Cholesterol Journal Articles

Record 1221 to 1240

Balance of unsaturated fatty acids is important to a cholesterol-lowering diet: comparison of mid-oleic sunflower oil and olive oil on cardiovascular disease risk factors
Binkoski, A. E., P. M. Kris-Etherton, et al. (2005), J Am Diet Assoc 105(7): 1080-6.
Abstract: OBJECTIVE: To evaluate the effects of a trans fat-free monounsaturated fatty acid-rich vegetable oil (NuSun sunflower oil, National Sunflower Association, Bismark, ND) that is a good source of polyunsaturated fatty acids (PUFA) and low in saturated fatty acids on lipid and lipoprotein levels and oxidative stress. DESIGN: A double-blinded, randomized, three period crossover, controlled feeding study. SUBJECTS/SETTING: Thirty-one men (n=12) and women (n=19) with moderate hypercholesterolemia who were 25 to 64 years of age. INTERVENTION: Experimental diets provided 30% fat (olive oil or NuSun sunflower oil contributed one half of the total fat), 8.3% vs 7.9% saturated fatty acid, 17.2% vs 14.2% monounsaturated fatty acid, and 4.3% vs. 7.7% PUFA (olive oil and NuSun sunflower oil, respectively), and 294 mg cholesterol. The control diet was an average American diet (34% fat, 11.2% saturated fatty acid, 14.9% monounsaturated fatty acid, 7.8% PUFA). Subjects consumed each diet for 4 weeks with a 2-week compliance break before crossing over to another diet. MAIN OUTCOME MEASURES: Lipid and lipoprotein levels were measured, and measures of oxidative stress, including lag time, rate of oxidation, total dienes, and lipid hydroperoxides, were assessed. STATISTICAL ANALYSIS: The mixed model procedure was used to test for main effects of diet, feeding period, and order of diets. Tukey-Kramer adjusted P values were used to determine diet effects. RESULTS: The NuSun sunflower oil diet decreased both total and low-density lipoprotein cholesterol levels compared with the average American diet and the olive oil diet. There was no effect of the olive oil diet compared with the average American diet. Total cholesterol decreased 4.7% and low-density lipoprotein cholesterol decreased 5.8% on the NuSun sunflower oil diet vs the average American diet. There was no effect of the experimental diets on triglyceride levels, rate of oxidation, total dienes, lipid hydroperoxides, or alpha-tocopherol. Lag time was the longest following the olive oil diet and shortest following the NuSun sunflower oil diet. CONCLUSIONS: The higher PUFA content appeared to account for the greater total and low-density lipoprotein cholesterol lowering and reduction in lag time of the NuSun sunflower oil diet. However, the fact that there were no differences in the resulting oxidation products suggests there were no adverse effects on low-density lipoprotein oxidation. Since PUFAs are important for cholesterol lowering, foods that replace saturated fatty acids should include a balance of unsaturated fatty acids.

Balancing unsaturated fatty acids: what's the evidence for cholesterol lowering?
Karmally, W. (2005), J Am Diet Assoc 105(7): 1068-70.

Barley and wheat foods: influence on plasma cholesterol concentrations in hypercholesterolemic men
McIntosh, G. H., J. Whyte, et al. (1991), Am J Clin Nutr 53(5): 1205-9.
Abstract: Twenty-one mildly hypercholesterolemic men aged 30-59 y were provided with comparable barley and wheat foods for each of 4 wk in a crossover-designed experiment. The purpose of the study was to examine the influence of two sources of dietary fiber (nonstarch polysaccharides, NSP) on blood lipids and glucose concentrations. Barley contains beta-glucan as a source of soluble dietary fiber (DF) whereas wheat contains the largely insoluble cellulose and hemicellulose fiber. Total dietary fiber increased from a previous intake of 21-38 g/d during the period of study for the two groups. Consumption of barley relative to wheat foods was associated with a significant fall in both plasma total cholesterol (6%, P less than 0.05) and in low-density-lipoprotein cholesterol (7%, P less than 0.02) whereas triglyceride and glucose concentrations did not change significantly. It is concluded that barley dietary fiber is more effective than wheat dietary fiber at lowering blood cholesterol in hypercholesterolemic men.

