| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Low-dose simvastatin is a well-tolerated and efficacious cholesterol-lowering agent in ciclosporin-treated kidney transplant recipients: double-blind, randomized, placebo-controlled study in 40 patients Arnadottir, M., L. O. Eriksson, et al. (1994), Nephron 68(1): 57-62. Abstract: The high prevalence of hypercholesterolemia in kidney transplant recipients probably contributes to the high cardiovascular mortality in these patients. Except for diet, there is no generally recommended cholesterol-lowering treatment. We conducted a double-blind, randomized, placebo-controlled study with low-dose simvastatin in 40 ciclosporin (CS)-treated kidney transplant recipients during 16 weeks, focusing on side effects and dose finding. In the simvastatin group, the mean serum total and LDL cholesterol concentrations decreased by 23 and 33%, respectively, and the mean serum HDL cholesterol concentration increased by 12%, after 4 weeks of treatment with simvastatin 10 mg daily. Increasing the dose to 20 mg daily in a few patients only resulted in marginal further reductions of the serum cholesterol concentrations at the expense of doubling the plasma simvastatin 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitory activity concentrations. The differences between the changes in the serum cholesterol concentrations in the simvastatin group and the negligible changes in the placebo group were statistically significant. There was no case of proximal myopathy and the serum creatine kinase concentrations did not differ between treatment groups. In conclusion, low-dose simvastatin appears to be a well tolerated and efficacious cholesterol-lowering treatment in CS-treated kidney transplant recipients. Simvastatin 10 mg daily seems to be the most suitable dose for the majority of these patients. |
| Low-dose, time-release nicotinic acid: effects in selected patients with low concentrations of high-density lipoprotein cholesterol Squires, R. W., T. G. Allison, et al. (1992), Mayo Clin Proc 67(9): 855-60. Abstract: In a retrospective analysis, 63 participants in a cardiac rehabilitation-preventive cardiology program were identified as having low blood concentrations (mean, 34 mg/dl) of high-density lipoprotein cholesterol (HDL-C) and a mean total cholesterol level of 223 mg/dl after 3 months of hygienic measures (aerobic exercise, avoidance of tobacco, diet, and weight loss) designed to increase the HDL-C level. These patients (treatment group) were treated with low-dose, time-release nicotinic acid (mean, 1,297 mg/day) for a mean duration of 7.4 months. All subjects were able to take the drug without intolerable side effects. Fifty-four patients similar to those in the treatment group participated in the same program but were not treated with nicotinic acid (control group). Exercise, diet, body weight, and smoking remained stable throughout the period of observation. For the treatment group, HDL-C levels increased a mean of 18% (+6 mg/dl), total cholesterol concentrations decreased 9% (-20 mg/dl), the ratio of total cholesterol to HDL-C decreased 25% (from 6.8 to 5.1), low-density lipoprotein cholesterol levels decreased 13% (-20 mg/dl), and triglyceride levels decreased 20% (from 165 mg/dl to 132 mg/dl). Aspartate aminotransferase and uric acid concentrations were minimally increased after treatment, and the blood glucose level was unchanged. In the control group, HDL-C levels increased a mean of 8% (+3 mg/dl) and the other blood lipid variables were not improved after a mean of 8.3 additional months of diet and exercise.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Lower cholesterol to lower heart risk Clark, W. L. (2004), Diabetes Self Manag 21(3): 19, 21-2, 25. |
| Lower degree of esterification of serum cholesterol in depression: relevance for depression and suicide research Maes, M., J. Delanghe, et al. (1994), Acta Psychiatr Scand 90(4): 252-8. Abstract: Previous studies have suggested that depression and suicide are related to alterations in total cholesterol serum concentrations, and that an altered distribution of haptoglobin (Hp) phenotypes in major depression indicates that variation on chromosome 16 may be associated with that illness. Lecithin:cholesterol acyl transferase (LCAT, EC 2.3.1.43), the enzyme that catalyzes the esterifying reaction of cholesterol in serum, is located close to the Hp gene. This study examined the serum concentrations of total and free cholesterol and the esterified cholesterol ratio in 26 healthy controls, 47 unipolar depressed subjects (16 minor, 14 simple major and 17 melancholic depressed subjects) and 12 relatives of melancholic subjects. Depressed subjects (regardless of subtype) and relatives of depressed subjects had a significantly lower esterified cholesterol ratio than normal controls. No significant differences in total or free cholesterol concentrations were found between the above study groups. In depressed subjects, there were no significant relationships between the esterified cholesterol ratio, total or free cholesterol and postdexamethasone adrenocorticotropic or cortisol values, Hp phenotypes, severity of illness or suicidal symptoms. It is hypothesized that lower esterification in serum cholesterol may constitute a vulnerability factor for depression through alterations in cell membrane microviscosity. |
| Lower extremity blood flow in healthy men: effect of smoking, cholesterol, and physical activity--a Doppler study Asgeirsdottir, L. P., U. Agnarsson, et al. (2001), Angiology 52(7): 437-45. Abstract: Tobacco smoking is one of the principal risk factors of peripheral arterial disease (PAD); cholesterol level has a lesser impact. The effect of leisure-time physical activity (LTPA) has not been studied in depth. The aim of this study was to determine the relative effects of smoking, total cholesterol, and leisure-time physical activity on blood flow parameters in the lower extremities of healthy middle-aged men with no prior symptoms or diagnosis of PAD. The authors examined 130 men, aged 40-65 years, free of known arterial disease and hypertension. The men had either a total cholesterol concentration of < 5.7 or > 7.0 mmol/L, and were either smokers or nonsmokers. LTPA was addressed by a questionnaire. Ankle-brachial index (ABI) was calculated and Doppler examination of the femoral artery was performed before and after an exercise test. Tobacco smoking related significantly to abnormal ABI and Doppler results (odds ratio OR 2.42) while the total cholesterol level did not. LTPA had a favorable effect (OR 0.51). Abnormal ABI response was greatest in smokers with high total cholesterol (p < 0.01). Tobacco smoking is a significant risk factor for abnormal ABI response and blood flow abnormalities in healthy men. Regular physical activity has a measurable protective effect. An abnormal ABI suggests early atherosclerosis and indicates risk factor assessment and physician intervention. |
