| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Dyslipidemias with desirable plasma total cholesterol levels and angiographically demonstrated coronary artery disease Miller, M., L. A. Mead, et al. (1990), Am J Cardiol 65(1): 1-5. Abstract: The National Cholesterol Education Program treatment guidelines define a plasma total cholesterol of less than 200 mg/dl as "desirable" and recommend no further evaluation of plasma lipid or lipoprotein levels in patients with coronary artery disease (CAD). To determine the prevalence of dyslipidemias in the presence of coexistent CAD and total cholesterol less than or equal to 200 mg/dl, a retrospective case-control study of 1,000 patients who underwent diagnostic coronary angiography was performed. Of 351 patients with total cholesterol less than or equal to 200 mg/dl, 76% of the men (244) and 44% of the women (107) had angiographically demonstrated CAD. In men with CAD and total cholesterol less than or equal to 200 mg/dl, there was a significantly greater prevalence of low levels of high density lipoprotein (HDL) cholesterol (less than or equal to 35 mg/dl), age greater than 50 years, systemic hypertension and diabetes mellitus compared to non-CAD control subjects. In women with CAD and total cholesterol less than or equal to 200 mg/dl, HDL cholesterol less than or equal to 45 mg/dl and diabetes mellitus were also significantly prevalent. Multiple logistic regression analyses revealed that HDL cholesterol, hypertension and age in men and very low density lipoprotein cholesterol in women were significantly associated with CAD after adjustment for other risk factors. These results suggest that a complete lipid and lipoprotein analysis be obtained in all patients with CAD, irrespective of the plasma (or serum) total cholesterol level. |
| Early alterations in serum creatine kinase and total cholesterol following high intensity eccentric muscle actions Shahbazpour, N., T. J. Carroll, et al. (2004), J Sports Med Phys Fitness 44(2): 193-9. Abstract: AIM: The purpose of this experiment was to assess the levels of muscle soreness, serum total cholesterol (TC) and creatine kinase (CK) in the first 48 hours following fatiguing eccentric exercise performed with the triceps brachii. METHODS: Eleven untrained male college students performed a total of 50 eccentric elbow extensions in 8 sets (6 x 7 and 2 x 4) with a load equal to 85% of their maximal concentric elbow extension strength. Isometric elbow extension strength, muscle soreness and circumference, and serum CK and TC concentrations were measured before, immediately after, and 2, 24 and 48 hours after the exercise. RESULTS: Statistically reliable changes in isometric strength, serum CK and TC, muscle soreness and upper arm circumference occurred within the first 48 hours following eccentric exercise. Serum TC concentrations exhibited a very rapid (within 2 hours) reduction from pre-exercise values after eccentric exercise to a relatively stable concentration of approximately 85% of baseline. CONCLUSION: These results suggest that serum TC concentration may follow the time-course of reductions in force generating capacity more closely than other biochemical markers of muscle damage. |
| Early changes in fine structures of the aortic arch in hamsters fed a high cholesterol diet Takasu, N., H. Kurihara, et al. (1990), Arch Histol Cytol 53(2): 211-8. Abstract: Intimal changes at the prelesional stage of atherosclerotic lesions were investigated ultrastructurally using hamsters fed a high cholesterol diet for 1 day to 1 month. Observations were restricted to the lesion-prone area in the aortic arch. The endothelial cells began to show well-developed rough endoplasmic reticulum and Golgi apparatus after a few days of the cholesterol diet. After three days, macrophages which contained a few lipid droplets were observed just below the endothelium. We found that the intimal smooth muscle cell formed a gap junction with the process of the medial smooth muscle cell. After a few weeks to 1 month on the diet, the intima became markedly thickened and filled with dense extracellular matrices. The intimal smooth muscle cells showed well-developed rough endoplasmic reticulum and Golgi apparatus with immature granules, suggestive of high secretory activity. The present study showed that endothelial ultrastructural changes, macrophage invasion, and medial smooth muscle cell migration are very early events occurring within a few days after cholesterol intake commences. |