Barley beta-glucan lowers serum cholesterol based on the up-regulation of cholesterol 7alpha-hydroxylase activity and mRNA abundance in cholesterol-fed rats
Yang, J. L., Y. H. Kim, et al. (2003), J Nutr Sci Vitaminol (Tokyo) 49(6): 381-7.
Abstract: Barley, which is high in soluble dietary fiber (particularly beta-glucan), is thought to have hypocholesterolemic effects. The present study was performed to further elucidate the hypocholesterolemic actions of waxy barley, and the extent to which they can be attributed to beta-glucan. Male Sprague-Dawley rats (n=21) were fed control (fiber-free) diets, diets with the addition of 2.5%, refined beta-glucan or 30% waxy barley that provides approximately 2.5% beta-glucan in the diet for 2 wk. Body weight gain and food efficiency of rats were unaffected by diet. beta-glucan or waxy barley decreased serum levels of total cholesterol (p < 0.05) by 13.5% or 18.9%, and also decreased LDL-cholesterol 19.4% or 24.3%, respectively. Addition of refined beta-glucan or waxy barley to the diet resulted in greater bile acid excretions (p < 0.05) compared to the control group. The waxy barley diet up-regulated by 2. 3 times and the beta-glucan diet by 1.5 times the activity of cholesterol 7a-hydroxylase (CYP7A1). Hepatic CYP7A1 mRNA level paralleled the increases in enzyme activity. The results of this study suggest that the hypocholesterolemic effects of both beta-glucan and a waxy barley diet may be due to the enhancement of CYP7A1 expression resulting from increased fecal excretion of bile acids.

Barley beta-glucans alter intestinal viscosity and reduce plasma cholesterol concentrations in chicks
Wang, L., R. K. Newman, et al. (1992), J Nutr 122(11): 2292-7.
Abstract: Ninety-six 14-d-old male broiler chicks were divided into three dietary groups and fed a corn-soybean meal diet, a barley diet with beta-glucanase and that diet without beta-glucanase. All diets contained 4 g cholesterol/kg. Average daily body weight gain, plasma total cholesterol concentration, LDL cholesterol concentration and digestibility of lipids and protein were lowest (P < 0.05) in the chicks fed the barley diet without beta-glucanase and highest (P < 0.05) in the chicks fed corn-soybean meal diet. Supplementation of the barley diet with beta-glucanase resulted in greater (P < 0.05) average daily weight gain, plasma total and LDL cholesterol concentrations and digestibility of lipids. Viscosity of small intestinal digesta was greatest in chicks fed barley, lowest in those fed the corn-soybean diet and intermediate in chicks fed enzyme-treated barley. Significant (P < 0.01) negative correlations occurred between viscosity of the small intestinal contents and average daily weight gain, plasma total and LDL cholesterol concentrations, and digestibility of lipids and protein. A lower concentration of insoluble beta-glucans in small intestinal digesta of the chicks fed barley supplemented with beta-glucanase compared with the chicks fed the unsupplemented barley diet reflects hydrolytic activity of the supplemental beta-glucanase in the diet.

Barley foods and their influence on cholesterol metabolism
McIntosh, G. H., R. K. Newman, et al. (1995), World Rev Nutr Diet 77: 89-108.

Barriers to cholesterol testing in a rural community
Franks, P., M. R. Gold, et al. (1991), J Fam Pract 32(6): 614-8.
Abstract: BACKGROUND. The purpose of this study was to investigate the factors that determine whether residents in a rural community have their cholesterol tested. METHODS. A population-based survey was conducted in 1987 as part of a community-oriented primary care project that sought to define and address the causes of and burden caused by increased cardiovascular disease in an economically depressed agricultural region of New York. All of the residents living in two towns in the region who were over 16 years of age and who lived in their homes year-round were surveyed. Demographic information was obtained from the participants, as well as information about previous cholesterol testing and their cardiovascular-risk knowledge and behaviors. The serum cholesterol of each participant was measured. RESULTS. Of the 557 households contacted, 508 (91%) households participated. A total of 1063 persons over 16 years of age were surveyed, and 973 (92%) were screened for cholesterol. Overall, 24% reported prior cholesterol testing. Logistic regression analysis identified several independent factors that were associated with a reduced likelihood of ever having had a cholesterol test. These factors included: (1) age under 45 years, (2) having less than 12 years of education, (3) having an income of less than $10,000, (4) not having health insurance, (5) not having visited a physician within the previous year, and (6) practicing three or more high-risk cardiovascular behaviors. The participants' cardiovascular knowledge made no independent contribution to having had their cholesterol levels tested. CONCLUSIONS. Many of the factors that prevent cholesterol testing are socially determined. The results of this study suggest that financial and social barriers are two of the major obstacles to residents of rural communities having their cholesterol levels tested.

