P. Mikhailidis, et al. (2002), Curr Med Res Opin 18(8): 499-502. Abstract: The GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) Study compared two standards (structured vs. usual care) of lipid lowering treatment in 1600 patients with coronary heart disease (CHD). Structured care aimed at achieving (with atorvastatin 10-80 mg) the low-density lipoprotein cholesterol (LDL-C) (2.6 mmol/l; 100 mg/dl) goal described in the NCEP ATP II and III guidelines for patients with CHD. Structured care was associated with a significant reduction in overall mortality and coronary events compared to usual care. In the present brief report we interpret the results of GREACE using the United Kingdom (UK) and European Atherosclerosis Society (EAS) treatment goal for LDL-C in secondary CHD prevention (3.0 mmol/l; 115 mg/dl. The mean dose of atorvastatin decreased from 24 mg to 22 mg/day. More patients achieved the UK and EAS LDL-C target (95.6 vs. 95%) in the structured care arm of the trial; 90% of the patients achieved this target with 10 or 20 mg atorvastatin. These findings may have cost implications, especially if the LDL-C target for high-risk patients will fall below those described above. |
| Attaining United States and European guideline LDL-cholesterol levels with simvastatin in patients with coronary heart disease (the GOALLS study) Garmendia, F., A. S. Brown, et al. (2000), Curr Med Res Opin 16(3): 208-19. Abstract: The effectiveness and safety of simvastatin in reducing low-density lipoprotein cholesterol (LDL-C) to target levels in patients with coronary heart disease (CHD) were evaluated in the GOALLS (Getting to Appropriate LDL-C Levels with Simvastatin) study. This multinational, multicentre, prospective, open-label, study consisted of a six-week diet washout period followed by a 14-week titrate-to-goal treatment period with simvastatin. One hundred and ninety-eight men and women with documented CHD and a fasting LDL-C level between 115 mg/dl (3.0 mmol/l) and 180 mg/dl (4.7 mmol/l) and triglycerides (TGs) < or = 400 mg/dl (4.5 mmol/l) were enrolled. The patients were started on 20 mg simvastatin with dose titration up to 80 mg if the LDL-C remained above 100 mg/dl at weeks 6 and 10. The key efficacy parameters were the percentage of patients achieving US and European LDL-C goals < or = 100 mg/dl (2.6 mmol/l) and < or = 115 mg/dl (3.0 mmol/l), respectively. Safety was evaluated by monitoring laboratory tests and recording adverse events. After 14 weeks of simvastatin (20-80 mg) treatment, approximately 90% of the patients achieved LDL-C goals according to US (87%) and European (94%) guidelines. Most patients (72-93%) achieved target LDL-C levels on 20 mg simvastatin. An estimated 14% of the patients required titration to the 80 mg dose. Treatment with simvastatin (20-80 mg) produced statistically significant improvements in all measured lipid variables by the end of the study. The mean reductions in total cholesterol and LDL-C, and the median reduction in TG, were 28%, 41% and 16%, respectively. The increase in high-density lipoprotein cholesterol and apolipoprotein A-1 were 5% and 4%, respectively. Simvastatin was well tolerated across the dosage range. In conclusion, simvastatin, 20-80 mg/day, was safe and highly effective at reducing LDL-C levels. The recommended US and European LDL-C treatment goals were achieved in approximately 90% of the patients. These goals were similarly achieved for a variety of high-risk sub-groups (hypertensives, diabetics and elderly patients). |
| Attendance patterns and characteristics of participants in public cholesterol screening Greenland, P., N. G. Hildreth, et al. (1992), Am J Prev Med 8(3): 159-64. Abstract: We conducted free, voluntary, public cholesterol screenings in supermarkets in the Rochester, New York, area during a four-month period for demonstration and research purposes. We assessed demographic characteristics and attendance patterns of the 8,583 participants. Compared with 1980 census data for the same census tracts, our participants were likelier to be white, older, female, and better educated than the general population in the area. Most screenees knew about the screenings in advance, and 79% came to the store just for screening. Weekend and weeknight screenings attracted more men and more younger people, in comparison to weekday screenings. However, referral rates based on high cholesterol (HC) test results were similar during all screening times. Overall, 22% of screenees reported a previous diagnosis of HC, but in the highest cholesterol-level group, 45% of screenees reported a history of HC. Previous awareness of HC did not vary according to screening time. These findings indicate that, like other screenings, cholesterol screenings in a public setting do not attract a representative sample of the whole population. The screenings did, however, attract a large number of high-risk individuals, many of whom had no prior awareness of HC. These results should be valuable in planning and targeting future cholesterol screenings. |