| Early detection of dyslipidemias. Is the isolated determination of total cholesterol efficient? Argimon, J. M., C. Fiol, et al. (1991), Med Clin (Barc) 97(19): 729-32. Abstract: BACKGROUND: The aim of this study was to analyze the percentage of individuals with hypoalphalipoproteinemia and isolated hypertriglyceridemia which would not be detected if only total cholesterol were included in the initial detection of dyslipemia. METHODS: Five hundred forty-one individuals participating in a study concerning factors of cardiovascular risk were included in the present study which consisted in a survey on risk factors and a medical examination. The population studied was divided according to the concentration of total cholesterol (TC) in desirable concentrations (5.2 mmol/l), intermediate (5.2-6.2 mmol/l) and elevated (6.2 mmol/l). The concentrations of cholesterol bound to high density lipoproteins (cHDL) less than 0.9 mmol/l and of triglycerides (TG) greater than 2.3 mmol/l were considered as high risk. RESULTS: Hypoalphalipoproteinemia would not be detected in 2.9% of the population studied (IC 95%: 1.5%-4.3%) and isolated triglyceridemia in 2.4% (IC 95%: 1.1%-3.7%) if the cHDL and the TG were only determined in the individuals who had high or elevated CT concentrations and two or more cardiovascular risk factors. CONCLUSIONS: These data support the efficacy of CT as the only test for initial detection of dyslipemia and question the convenience of initial quantification of cHDL and triglycerides in all cases as some authors request. |
| Early detection of high cholesterol levels in young adults Grundy, S. M. (2000), Jama 284(3): 365-7. |
| Early extracellular and cellular lipid deposits in aorta of cholesterol-fed rabbits Guyton, J. R. and K. F. Klemp (1992), Am J Pathol 141(4): 925-36. Abstract: Subendothelial accumulation of extracellular liposomes rich in unesterified cholesterol has been described as an early feature of atherosclerosis induced by cholesterol feeding in rabbits. Beta-very-low-density lipoproteins, however, the presumed source of atherogenic lipid in this animal model, contain mostly esterified cholesterol. The purpose of this study was to test for the presence of extracellular neutral lipid deposits consistent with esterified cholesterol, by employing new electron microscopic techniques. Rabbits were fed 0.5% cholesterol, 5% butter for 0, 1, 2, and 4 weeks. The lipid-preserving ultrastructural techniques showed, in control and atherosclerotic rabbit arteries, neutral lipid droplets adherent to the endothelial luminal surface. After 1 to 2 weeks, subendothelial extracellular deposits of mostly membranous lipid appeared; these deposits contained variable amounts of neutral lipid. At the same time, cytoplasmic neutral lipid droplets appeared in smooth muscle cells and in a small number of subendothelial macrophagelike cells. After 4 weeks, monocytic infiltration and macrophage foam cell development were prominent, but abundant extracellular lipid deposits also were found. Therefore, in arteries of cholesterol-fed rabbits, deposition of membranous and neutral lipid in the extracellular space and neutral lipid accumulation in resident arterial cells are early and probably independent events, both occurring before monocytic infiltration of the arterial intima. |
| Early historical milestones in HDL-cholesterol assay Delahunty, T. (1998), Clin Chem 44(4): 898-9. |
| Early lesion development in the aortas of rabbits fed low-fat, cholesterol-free, semipurified casein diet Richardson, M., E. M. Kurowska, et al. (1994), Atherosclerosis 107(2): 165-78. Abstract: The initial endothelial morphological alterations and the development of raised, lipid-containing lesions in rabbit aortas were examined after 1 and 3 months on a casein-enriched, semipurified, cholesterol-free diet. The alterations were compared with those in rabbits fed soy-protein in the place of casein and with age-matched, chow-fed, control animals. Using immunohistochemistry macrophages, T-lymphocytes, and smooth muscle cells were identified in the lesions, and an expression of leukocyte adhesion molecules, VCAM-1, ICAM-1 and, occasionally, E-selectin was seen in sections of the aortas of casein-fed rabbits. The initial alterations in the endothelium appear to include evidence of endothelial injury and white blood cell adhesion. No evidence of extracellular liposome formation was observed. This model of atherogenesis is consistent with endothelial injury being an important component of diet-induced atherogenesis and has similarities to human atherosclerosis. |