Basal and postprandial serum-promoted cholesterol efflux in normolipidemic subjects: Importance of fat mass distribution
Autran, D., B. Guerci, et al. (2001), Metabolism 50(11): 1330-5.
Abstract: Excess of adipose tissue may affect the reverse cholesterol transport mediated by high-density lipoprotein (HDL). Impairments in this system may be one possible factor favoring atherosclerosis development in obesity. To investigate if gender and regional fat mass distribution independently influence reverse cholesterol transport (RCT), we studied in vitro the capacity of serum to promote the cell cholesterol efflux. Measurements were performed both in the fasting state and in the postprandial state, a setting known to stimulate cholesterol transport and altered in obesity. Thirteen obese women with an android phenotype, waist-to-hip ratio (WHR): 0.98 to 0.85 and 51 normal-weight subjects: 25 women and 26 men, with a similar WHR range: 0.96 to 0.67, were recruited. All the participants were normolipoproteinemic in the fasting state and were given an oral fat load. Blood samples were taken before giving the oral fat load and after every 2 hours. The measurements of the ability of serum to promote cholesterol efflux from cells were performed using 3H-cholesterol labeled Fu5AH hepatoma cells in the fasting state 6 and 8 hours after the lipid rich meal. Incremental serum triglyceride (TG), area under the curve (iAUC) and AUC of retinyl palmitate (RP) for the obese women and nonobese subjects were similar. Basal cholesterol efflux was reduced in obese women compared with normal-weight women (26.75% +/- 3.1% v 30.81% +/- 4.2%, P =.004). However, the magnitude of cholesterol efflux promoted by whole serum increased similarly in all the groups. In the subjects with similar WHR, no gender difference was observed in the postprandial TG response and in the first step of RCT. Multivariate regression analyses indicated that plasma HDL-cholesterol (HDL-C) concentration is the best predictor of cholesterol efflux in the fasting state with an independent mild additive effect of WHR. Conversely, postprandial efflux appeared to be mostly related to the WHR with a mild additive effect of HDL-C. Our results indicate that alterations in the first step of RCT can occur in normolipidemic obese subjects and are tightly associated with the abdominal distribution of fat mass. Android obesity in women brings them to the level of men with respect to RCT.

Basal growth hormone levels are positively correlated with high-density lipoprotein cholesterol levels in women
Bansch, D., A. Dirkes-Kersting, et al. (1997), Metabolism 46(9): 1039-43.
Abstract: Previous studies in patients with either a deficiency or an excess of growth hormone (GH) yielded contradictory results on the regulation of lipoprotein metabolism by GH. In a cross-sectional study of 563 male and 126 female participants of the Prospective Cardiovascular Munster (PROCAM) Study, we determined biometric and demographic data, serum levels of total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo)A-I, A-II, and B, and unstimulated GH levels. The median of basal GH levels was higher in women than in men. Moreover, 44.2% of men but only 8.7% of women had basal GH levels less than the detection limit of 0.05 microgram/L. The relationship between basal GH and lipoprotein metabolism was investigated by univariate and multivariate regression analysis of data from 315 men and 126 women with detectable basal GH levels. In men, GH correlated positively with HDL cholesterol and negatively with body mass index (BMI), age, and triglycerides. After multivariate analysis, the correlation with triglycerides remained independent of age and BMI. Among women, GH correlated positively with the use of hormonal contraception, HDL cholesterol, apoA-I, and apoA-II, and negatively with BMI, age, menopause, triglycerides, and apoB. With multivariate analysis, the positive correlations of GH with HDL cholesterol and apoA-I in women were independent of age. BMI, menopause, and oral contraception. We conclude that GH contributes to the regulation of HDL cholesterol levels. Moreover, in women the well-known effects of exogenous estrogen or estrogen loss on HDL metabolism may be partially mediated via GH.