| Attenuated hypercholesterolemic response to a high-cholesterol diet in subjects heterozygous for the apolipoprotein A-IV-2 allele McCombs, R. J., D. E. Marcadis, et al. (1994), N Engl J Med 331(11): 706-10. Abstract: BACKGROUND. Previous studies have suggested that the variant apolipoprotein (apo) allele apo A-IV-2 may influence the response of the plasma cholesterol concentration to dietary cholesterol. METHODS. We measured plasma lipids and lipoproteins in 11 subjects who were heterozygous for the apo A-IV-2 allele (apo A-IV-1/2 heterozygotes) and a control group of 12 subjects who were homozygous for the common apo A-IV allele (apo A-IV-1/1 homozygotes) in an outpatient dietary-modification study. (Approximately one in seven persons in the United States is a heterozygote.) The subjects consumed a low-cholesterol diet (about 200 mg 0.5 mmol of cholesterol per day) during a two-week run-in period; daily cholesterol intake was then increased to approximately 1100 mg (2.8 mmol) by the addition of four egg yolks per day. RESULTS. The fat intake and the ratio of polyunsaturated to saturated fat were similar in the two groups throughout the study. After three weeks of egg intake, the mean plasma total cholesterol increased by 22 mg per deciliter (0.57 mmol per liter) in the apo A-IV-1/1 group, but by only 6 mg per deciliter (0.15 mmol per liter) in the apo A-IV-1/2 group (P = 0.05). The mean plasma low-density lipoprotein cholesterol increased by 19 mg per deciliter (0.49 mmol per liter) in the apo A-IV-1/1 group, but by only 1 mg per deciliter (0.03 mmol per liter) in the apo A-IV-1/2 group (P = 0.03). There were no changes in the plasma triglyceride or high-density lipoprotein cholesterol concentrations in either group. CONCLUSIONS. The apo A-IV-2 allele attenuates the hypercholesterolemic response to the short-term ingestion of a very-high-cholesterol diet and may partially account for the heterogeneous response to dietary cholesterol. However, cholesterol intake in this study was more than twice that of the general population; whether the apo A-IV-2 allele alters responsiveness at lower levels of cholesterol intake remains to be determined. |
| Attenuated total reflection (ATR) Fourier transform infrared spectroscopy of dimyristoyl phosphatidylserine-cholesterol mixtures Bach, D. and I. R. Miller (2001), Biochim Biophys Acta 1514(2): 318-26. Abstract: Mixtures of cholesterol with dimyristoyl phosphatidylserine or deuterated dimyristoyl phosphatidylserine were investigated by polarized and non polarized attenuated total reflection (ATR) Fourier transform infrared (FTIR) Spectroscopy. From polarized spectra the dichroic ratios of various vibrations as a function of cholesterol were calculated. Dichroic ratios of methylene vibration (CH(2)) 2934 cm(-1) of cholesterol decreases with increase of cholesterol concentration leveling off in the region where cholesterol phase separation takes place. The orientation of deuterated methylene (CD(2)) symmetric and asymmetric bands of the deuterated dimyristoyl phosphatidylserine is influenced little by cholesterol. In the polar region of dimyristoyl phosphatidylserine no effect of cholesterol on the dichroic ratios of carbonyl (C==O) and asymmetric phosphate (PO(2)(-)) vibrations were detected. For nonpolarized spectra the broad bands in the polar region of the phospholipid were deconvoluted. The carbonyl band (C==O) in pure dimyristoyl phosphatidylserine is composed of five bands; in the presence of increasing concentrations of cholesterol conformational change of these vibrations takes place evolving into one predominant band. Similar conformational change takes place in the presence of 75 molecules water/molecule DMPS. For the asymmetric phosphate band very small shifts due to interaction with cholesterol were detected. |