| Early pathological changes of endothelia in a model using LDL perfusion at physiological LDL-cholesterol concentration Chui, D. H., F. Marotta, et al. (1992), Proc Soc Exp Biol Med 199(1): 136-8. Abstract: The aim of the present research was to provide further insight into the debated problem of the existence of modified LDL in vivo. For this purpose a novel model was devised for studying LDL injurious effect on endothelial cells (EC) by infusing native cholesterol rich LDL, diluted to physiological LDL cholesterol concentration. Normal rabbits were infused with LDL separated from rabbits previously fed either with standard food (I-LDL Group), 1% cholesterol (II-LDL Group) or 1% cholesterol plus probucol (IV-LDL Group). Cu++ modified II-LDL was infused as well (III-LDL Group). After dilution as above, lipid oxide (LP) significantly increased in III- and II-LDL media, as compared to I- and IV-LDL media. EC of III- and II-LDL Groups showed irregular shape and surface pattern. Further, they showed adhering clusters of monocytes, platelets and erythrocytes. Endocytic vesicles and ruthenium red-positive particles increased too. EC of IV-LDL Group were only slightly affected as compared to I-LDL Group. These data suggest that native LDL from hypercholesterolemic rabbits contain an oxidized form which is noxious to EC even when LDL is infused at physiological LDL-cholesterol concentration. This early injury is in part LP-associated and actively involves platelets and monocytes. |
| Early steps in androgen biosynthesis: from cholesterol to DHEA Miller, W. L. (1998), Baillieres Clin Endocrinol Metab 12(1): 67-81. Abstract: Sex steroids, both androgens and oestrogens, are made from dehydroepiandrosterone (DHEA). The biosynthesis of DHEA from cholesterol entails four steps. First, cholesterol enters the mitochondria with the assistance of a recently described factor called the steroidogenic acute regulatory protein (StAR). Mutations in the StAR gene cause congenital lipoid adrenal hyperplasia. Next, cholesterol is converted to pregnenolone by the cholesterol side chain cleavage enzyme, P450scc. Mutations in the gene for P450scc and for its electron transfer partners, ferredoxin reductase and ferredoxin, have not been described and are probably incompatible with term gestation. Third, pregnenolone undergoes 17 alpha-hydroxylation by microsomal P450c17. Finally, 17-OH pregnenolone is converted to DHEA by the 17,20 lyase activity of P450c17. Isolated 17,20 lyase deficiency is rare, but the identification of its genetic basis and the study of P450c17 enzymology have recently clarified the mechanisms by which DHEA synthesis may be regulated in adrenarche, and have suggested that the lesion underlying polycystic ovary syndrome might involve a serine kinase. |
| Economic evaluation of cholesterol lowering Partanen, J. (1991), Am J Cardiol 68(10): 1120. |
| Economic evaluation of pharmaceuticals: a critical appraisal of seven studies on cholesterol-lowering agents Gazzaniga, P. and L. Garattini (1992), Pharmacoeconomics 2(4): 270-8. |
| Economic impact of community pharmacist intervention in cholesterol risk management: an evaluation of the study of cardiovascular risk intervention by pharmacists Simpson, S. H., J. A. Johnson, et al. (2001), Pharmacotherapy 21(5): 627-35. Abstract: The Study of Cardiovascular Risk Intervention by Pharmacists, a randomized, controlled trial in over 50 community pharmacies in Alberta and Saskatchewan, Canada, demonstrated that a pharmacist intervention program improved cholesterol risk management in patients at high risk for cardiovascular disease. In a substudy, costs and consequences were analyzed to describe the economic impact of the program. Two perspectives were taken: a government-funded health care system and a pharmacy manager. Costs were reported in 1999 Canadian dollars. Incremental costs to a government payor and community