Basal growth hormone levels in women are positively correlated with high-density lipoprotein cholesterol and apolipoprotein A-I independently of insulin-like growth factor 1 or insulin
Bansch, D., C. Chen-Haudenschild, et al. (1998), Metabolism 47(3): 339-44.
Abstract: Previous studies in growth hormone (GH)-deficient or acromegalic patients yielded contradictory results on the effect of GH on lipoprotein metabolism. In a cross-sectional study, we analyzed the relationships between unstimulated GH, insulin-like growth factor 1 (IGF1), insulin, and lipoprotein metabolism in 44 non-obese young women. On univariate analysis, basal serum levels of GH correlated positively with triglycerides, high-density lipoprotein (HDL) cholesterol, apolipoprotein A-I (apoA-I) and apoA-II and negatively with lipoprotein lipase (LPL) activity. These associations remained significant on multivariate analyses that, in addition to GH, took into account the effects of insulin or C-peptide, as well as the effects of total, protein-bound, or free IGF1. In most cases, the relationships of these lipid parameters with insulin/C-peptide and IGF1 and its free or protein-bound subfractions were opposite of those with GH and not significant. Thus, GH appears to regulate the metabolism of HDL and triglycerides independently of IGF1 and insulin.

Baseline characteristics in the Cholesterol and Recurrent Events (CARE) trial of secondary prevention in patients with average serum cholesterol levels
Sacks, F. M., J. L. Rouleau, et al. (1995), Am J Cardiol 75(8): 621-3.

Baseline cholesterol level and magnitude of coronary event reduction in diabetic patients with myocardial infarction
Johnston, D. C. (1999), Circulation 100(25): e154.

Baseline fat-related dietary behaviors of white, Hispanic, and black participants in a cholesterol screening and education project in New England
Gans, K. M., G. J. Burkholder, et al. (2003), J Am Diet Assoc 103(6): 699-706; discussion 706.
Abstract: OBJECTIVE: To examine baseline fat-related dietary behaviors of white, Hispanic, and black participants in Minimal Contact Education for Cholesterol Change, a National Institutes for Health-funded cholesterol screening and education project conducted in New England. SUBJECTS: A sample of 9,803 participants who joined the study at baseline (n=7,817 white; n=1,425 Hispanic; and n=561 black). METHODS: Participants completed baseline questionnaires that included demographic and psychosocial items as well as the Food Habits Questionnaire, a dietary assessment tool measuring fat-related dietary behaviors. They also had their blood cholesterol level and height and weight measured. STATISTICAL ANALYSES: Analysis of variance (ANOVA) was used to compare racial/ethnic groups on continuous demographic variables, and the chi(2) test of association was used to compare groups on demographic categorical variables. Multivariate analysis of variance (MANOVA) was used to compare mean differences between racial/ethnic groups on six behavioral subscales (Fat Factors) differentiating domains of behavior related to fat intake and to compare 27 individual fat-related dietary behaviors. RESULTS: After adjusting for sex, age, marital status, education, employment status, and percent time lived in the United States, white participants had the lowest Food Habits Questionnaire summary score (2.44) (indicating a lower fat diet), followed by Hispanic (2.61) and black (2.68) participants. The three ethnic groups also differed on the prevalence of Fat Factors and specific fat-related dietary behaviors. White participants were more likely to use lower-fat alternatives, to avoid frying, to replace meat, and to modify meat to make it lower in fat. However, they were least likely to eat fruits and vegetables for snacks and desserts. Hispanic participants were more likely to engage in fat-avoidance behaviors and to eat fruits and vegetables for snacks and desserts. Black participants were less likely to eat meatless meals and modify meats to make them lower in fat. Black and Hispanic participants were more likely than white participants to fry foods. Hispanics were less likely to read food labels for nutrition information. The most and least prevalent fat-related behaviors also differed by each ethnic group, showing that different behaviors were more and less easily implemented by each ethnic group. CONCLUSIONS/APPLICATIONS: The results of this study suggest that there is a need for improvement in dietary behaviors related to fat intake, especially for blacks and Hispanics, and that the specific dietary behavior issues differ widely by ethnicity. These results can be used by nutrition educators and researchers to help them decide what messages to emphasize in dietary counseling, nutrition education programs, and materials. The results can also be used to help design better dietary assessment tools and more effective interventions for culturally diverse populations.