| Attenuation of atherosclerosis in a modified strain of hypercholesterolemic Watanabe rabbits with use of a probucol analogue (MDL 29,311) that does not lower serum cholesterol Mao, S. J., M. T. Yates, et al. (1991), Arterioscler Thromb 11(5): 1266-75. Abstract: Probucol is a drug that lowers plasma cholesterol in both humans and animals. In low density lipoprotein (LDL) receptor-deficient Watanabe rabbits, probucol reduces the progression of atherosclerosis. This effect may be attributed to the antioxidant and/or the cholesterol-lowering properties of the drug. In the present report we studied the antiatherogenic effect of a probucol analogue (MDL 29,311) that possesses antioxidant activity but that does not lower cholesterol. Modified Watanabe rabbits (11-12 weeks of age) produced by crossing British Brown and Japanese Watanabe rabbits were fed normal chow (n = 8), chow containing 1% probucol (n = 9), or chow containing 0.1% (n = 9), 0.5% (n = 8), or 1% (n = 6) probucol analogue. After 70 days serum cholesterol levels and the percent area of sudanophilic lesions in the thoracic region of aortas were determined. Total serum cholesterol was significantly lowered (p less than 0.05) in the probucol group (560 +/- 54 mg/dl) compared with that of controls receiving no drug (731 +/- 67 mg/dl) but was not lowered in the analogue groups (722-802 mg/dl). The lesioned area (mean% +/- SEM) in the probucol group (16 +/- 3) was significantly lower (p less than 0.01) than in the controls (52 +/- 8). There were 43 +/- 7%, 33 +/- 8%, and 35 +/- 5% of lesions for the 0.1%, 0.5%, and 1% analogue groups, respectively. After combining the data for the 0.5% and 1% analogue groups, the value (34%) was lower than that of the controls and almost reached significance (p = 0.066). The mean serum drug concentration in the 1% probucol group was 58 +/- 4 micrograms/ml compared with 13 +/- 2, 44 +/- 8, and 74 +/- 8 micrograms/ml for the 0.1%, 0.5%, and 1% analogue groups, respectively. Thus, the decreased effectiveness of the probucol analogue in preventing atherosclerosis could not be explained by a lack of bioavailability. LDLs isolated from rabbits treated with the drug were resistant to Cu(2+)-induced lipid peroxidation, as determined by thiobarbituric acid-reactive substances. The resistance within the analogue groups was dependent on the number of antioxidant molecules per LDL particle. However, there was no significant difference in atherosclerotic lesions between these two groups, suggesting, although not definitively, that the maximal antiatherogenic effect had been reached. Our data suggest that the antioxidant activity of this class of compounds may play an important role in reducing atherosclerosis, but not in reducing cholesterol levels, and that hypocholesterolemic and possibly other activities of probucol might further enhance its antiatherogenic activity. |
| Attenuation of channel kinetics and conductance by cholesterol: an interpretation using structural stress as a unifying concept Chang, H. M., R. Reitstetter, et al. (1995), J Membr Biol 143(1): 51-63. Abstract: The ubiquity of cholesterol in cell membranes and changes in its concentration during development, aging and in various diseases suggest that it plays an important role in modulating cell function. We examined this possibility by monitoring the effects of cholesterol on the activity of the calcium-activated potassium (BK) channel reconstituted into lipid bilayers from rat brain homogenates. Increasing the cholesterol concentration to 11% of total lipid weight resulted in a 70% reduction in channel mean open time and a reduction of the open probability of the channel by 80%. Channel conductance was reduced by 7%. Cholesterol is known to change the order state and the modulus of compressibility of bilayers. These physico-chemical changes may be translated into an overall increase in the structural stress in the bilayer, and this force may be transmitted to proteins residing therein. By examining the characteristics of the BK channel as a function of temperature, in the presence and absence of cholesterol, we were able to estimate the activation energy based on Arrhenius plots of channel kinetics. Cholesterol reduced the activation energy of the BK channel by 50% for the open to closed transition. This result is consistent with an increased stress energy in the bilayer and favors the channel moving into the closed state. Taken together, these data are consistent with a model in which cholesterol induces structural stress which enhances the transition from the open to the closed state of the channel. We suggest that this is an important mechanism for regulating the activity of membrane-integral proteins and therefore membrane function, and that the concept of structural stress may be relevant to understanding the modulation of ion channel activity in cell membranes. |