pharmacy manager were $6.40/patient and $21.76/patient, respectively, during the 4-month follow-up period. The community pharmacy manager had an initial investment of $683.50. The change in Framingham risk function for the intervention group from baseline also was reported. The 10-year risk of cardiovascular disease decreased from 17.3% to 16.4% (p<0.0001) during the 4 months. The intervention program in this study led to a significant reduction in cardiovascular risk in the intervention group during the 4-month follow-up period. The incremental cost to provide the program appeared minimal from both government and pharmacy manager perspectives. It is hoped that these results could support negotiations for reimbursement of clinical pharmacy services with payors. |
| Ectoplasmic insertion of a glycosylphosphatidylinositol-anchored protein in glycosphingolipid- and cholesterol-containing phosphatidylcholine vesicles Nosjean, O. and B. Roux (1999), Eur J Biochem 263(3): 865-70. Abstract: Glycosylphosphatidylinositol (glycosyl-PtdIns)-anchored proteins are proposed to be clustered in membrane microdomains enriched in cholesterol and glycosphingolipids (GlySphs). We have prepared biomimetic membranes in order to study the possible phenomena of surface aggregation of these membrane components. Phosphatidylcholine liposomes were treated by octylglucoside to insert a glycosyl-PtdIns-protein, alkaline phosphatase (ALP), some cholesterol, and a GlySph, the lactocerebroside. The association of these compounds was shown by centrifugation on a density gradient. The presence of ALP on the surface of the vesicles was shown by the action of a phospholipase, and the presence of the lactocerebroside was shown by the use of a galactose-specific tetravalent lectin. Our data show that total alkaline phosphatase and half to total lactocerebroside were ectoplasmically inserted in the vesicles membrane. In addition, we observed that the presence of small amounts of ALP in the liposomes led to significant changes in membrane stability with regard to detergent, as shown by the changes in the solubilization process monitored by turbidimetry. Furthermore, we have built an original method to study the cohesion of the vesicles membrane, in which some magnesium ions were trapped in the luminal space of the liposomes during several days. The ALP is magnesium-dependent for its catalytic activity and was inhibited after incubation of ALP-containing liposomes in a magnesium-free buffer. The ALP activity was restored by the addition of detergent to the liposomes, due to the release of the luminal magnesium ions. Surface aggregation phenomena will now be investigated by atomic force microscopy. |
| EDTA reduces liver cholesterol content in cholesterol-fed rabbits Uhl, H. S., R. C. Dysko, et al. (1992), Atherosclerosis 96(2-3): 181-8. Abstract: A study conducted in 1953 by one of the authors (H.S.M. Uhl) reported that orally administered ethylenediamine tetraacetic acid (EDTA) both prevented the accumulation of cholesterol in the liver of cholesterol-fed rabbits and caused the removal of accumulated cholesterol from the liver. These observations were made in rabbits fed high concentrations of cholesterol and have never been confirmed in the literature. The purpose of the present study was to determine if this original observation could be confirmed using lower amounts of dietary cholesterol and more modern and comprehensive methods for analysis of tissue lipids and plasma lipoproteins. New Zealand White rabbits were fed diets containing 0.1% cholesterol with or without EDTA (3 g/day). After 16 weeks, significantly lower concentrations of hepatic cholesterol were found in rabbits fed EDTA (6.95 mg/g wet weight) compared with controls fed the same cholesterol-containing diet without EDTA (16.6 mg/g wet weight). Plasma cholesterol levels in both groups of animals were not significantly different from one another; therefore, the effect of EDTA in reducing liver cholesterol accumulation was independent of changes in plasma cholesterol concentrations. Although the mechanism of this EDTA effect is unknown, it may provide a tool to gain further insight into mechanisms of regulation of hepatic lipoprotein and cholesterol metabolism. |