Baseline intestinal absorption and synthesis of cholesterol regulate its response to hypolipidaemic treatments in coronary patients
Gylling, H. and T. A. Miettinen (2002), Atherosclerosis 160(2): 477-81.
Abstract: Baseline cholesterol metabolism was hypothesized to regulate responses of cholesterol synthesis and absorption, and serum cholesterol lowering to hypolipidaemic treatment. Thus, serum cholesterol and non-cholesterol sterols were measured before and during long-term simvastatin treatment (inhibition of cholesterol synthesis) and subsequent combination of statin with plant stanol ester margarine (inhibition of cholesterol absorption) consumption in subjects with low (n=15) and high (n=15) absorption of cholesterol, defined by respective low and high baseline ratios of serum cholestanol to cholesterol. Cholesterol synthesis (defined by precursors of cholesterol) was markedly reduced by the long-term statin treatment in both groups, but more extensively in the low than high absorption group (P<0.05), yet the respective serum cholesterol reductions were similar. From among the absorption markers, sitosterol and cholestanol ratios were correspondingly increased more in the low than in the high absorption group. Plant stanol ester margarine consumption, combined with chronic statin treatment, further lowered the serum cholesterol level (P<0.001) only in the high absorption group. The sum of cholesterol absorption markers was reduced more (P<0.05) in the high than in the low absorption group, while the non-significant serum cholesterol reduction of the low absorption group was associated with relatively high increase of cholesterol synthesis. Thus, stanol ester margarine combined with chronic simvastatin treatment reduces cholesterol absorption and serum cholesterol more consistently in subjects with high than low baseline absorption of cholesterol. The profile of baseline cholesterol metabolism determines the changes in synthesis and absorption of cholesterol to hypolipidaemic treatments, but affects less differently serum cholesterol level.

Baseline levels of low-density lipoprotein cholesterol and lipoprotein (a) and the AvaII polymorphism of the low-density lipoprotein receptor gene influence the response of low-density lipoprotein cholesterol to pravastatin treatment
Lahoz, C., R. Pena, et al. (2005), Metabolism 54(6): 741-7.
Abstract: To investigate some individual and genetic factors that may influence the response of low-density lipoprotein cholesterol (LDL-C) to pravastatin treatment, we recruited 440 subjects with hypercholesterolemia (mean age, 57 years; 43% men) from 21 primary health care centers-outpatient clinics into a prospective, multicentered intervention trial. Pravastatin (20 mg/d) was prescribed for 16 weeks. The main outcome was the percentage variation in LDL-C concentration relative to baseline. Blood analyses and genotyping were performed centrally. The results indicated that LDL-C decreased by 20.5% (range, +21% to -66%) after pravastatin treatment. Baseline concentration of LDL-C (the higher the concentration, the greater the decrease), lipoprotein (a) levels (the lower the concentration, the greater the response), and Ava II polymorphism of the LDL-receptor gene significantly influenced the hypolipemic effect (P <.001, P =.014, and P =.004, respectively). These 3 factors combined explained 10.6% of the variation in LDL-C response. Age, sex, smoking habit, alcohol consumption, body mass index, and apolipoprotein E genotype had no significant effect on response. We conclude that baseline levels of LDL-C and lipoprotein (a) together with the Ava II polymorphism of the LDL-receptor gene have a significant influence on the LDL-C response to pravastatin treatment in patients monitored in a standard primary health care outpatient clinic setting.