| Attenuation of lipid peroxidation and hyperlipidemia by quercetin glucoside in the aorta of high cholesterol-fed rabbit Kamada, C., E. L. da Silva, et al. (2005), Free Radic Res 39(2): 185-94. Abstract: Antioxidative activity of dietary flavonoids is suggested to be, at least partly, responsible for a wide variety of their biological effects relating to anti-atherosclerosis. However, it is not known whether dietary flavonoids reach to the target site and act as antioxidants. In this study, we tried to evaluate the antioxidative effect of quercetin 3-O-beta-D-glucoside (Q3G), a typical flavonoid present in vegetables, in rabbit aorta. New Zealand White rabbits were fed a control diet (control group), 2.0% cholesterol diet (HC group) and 2.0% cholesterol plus 0.1% Q3G (HC + Q3G group) for one month. The amounts of total cholesterol, triacylglycerol and total fatty acids in both the plasma and aorta were significantly lower in the HC + Q3G group as compared with the HC group. Quercetin was detected in the aorta of the HC + Q3G group after enzymatic deconjugation, indicating that quercetin accumulated as conjugated metabolites in the aorta. The contents of TBA-reacting substances (TBARS) and cholesteryl ester hydroperoxides (CEOOH) in the aorta of the HC + Q3G group were significantly lower than those in the HC group. The aorta of HC + Q3G group was more resistant than that of HC group in copper ion-induced lipid peroxidation ex vivo. HC + Q3G group accumulated a higher amount of vitamin E per total cholesterol than HC group in the aorta. These results strongly suggest that quercetin glucosides accumulate in the aorta as their metabolites and attenuate lipid peroxidation occurring in the aorta, along with the attenuation of hyperlipidemia. |
| Attenuation of plasma low density lipoprotein cholesterol by select 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors in mice devoid of low density lipoprotein receptors Bisgaier, C. L., A. D. Essenburg, et al. (1997), J Lipid Res 38(12): 2502-15. Abstract: Low density lipoprotein (LDL) reduction independent of LDL receptor regulation was investigated using HMG-CoA reductase inhibitors in LDL receptor-deficient mice. In males, LDL cholesterol dose-dependently decreased with atorvastatin treatment after 1 week. As untreated mice grew older, their LDL cholesterol progressively rose above basal levels, but was quelled with atorvastatin treatment. In females, atorvastatin treatment time-dependently decreased LDL cholesterol levels and induced hepatic HMG-CoA reductase activity. Unlike males, cholesterol-lowering effects of the drug were sustained in females. Lovastatin, simvastatin, and pravastatin also reduced total and LDL cholesterol; however, additional studies in females demonstrated that atorvastatin caused the greatest dose-dependent and sustained effect after 2 weeks. In females, hepatic HMG-CoA reductase mRNA inversely correlated with LDL cholesterol lowering, with atorvastatin showing the greatest increase in mRNA levels (17.2-fold), followed by lovastatin (10.7-fold), simvastatin (4.1-fold), and pravastatin (2.5-fold). Atorvastatin effects on lipoprotein production were determined after acute (1 day) or chronic (2 week) treatment prior to intraperitoneal injection of Triton WR1339. Acute treatment reduced cholesterol (-29%) and apoB (-16%) secretion, with no change in triglyceride secretion. In contrast, chronic treatment elevated cholesterol (+20%), apoB (+31%), and triglyceride (+57%) secretion. Despite increased cholesterol and apoB secretion, plasma levels were reduced by 51% and 46%, respectively. Overall, under acute or chronic conditions, apoB paralleled cholesterol secretion rates, and triglyceride to cholesterol secretion ratios were elevated by 38% and 32%, respectively. We propose that atorvastatin limits cholesterol for lipoprotein assembly, which is compensated for by triglyceride enrichment. In addition, with either acute or chronic atorvastatin treatment, apoB-100 secretion was blocked, and compensated for by an increased secretion of apoB-48. The apoB-48 particles produced are cleared by LDL receptor-independent mechanisms, with an overall effect of reducing LDL production in these mice. These studies support the idea that HMG-CoA reductase inhibitors modulate lipoprotein levels independent of LDL receptors, and suggest they may have utility in hyperlipidemias caused by LDLreceptor disorders. |
