| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Is the decreased high-density lipoprotein cholesterol in the metabolic syndrome due to cellular lipid efflux defect? Alenezi, M. Y., M. Marcil, et al. (2004), J Clin Endocrinol Metab 89(2): 761-4. Abstract: The metabolic syndrome (MS) is associated with cardiovascular disease. The low high-density lipoprotein cholesterol (HDL-C) seen in the MS is associated with increased hepatic secretion of apolipoprotein B-containing lipoproteins. Patients with low HDL-C and abnormal cellular lipid efflux due to ABCA1 gene defects (Tangier disease) also have elevated plasma triglycerides. In the present study, we examined the cellular cholesterol and phospholipid efflux in patients with low HDL-C and features of the MS. Forty-four patients with a HDL-C below the fifth percentile for age and gender were selected. The MS was defined by a low HDL-C and at least two additional features: body mass index at least 30 kg/m(2), plasma triglycerides at least 150 mg/dl, fasting glucose at least 110 mg/dl, and blood pressure at least 130/85 mm Hg. Cellular lipid efflux was examined on fibroblasts obtained from study subjects, nine normal controls and six subjects with Tangier disease. In 22 patients identified with the MS, HDL-C was 21 +/- 7 mg/dl, triglyceride levels were 340 +/- 157 mg/dl, and cellular cholesterol and phospholipid efflux were 107 +/- 18% and 105 +/- 17% of controls, respectively. No patient with the MS and low HDL-C showed a cellular lipid efflux defect. We conclude that primary cellular lipid efflux defects do not contribute to the low HDL-C frequently encountered in the MS. |
| Is the determination of LDL cholesterol according to Friedewald accurate in CAPD and HD patients? Nauck, M., A. Kramer-Guth, et al. (1996), Clin Nephrol 46(5): 319-25. Abstract: Lipid abnormalities are a major cause of accelerated atherosclerosis in patients with end-stage renal disease. In many clinical laboratories, the concentration of low density lipoproteins (LDL), the most atherogenic lipoprotein fraction, is estimated by calculating LDL cholesterol according to Friedewald. Hypertriglyceridemia, a common finding in uremic patients, is a main limitation to the use of the Friedewald formula, and the estimation of LDL cholesterol may, therefore, not be reliable in these patients. As accurate quantitation of LDL cholesterol is needed to decide on the initiation of lipid lowering therapy, we have evaluated the accuracy of the Friedewald formula in 171 patients on continuous ambulatory peritoneal dialysis (CAPD), 136 hemodialysis (HD) patients and 887 clinically healthy individuals by comparing it with a combined ultracentrifugation and precipitation 'reference' method. When we excluded sera with total triglycerides above 400 mg/dl 4.56 mmol/l, the Friedewald formula correlated excellently with the reference method; non-parametric correlation coefficients were 0.976, 0.971, and 0.956 in clinically healthy individuals, CAPD and HD patients, respectively. In the control individuals, the Friedewald formula produced slightly lower concentrations of LDL cholesterol than the reference method (means: 142 +/- 40 mg/dl vs 150 +/- 39 mg/dl or 3.68 + 1.04 mmol/l vs. to 3.89 + 1.01 mmol/l, respectively). This was also true in HD patients (means: 145 +/- 51 vs. 146 +/- 49 mg/dl or 3.76 +/- 1.32 vs. 3.78 +/- 1.27 mmol/l, respectively), but not in CAPD patients (means: 165 +/- 50 vs. 162 +/- 47 mg/dl or 4.27 +/- 1.30 vs. 4.20 +/- 1.22 mmol/l). Our data show that, unlike in other forms of secondary dyslipoproteinemia, the Friedewald formula is sufficiently reliable in patients with end-stage renal disease. Much the same, however, as in control individuals, other methods to quantify LDL cholesterol like ultracentrifugation or lipoprotein electrophoresis are recommended when serum triglycerides exceed 400 mg/dl 4.56 mmol/l. |
| Is the Finnish "healthy margarine" food or medicine? Addition of plant sterols can lower cholesterol levels Wikstrom, A. C. (1998), Lakartidningen 95(46): 5146-8. Abstract: Sine the autumn of 1995, Benecol, a proprietary brand of cholesterol-lowering margarine, has been available in ordinary grocery shops in Finland. The active ingredient is a sitostanol ester. Several studies in humans have shown use of the margarine to result in an approximately 10 per cent reduction in total serum cholesterol, and a 13-15 per cent reduction of LDL-cholesterol. However, further studies are required of its phyto-oestrogenic and endocrine effects, and its effects on growing children, particularly regarding subsequent fertility in boys. Although the margarine is classed as a 'functional food' in Finland, the question arises where the line is to be drawn between medicines and food-stuffs. |