Baseline serum total cholesterol and coronary heart disease incidence in African-American women (the NHANES I epidemiologic follow-up study). National Health and Nutrition Examination Survey
Gillum, R. F., M. E. Mussolino, et al. (1998), Am J Cardiol 81(10): 1246-9.
Abstract: Proportional-hazards analyses for African-American women aged 25 to 74 revealed a variable association of coronary heart disease risk with baseline serum total cholesterol (after adjusting for age fifth vs first quintile: RR = 1.62, 95% confidence interval CI 0.89 to 2.98, p = 0.12; after adjusting for age, systolic blood pressure, body mass index, smoking, history of diabetes, low education, and low family income: RR = 1.88, 95% CI 1.02 to 3.45, p = 0.04). Perhaps due to the relatively small number of events, the association of serum total cholesterol with coronary heart disease incidence in African-American women was not consistently significant.

Basement membrane-type heparan sulfate proteoglycan (perlecan) and low-density lipoprotein (LDL) are co-localized in granulation tissues: a possible pathogenesis of cholesterol granulomas in jaw cysts
Yamazaki, M., J. Cheng, et al. (2004), J Oral Pathol Med 33(3): 177-84.
Abstract: BACKGROUND: As perlecan contains a low-density lipoprotein (LDL) receptor-like repeats in the second domain of its core protein, LDL may be bound to perlecan, which is rich in granulation tissues. We wanted to study if this is the case in the cyst wall of radicular cysts, which are often associated with cholesterol granuloma. METHODS: Thirty-three specimens of radicular cyst with cholesterol granulomas were immunohistochemically examined for comparative localizations of perlecan, apoprotein B (apo B), and oxidized LDL (Ox-LDL), and for mRNA expression levels for perlecan. RESULTS: Myxoid or edematous stroma of immature granulation tissues was strongly positive for perlecan and simultaneously for apo B and Ox-LDL. Macrophages including foamy cells scattered in the granulation tissues were also immunopositive for Ox-LDL and occasionally for apo B. In situ hybridization showed that fibroblasts, endothelial cells, and pericytes had strong signals for perlecan, which was also confirmed by RT-PCR. CONCLUSION: These results suggest that perlecan, which is abundantly produced and accumulated in the cyst wall of immature granulation tissue, traps Ox-LDL locally, and that Ox-LDL is phagocytosed by macrophages. Thus, LDL-laden foamy macrophages are aggregated in the granulation tissue, and free cholesterol from ruptured macrophages may be concentrated locally to be crystallized, which may induce foreign body granulomas in the cyst wall.

BASIC microcomputer program for generating percentile values, based on age and serum cholesterol levels
Lo, J. W. and C. H. Fung (1991), Arch Pathol Lab Med 115(2): 106-7.

Behavior of a photoactivatable analog of cholesterol, 6-photocholesterol, in model membranes
Mintzer, E. A., B. L. Waarts, et al. (2002), FEBS Lett 510(3): 181-4.
Abstract: 6-Photocholesterol, a new photoactivatable analog of cholesterol in which a diazirine functionality replaces the 5,6-double bond in the steroid nucleus, was used recently to identify cholesterol-binding proteins in neuroendocrine cells Thiele, C., Hannah, M.J., Farenholz, F. and Huttner, W.B. (2000) Nat. Cell Biol. 2, 42-49, to track the distribution and transport of cholesterol in Caenorhabditis elegans Matyash, V., Geier, C., Henske, A., Mukherjee, S., Hirsh, D., Thiele, C., Grant, B., Maxfield, F.R. and Kurzchalia, T.V. (2001) Mol. Biol. Cell 12, 1725-1736, and to probe lipid-protein interactions in oligodendrocytes Simons, M., Kramer, E.M., Thiele, C., Stoffel, W. and Trotter, J. (2000) J. Cell Biol. 151, 143-154. To determine whether 6-photocholesterol is a faithful mimetic of cholesterol we analyzed the ability of this probe, under conditions in which it is not photoactivated to a carbene, to substitute for cholesterol in two unrelated assays: (1) to condense 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine monomolecular films and (2) to mediate the fusion of two alphaviruses (Semliki Forest and Sindbis) with liposomes. The results suggest that this analog is a suitable photoprobe of cholesterol.

Behavior of arterial vascular contractility in the course of structural vascular changes during a cholesterol diet
Ludwig, M., A. Sauer, et al. (1991), Vasa Suppl 33: 153-4.

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Cholesterol Journal Articles