| Attenuation of the acute-phase response in thermally injured rats by cholesterol-containing cationic liposomes used as a delivery system for gene therapy Jeschke, M. G., R. E. Barrow, et al. (1999), Arch Surg 134(10): 1098-102. Abstract: HYPOTHESIS: Cholesterol-containing cationic liposomes alone modulate the acute-phase response and cytokine expression in thermally injured rats and are an effective delivery system for gene therapy in trauma. SETTING: Laboratory. INTERVENTION: Fifty-six adult male Sprague-Dawley rats with a full-thickness scald burn covering 60% of total body surface area were randomly divided into 2 groups to receive either intravenous injections of cholesterol-containing cationic liposomes or saline (control). MAIN OUTCOME MEASURES: Body weights, muscle and liver dry-wet weights, serum levels of constitutive hepatic proteins, acute-phase protein levels, and cytokine levels were determined at 1, 2, 5, and 7 days after thermal injury. RESULTS: Rats receiving cholesterol-containing cationic liposomes had less body weight loss, increased serum transferrin levels, and decreased serum alpha1-acid glycoprotein levels when compared with controls (P<.05). Serum interleukin 1beta and tumor necrosis factor alpha levels were decreased in rats receiving liposomes at 1 and 2 days after burn compared with controls (P<.05). CONCLUSIONS: These results suggest that cholesterol-containing cationic liposomes alone may have a beneficial effect in modulating the hypermetabolic response after burn injury by decreasing type 1 acute-phase proteins and the expression of the proinflammatory cytokines interleukin 1beta and tumor necrosis factor alpha. Therefore, cholesterol-containing cationic liposomes appear to be suitable as a delivery system for gene therapy in trauma. |
| Attitude changes of general practitioners towards lowering LDL cholesterol Strandberg, T. E., A. Pitkanen, et al. (1998), J Cardiovasc Risk 5(1): 43-6. Abstract: BACKGROUND: Clinical studies have demonstrated the benefit of lowering cholesterol in decreasing coronary complications. These results need to be implemented in clinical practice, where an important barrier are the attitudes of physicians. DESIGN: General practitioners in the city of Helsinki were asked to respond to two questionnaires sent to them by post 12 months apart (1996 and 1997); 284 responses were received in 1996 and 258 in 1997. METHODS: In addition to brief questions aimed to characterize the responding physician, the questionnaire included four examples of patients: (1) middle-aged man without, or (2) with coronary heart disease (CHD); (3) 70-year-old man with a history of stroke; (4) 70-year-old women with CHD. The physicians were asked at what level of serum low-density-lipoprotein (LDL) cholesterol they usually initiate drug therapy. Comparisons were made longitudinally between 1996 and 1997, as well as between different patients. Analyses are based on the responses of those physicians who reported that they treat atherosclerotic patients (241 and 237 in 1996 and 1997, respectively). RESULTS: In case 1 (primary prevention), 40.1% of general practitioners in 1996 compared with 52.4% in 1997 (difference +12.3, 95% CI +3.2(-)+20.9, P < 0.01) reported that they would initiate drug therapy at the LDL cholesterol level < 5.0 mmol/l. In case 2 (secondary prevention), 42.0% in 1996 and 54.8 in 1997 (difference +12.8, 95% CI +4.0(-)+21.8, P < 0.01) would initiate drug therapy at the LDL cholesterol level < 4.0 mmol/l. In case 3 (70 year man with stroke), 13.8% in 1996 compared with 30.4% in 1997 (difference +16.6, 95% CI +9.4(-)+24.0, P < 0.01) would initiate drug therapy at the LDL cholesterol level < 4.0 mmol/l. In case 4 (70 year old woman with CHD) 12.8% in 1996 compared with 34.2% in 1997 (difference +21.4%, 95% CI + 13.9(-)+28.7, P < 0.01) would initiate drug therapy at the LDL cholesterol level < 4.0 mmol/l. The physicians' attitudes were significantly more active towards LDL cholesterol lowering both in 1996 and 1997 in case 2 compared with case 1, case 3 or case 4. No difference was observed between case 3 and case 4. CONCLUSIONS: Between 1996 and 1997 the attitudes of general practitioners towards lowering LDL cholesterol have become significantly more active in all four patient categories. However, the attitudes are still not optimal concerning coronary patients and especially older atherosclerotic patients. |
| Attitude of blood donors towards cholesterol measurement Flesland, O., G. Botten, et al. (1992), Tidsskr Nor Laegeforen 112(13): 1710-2. Abstract: In analyses of cost-effectiveness it is customary to count knowledge of having a high serum cholesterol level as a negative factor. There is little support for this practice in the literature. We have studied the attitude of 305 Norwegian blood donors towards cholesterol testing. 63% stated that they were interested in their serum cholesterol level, and 40% said they knew their own serum cholesterol level. The attitude towards cholesterol testing was clearly positive, both among men and among women, regardless of age. Only one donor stated that she did not want to have her serum cholesterol tested in conjunction with blood donation. |