| Is the ileal bile acid-binding protein (I-BABP) gene involved in cholesterol homeostasis? Besnard, P., J. F. Landrier, et al. (2004), Med Sci (Paris) 20(1): 73-7. Abstract: In the body, cholesterol balance results from an equilibrium between supplies (diet and cellular de novo synthesis), and losses (cellular use and elimination in feces, essentially as bile acids). Bile acids are synthesized from cholesterol in the liver. After conjugation to glycine or taurine, bile acids are secreted with bile in the intestinal lumen where they actively participate to the digestion and absorption of dietary fat and lipid-soluble vitamins. In healthy subjects, more than 95% of bile acids are reabsorbed throughout the small intestine and returned by the portal vein to the liver, where they are secreted again into bile. This enterohepatic circulation is essential for maintenance of bile acids balance, and hence, for cholesterol homeostasis. Indeed, the bile acids not reclaimed by intestinal absorption constitute the main physiological way to eliminate a cholesterol excess. Little is known about the molecular mechanisms controlling bile acids reabsorption by the small intestine. The intestinal bile acids uptake mainly takes place through an active transport located in the distal part of the small intestine. To date, four unrelated proteins exhibiting a high affinity for bile acids have been identified in the ileum, and only one, the ileal bile acid-binding protein (I-BABP) is a soluble protein. Therefore, it is thought to be essential for efficient bile acids desorption from the apical plasma membrane, as well as for bile acids intracellular trafficking and targeting towards the basolateral membrane. If this assumption is correct, the I-BABP expression level might be rate limiting for the enterohepatic bile acids circulation, and hence, for cholesterol homeostasis. It was found that both bile acids and cholesterol, probably via oxysterols, are able to up-regulate the transcription rate of I-BABP gene. The fact that intracellular sterol sensors (FXR, LXR, and SREBP1c) are involved in the control of the I-BABP gene expression strongly suggests that I-BABP exerts an important role in maintenance of cholesterol balance. |
| Is there a connection between the concentration of cholesterol circulating in plasma and the rate of neuritic plaque formation in Alzheimer disease? Haley, R. W. and J. M. Dietschy (2000), Arch Neurol 57(10): 1410-2. |
| Is there a relationship between cholesterol reduction, low levels of cholesterol and mortality? LaRosa, J. C. (1995), Rev Esp Cardiol 48 Suppl 2: 14-7. Abstract: Cholesterol lowering in both primary and secondary prevention has been clearly demonstrated to lower coronary morbidity and, in secondary prevention, to lower coronary mortality as well. Putative dangers of cholesterol lowering remain unproven. Population studies linking low cholesterol to noncoronary mortalities do not demonstrate cause-and-effect relations. In fact, based on current studies, the opposite is more likely to be the case. Neither gender nor age should automatically exclude persons from cholesterol screening. Drug intervention, however, should be used conservatively, particularly in young adults and the elderly. Drugs should be used only after diet and lifestyle interventions have failed. The evidence linking high blood cholesterol to coronary atherosclerosis and cholesterol lowering to its prevention is broad-based and definitive. Concerns about cholesterol lowering and spontaneously low cholesterols should be pursued but should not interfere with the implementation of current public policies to reduce the still heavy burden of atherosclerosis in Western society. |
| Is there a relationship between plasma phenylalanine and cholesterol in phenylketonuric patients under dietary treatment? Colome, C., R. Artuch, et al. (2001), Clin Biochem 34(5): 373-6. Abstract: OBJECTIVES: To study the lipid profile in a group of treated phenylketonuric patients (PKU; n = 61) compared with a group of inborn error of intermediary metabolism patients (IEM; n = 22), a group of hyperphenylalaninemic children (HPA; n = 37), and a control group without dietary restriction (n = 41). DESIGN AND METHODS: Phenylalanine was analyzed by ion exchange chromatography and triglycerides, cholesterol and HDL were determined by standard procedures with the Cobas Integra analyzer. RESULTS: Serum total cholesterol concentrations were significantly lower in PKU patients compared with IEM patients (whose cholesterol daily intake was similar to those of PKU patients), HPA children and the control group. A negative correlation was observed between cholesterol and phenylalanine concentrations in the PKU patients. CONCLUSIONS: Our findings support the hypothesis of a relationship between high plasma phenylalanine levels and an inhibition of cholesterogenesis, although the low cholesterol intake of the special diets may also decrease serum cholesterol values. |
| Is there room for the non-surgical treatment of cholesterol gallstones? van Erpecum, K. J., M. F. Stolk, et al. (1991), Ned Tijdschr Geneeskd 135(35): 1569-73. |