| EDTA-plasma vs serum differences in cholesterol, high-density-lipoprotein cholesterol, and triglyceride as measured by several methods Beheshti, I., L. M. Wessels, et al. (1994), Clin Chem 40(11 Pt 1): 2088-92. Abstract: To investigate EDTA-plasma/serum (P/S) differences, we collected paired samples from 25 volunteers and measured total cholesterol (TC), triglyceride (TG) and high-density-lipoprotein cholesterol (HDLC), using the Cobas FARA, Ektachem 700, DuPont Dimension, and Baxter Paramax Analyzers. The mean (SD) P/S ratios for TC, HDLC, and TG concentrations were, respectively: 0.980 (0.0171), 1.063 (0.0704), and 0.961 (0.363) for Paramax; 0.976 (0.0189), 1.034 (0.1091), and 0.950 (0.557) for Dimension; 1.003 (0.0221), 1.059 (0.0304), and 0.988 (0.0179) for Ektachem; and 0.993 (0.0162), 1.063 (0.0830), and 1.013 (0.0410) for Cobas. We conclude that P/S ratios vary by analytical methods, and that HDLC ratios tend to be larger in magnitude and in the opposite direction from TC and TG. Both effects lead to significant biases in computed disease risk. |
| Educating high-risk Minnesotans about dietary fats, blood cholesterol, and heart disease Carson, C. A. and C. A. Hassel (1994), J Am Diet Assoc 94(6): 659-60. |
| Educating NPs to educate patients: cholesterol screening in pediatric primary care Windorski, S. K. and K. A. Kalb (2002), J Pediatr Health Care 16(2): 60-6. Abstract: INTRODUCTION: This study described practices, knowledge, and attitudes of primary care nurse practitioners (NPs) in Minnesota regarding cholesterol screening in children and adolescents. METHODS: A survey including 22 questions pertaining to cholesterol screening, adapted from a telephone survey used by Arneson, Luepker, Pirie, and Sinaiko (1992), was mailed to pediatric and family NPs. Eighty-three of 221 surveys (38%) were completed, returned, and used for data analysis. RESULTS: Although 96% of the respondents value childhood cholesterol levels as indicators of the risk of developing adult cardiovascular disease, only 64% follow the current recommendation to selectively screen cholesterol levels in patients who have a parent with hypercholesterolemia. Furthermore, only 55% of the respondents screen patients with a family history of premature cardiovascular disease, and only 58% screen patients with other cardiac risk factors. Whereas 57% of respondents correctly identified an acceptable total cholesterol level for children, only 34% correctly identified an acceptable LDL cholesterol level. DISCUSSION: Gaps in knowledge and practice may prevent NPs from implementing recommended guidelines for childhood cholesterol screening. Educating NPs about cholesterol screening is necessary to ensure the comprehensive cardiac health assessment and management of pediatric patients. |
| Education, race, and high-density lipoprotein cholesterol among US adults Freedman, D. S., D. S. Strogatz, et al. (1992), Am J Public Health 82(7): 999-1006. Abstract: OBJECTIVES. Although educational achievement is positively related to levels of high-density lipoprotein cholesterol (HDL-C) among White adults, there is an inverse association among Blacks. We assessed whether this interaction could be attributed to differences in the relation of education to correlates of HDL-C. METHODS. Cross-sectional analyses were based on data from 8391 White and 995 Black adults who participated in the Second National Health and Nutrition Examination Survey. RESULTS. Associations between education and HDL-C levels varied from negative (Black men), to nearly nonexistent (White men and Black women), to positive (White women). Mean HDL-C levels were higher among Blacks than among Whites, but differences varied according to educational achievement. Among adults with less than 9 years of education, mean levels were 6 to 10 mg/dL higher among Blacks, but the radical difference was less than 1 mg/dL among adults with at least 16 years of education. About 20% to 40% of these differences could be accounted for by obesity, alcohol consumption, and other characteristics. CONCLUSIONS. Because of the implications for coronary heart disease risk, consideration should be given to behavioral characteristics associated with the interaction between race and educational achievement. |
| Efavirenz induces a striking and generalized increase of HDL-cholesterol in HIV-infected patients Negredo, E., J. Ribalta, et al. (2004), Aids 18(5): 819-21. |