| Attitudes to cholesterol measurement and intervention among general practitioners in Bornholm Madsen, O. R. and F. Lynggaard (1991), Ugeskr Laeger 153(29): 2058-61. Abstract: In 1985 an explanatory report was published about investigation and treatment of hyperlipidaemia. This report, together with a consensus report published subsequently, formed the background for a nationwide cholesterol campaign. The attitudes of general practitioners to measurement of cholesterol and intervention must be considered to have decisive influence on performance of the goal of the consensus report, viz, reduction of the incidence of ischaemic heart disease (IHD). By means of a nine-page questionnaire, an attempt was made to assess the attitudes to measurement of cholesterol and intervention among the general practitioners on Bornholm. Out of the 35 questionnaires sent, 27 were returned (77%). Just under 40% of the general practitioners would screen all men aged between 20 and 59 years. Approximately 25% would screen women in the same age group. Opinions were unanimous about screening patients with diabetes, hypertension or IHD. Attitudes towards intervention were, by and large, in agreement with the cholesterol limits recommended in the explanatory report. In general, the general practitioners had well balanced attitudes towards tracing and treatment of individuals with raised serum cholesterol with relevant consideration of cholesterol as an important risk factor in the development of IHD. |
| Atypical Fabry's disease presenting with cholesterol crystal embolization Shirai, T., T. Ohtake, et al. (2000), Intern Med 39(8): 646-9. Abstract: We describe a 65-year-old man who presented with pulmonary hemorrhage and progressive renal insufficiency three months after resection surgery for an abdominal aortic aneurysm. Intensive treatment with corticosteroids and hemodialysis were not effective, and the patient died. Postmortem examination of the kidneys revealed widespread cholesterol clefts within the renal arterioles and a number of lamellar inclusion bodies were observed by electron microscopy. The diagnosis of Fabry's disease was made by the absence of plasma alpha-galactosidase A activity. This was a very rare case of subclinical Fabry's disease coexistent with cholesterol crystal embolization, mimicking pulmonary-renal syndrome. |
| Atypical magnetic resonance findings in an orbitofrontal cholesterol granuloma Dickey, J. B., C. D. Mullenix, et al. (1992), Ophthal Plast Reconstr Surg 8(3): 215-20. Abstract: Cholesterol granuloma of the orbit is an uncommon entity, although it frequently occurs in the middle ear and petrous apex. It is isodense with brain on computed tomographic scanning and cannot always be differentiated from more serious conditions. Magnetic resonance imaging (MRI) has facilitated the preoperative diagnosis of cholesterol granuloma outside of the orbit because of high signal characteristics on T1- and T2-weighted images. These findings have been considered nearly pathognomonic, but they have previously been described in only one patient with orbitofrontal involvement. We present a case of orbitofrontal cholesterol granuloma with uncharacteristic signal intensities on magnetic resonance imaging. |
| Atypical xanthomatosis in apolipoprotein E-deficient mice after cholesterol feeding van Ree, J. H., M. J. Gijbels, et al. (1995), Atherosclerosis 112(2): 237-43. Abstract: Apolipoprotein (apo) E-deficient mice were fed a hypercholesterolemic diet for 14 weeks. Mean serum cholesterol levels rose to 37.5 mM. Upon complete necroscopy, massive xanthomatous lesions were noticed in various tissues, with a predilection for subcutaneous and peritendinous tissues, while control animals on the same diet (3.4 mM serum cholesterol) and apo E-deficient mice on a regular chow diet (20 mM serum cholesterol) did not show such lesions. Also, apo E3-Leiden transgenic mice fed a high fat diet, with 60 mM of serum cholesterol, did not exhibit any xanthomatosis. The xanthomatous lesions found in the Apoe knock-out mouse clearly differed in location from xanthomas previously found in low density lipoprotein receptor-deficient mice. We conclude that the lack of apo E results in atypical disseminated xanthomatosis, suggesting that apo E has an important role in determining the tissue distribution of cholesterol deposition. |