| Is total cholesterol a good predictor of attempting suicide? Janik, M., H. Lewandowska-Stanek, et al. (2003), Przegl Lek 60(4): 251-4. Abstract: The aim of the study was to verify a correlation between total cholesterol and a risk of attempting suicide. There has been data suggesting that individuals with low cholesterol are prone to commit a suicide. This could be due to the altered serotonin metabolism that in turn increases the level of aggressiveness, compulsiveness an promotes attempting suicide. We analyzed data from 300 poisonings, also with drugs, which were considered as attempted suicides. There was no evident correlation between cholesterol level and incidence of poisoning with drugs, acute alcohol poisoning and chronic alcohol abuse. Moreover, we did not find a correlation between low cholesterol level and a need of psychiatric treatment, both in hospital and in outpatient clinic. Further study are needed to elucidate the exact role of low cholesterol as a predictor of suicide attempt. |
| Is treatment of increased total cholesterol level indicated? Petersson, B. H. (1993), Ugeskr Laeger 155(10): 729-30. |
| Is weight loss a modifier of the cholesterol-heart disease relationship in older persons? Data from the NHANES I Epidemiologic Follow-up Study Harris, T., J. C. Kleinman, et al. (1992), Ann Epidemiol 2(1-2): 35-41. Abstract: The relationship between cholesterol and 14-year incidence of coronary heart disease was compared for men and women of two age groups, 25 to 64 years and 65 to 74 years. While cholesterol levels of 6.2 mmol/L or higher were associated with a risk of coronary heart disease in the younger group, this was not true for either men or women aged 65 to 74. Further analyses for older persons showed that weight loss modified the cholesterol-heart disease relationship. Those with stable weight showed a positive relationship between cholesterol and coronary heart disease, similar to the younger age group (relative risk RR = 1.8 95% confidence interval: 1.1, 2.9 for men; RR = 1.6 7, 3.4 for women). Among those with a weight loss of 10% or more, the relationship of cholesterol to heart disease was inverse (RR =.8 5, 1.2 for men; RR =.6 3, 1.0 for women). These data suggest that the relationship of cholesterol to coronary disease in healthier older persons may be similar to that in younger persons, and that health status should be considered in analyses of cholesterol risk in old age. |
| Ischaemic heart disease and cholesterol. "Cholesterol papers" add to the confusion Sudlow, C. L. and M. R. MacLeod (1994), Bmj 308(6935): 1039-40, 1041. |
| Ischaemic heart disease and cholesterol. Absolute risk more informative than relative risk Vine, D. L. and G. E. Hastings (1994), Bmj 308(6935): 1040, 1041. |
| Ischaemic heart disease and cholesterol. but does it increase lifespan in others? Dugdale, A. (1994), Bmj 308(6935): 1041. |
| Ischaemic heart disease and cholesterol. Cholesterol reduction effective in established disease Durrington, P. N. (1994), Bmj 308(6935): 1040. |
| Ischaemic heart disease and cholesterol. Effective diets are unpalatable Ramsay, L. E., W. W. Yeo, et al. (1994), Bmj 308(6935): 1038-9, 1041. |
| Ischaemic heart disease and cholesterol. Hidden bias in observational study Millo, J. (1994), Bmj 308(6935): 1039, 1041. |
| Ischaemic heart disease and cholesterol. Optimism about drug treatment is unjustified Ravnskov, U. (1994), Bmj 308(6935): 1038, 1041. |
| Ischaemic heart disease and cholesterol. There's more to heart disease than cholesterol Bonneux, L. and J. J. Barendregt (1994), Bmj 308(6935): 1038, 1041. |
| Ischemic heart disease, serum cholesterol, and apolipoproteins in CAPD Gault, M. H., L. Longerich, et al. (1991), ASAIO Trans 37(3): M513-4. Abstract: Thirty-one patients, mean age 54 years, had been on chronic ambulatory peritoneal dialysis (CAPD) for an average of 38 months. Mean values (mg/dl) for triglycerides (567), total-C (267), LDL-C (133), and Apo-B (154) were elevated, and HDL-C (30) were low. The low values for total-C/Apo-B and LDL-C/Apo-B suggest an increase in the number of low density lipoprotein (LDL) particles, rather than in the amount of cholesterol per LDL particle. Without knowledge of lipids, ischemic heart disease for the 31 patients was categorized into five grades in the following manner. All patients were graded based on history (angina, myocardial infarction, and bypass surgery), electrocardiogram (EKG), and echocardiography. In addition, five patients underwent coronary angiography, the results of which were considered in their grading. The five grades were assigned as follows: Grade I, no evidence (n = 15); Grade II, angina with EKG ischemia (n = 4); Grade III, myocardial infarction (MI) (n = 1); Grade IV, MI with dyskinesia-akinesia on echo (n = 4); Grade V, severe three vessel disease on angiography, or multiple infarcts, or Grade IV with heart failure (n = 7). Only Apo-B (r = 0.56) and total-C/HDL-C (r = 0.57) correlated with severity of grade, with p less than 0.001. When patients with and without detectable ischemic heart disease were compared by stepwise logistic regression, Apo-B was the only variable that independently predicted heart disease (p = 0.001). However, contribution of the lipid changes induced by CAPD has not been established. |