| Audit of near patient cholesterol testing in occupational health clinics Majeed, F. A., H. J. Turner, et al. (1993), Occup Med (Lond) 43(1): 23-6. Abstract: An audit of near patient cholesterol testing was carried out in occupational health clinics. The aims were to examine the statistical agreement between Reflotron and laboratory measurements of blood cholesterol and to formulate a policy for the use of Reflotrons in cholesterol testing. Three hundred and fifty-two staff members attending occupational health clinics over a period of 10 months had blood taken for both Reflotron and laboratory measurements. The correlation between the two methods was 0.95. The Reflotron had a negative bias compared to the laboratory, with the mean difference between the two methods of measurement being -0.21 mmol/l (95 per cent confidence interval -0.18 to -0.25 mmol/l). Despite the high correlation coefficient and small mean difference, the scatter of Reflotron-laboratory differences was broad, with 95 per cent of the differences lying in the range of 0.95 mmol/l below to 0.52 mmol/l above the laboratory result. For Reflotron results of 5.50 mmol/l and greater, the sensitivity and specificity of the Reflotron in detecting subjects with laboratory cholesterol levels greater than 6.5 mmol/l were 100 per cent and 70 per cent respectively. The laboratory participated in two external quality assessment schemes for cholesterol testing during the course of the audit and all the results of these fell within the acceptable limits. The audit demonstrated that the Reflotron was too imprecise to be used to give accurate measurements of blood cholesterol. However, providing a suitable Reflotron result above which patients were sent for confirmatory laboratory testing was selected, it was an acceptable screening device in the detection of hypercholesterolaemia. Other Reflotron users should consider carrying out similar audits. |
| Augmented effects of methionine and cholesterol in decreasing the elastic lamina while thickening the aortic wall in the rat aorta Zulli, A., B. F. Buxton, et al. (1998), Clin Sci (Lond) 95(5): 589-93. Abstract: 1.Patients with an elevated plasma level of either homocysteine or cholesterol are at increased risk of cardiovascular disease. Both methionine, the precursor of homocysteine, and cholesterol are found primarily in the same foods; therefore we investigated the effect of methionine feeding alone, cholesterol feeding alone, and both, on the thickness of the aortic wall and the aortic elastic lamina of normotensive animals.2.Twenty normotensive rats were divided into four groups of five animals. The following diet was administered for 15 weeks: normal chow; normal chow supplemented with 2% methionine; normal chow supplemented with 2% cholesterol; normal chow supplemented with 2% methionine+2% cholesterol.3.The results showed a 3-fold decrease (P<0.003) in the aortic elastic lamina in the 2% methionine group and a 2.5-fold decrease in the 2% cholesterol group compared with the normal chow group. There was a 9-fold (P<0.0003) decrease in the 2% methionine+2% cholesterol group compared with the normal chow group. Furthermore, feeding with methionine plus cholesterol significantly increased aortic wall thickness compared with the methionine group, cholesterol group or control.4.These results demonstrate an augmented effect of cholesterol plus methionine in the deterioration of the aortic elastic lamina, and furthermore, the combination of these two agents increases the thickness of the aortic wall. The results indicate a more important role for these two agents in combination than for either agent alone. |
| Aural cholesterol granuloma in a dog Cox, C. L. and C. E. Payne-Johnson (1995), J Small Anim Pract 36(1): 25-8. Abstract: A five-year-old female Irish setter was referred for surgery for a left-sided aural mass. The dog was generally well, but had signs of left-sided otalgia for one week. Biopsy identified the lesion as a cholesterol granuloma. The mass was removed three weeks later by a total canal ablation/lateral bulla osteotomy. The dog recovered from surgery without any complications. Ten months later, there was no evidence of recurrence. The purpose of this paper is to report the clinical and histopathological findings of this unusual form of granuloma which has not previously been reported in the canine ear. |
| Autoaggressive behaviour and cholesterol Fritze, J., B. Schneider, et al. (1992), Neuropsychobiology 26(4): 180-1. Abstract: A retrospective analysis of a sample of 1,088 patients suffering from affective psychoses did not reveal associations between serum cholesterol and suicidal behaviour. However, suicide was associated with lower body weight. |