| Lower high-density lipoprotein cholesterol and increased omega-6 polyunsaturated fatty acids in first-degree relatives of bipolar patients Sobczak, S., A. Honig, et al. (2004), Psychol Med 34(1): 103-12. Abstract: BACKGROUND: Lower serum high-density lipoprotein cholesterol and increased ratio of omega-6/omega-3 fatty acids have been reported in unipolar and bipolar depressed patients. Changes in cholesterol and fatty acids have been suggested to affect membrane viscosity and consequently serotonergic neurotransmitter expression. The goal of this study was to investigate whether lower baseline cholesterol and increased omega-6 and lower omega-3 fatty acids are present in healthy first-degree relatives of bipolar patients compared with controls and whether these changes were associated with neuroendocrine responses to an i.v. tryptophan challenge or mood. METHOD: Baseline cholesterol, fatty acids and mood were determined in healthy first-degree relatives of patients with bipolar disorders (N = 30) and healthy matched controls (N = 15) (parallel-group design). Prolactin and cortisol were measured following tryptophan infusion. RESULTS: First-degree relatives showed significantly lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids. Lower total omega-3 and higher total omega-6 fatty acids in phospholipids were positively correlated with peak prolactin response to tryptophan. Lower total omega-3 fatty acids in phospholipids and cholesteryl esters were associated with lower mood. CONCLUSIONS: Abnormalities of lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids in these subjects are in agreement with findings in bipolar and major depressed patients. Changes in fatty acids show an association with central serotonergic parameters. It is suggested that these abnormalities in cholesterol and fatty acids may constitute a trait marker for bipolar disorders. |
| Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the Longitudinal Aging Study Amsterdam Schalk, B. W., M. Visser, et al. (2004), Age Ageing 33(3): 266-72. Abstract: BACKGROUND: Both serum albumin and total cholesterol are potential markers of frailty. A decline in functional status is one of the key components of frailty. OBJECTIVE: The aim of this study was to investigate the association of serum albumin and total cholesterol, separately and combined, with future decline in functional performance. DESIGN: The Longitudinal Aging Study Amsterdam, an ongoing population-based longitudinal study, started in 1992/1993 with a follow-up every 3 years. Participants: 1,064 men and women aged 55-85 years with complete data on serum albumin and total cholesterol at baseline, and functional performance at baseline and 3-year follow-up. MEASUREMENTS: At baseline, serum albumin and total cholesterol were measured. At baseline and 3 years later, decline in functional status was measured with three performance tests (chair stand, 3-metre walk, putting on and taking off a cardigan). Associations were adjusted for age, life-style and health-related factors. RESULTS: Albumin concentration was not associated with decline in functional performance in men and women. Women with lower serum total cholesterol concentration ( |
| Lower plasma levels and accelerated clearance of high density lipoprotein (HDL) and non-HDL cholesterol in scavenger receptor class B type I transgenic mice Ueda, Y., L. Royer, et al. (1999), J Biol Chem 274(11): 7165-71. Abstract: Recent studies have indicated that the scavenger receptor class B type I (SR-BI) may play an important role in the uptake of high density lipoprotein (HDL) cholesteryl ester in liver and steroidogenic tissues. To investigate the in vivo effects of liver-specific SR-BI overexpression on lipid metabolism, we created several lines of SR-BI transgenic mice with an SR-BI genomic construct where the SR-BI promoter region had been replaced by the apolipoprotein (apo)A-I promoter. The effect of constitutively increased SR-BI expression on plasma HDL and non-HDL lipoproteins and apolipoproteins was characterized. There was an inverse correlation between SR-BI expression and apoA-I and HDL cholesterol levels in transgenic mice fed either mouse chow or a diet high in fat and cholesterol. An unexpected finding in the SR-BI transgenic mice was the dramatic impact of the SR-BI transgene on non-HDL cholesterol and apoB whose levels were also inversely correlated with SR-BI expression. Consistent with the decrease in plasma HDL and non-HDL cholesterol was an accelerated clearance of HDL, non-HDL, and their major associated apolipoproteins in the transgenics compared with control animals. These in vivo studies of the effect of SR-BI overexpression on plasma lipoproteins support the previously proposed hypothesis that SR-BI accelerates the metabolism of HDL and also highlight the capacity of this receptor to participate in the metabolism of non-HDL lipoproteins. |
| Lower serum cholesterol level and later decline in cognitive function in older people living in the community, Japan Wada, T., K. Matsubayashi, et al. (1997), J Am Geriatr Soc 45(11): 1411-2. |
| Lower serum high-density lipoprotein cholesterol (HDL-C) in major depression and in depressed men with serious suicidal attempts: relationship with immune-inflammatory markers Maes, M., R. Smith, et al. (1997), Acta Psychiatr Scand 95(3): 212-21. Abstract: Recently, there have been some reports that changes in serum lipid composition may be related to suicide, major depression and immune-inflammatory responses. Findings from our laboratory suggest that major depression is accompanied by reduced formation of cholesteryl esters and perhaps by impairment of reverse cholesterol transport. The latter is reportedly accompanied by lower serum high-density lipoprotein cholesterol (HDL-C). The aim of this study was to examine whether (i) major depression is accompanied by lower serum HDL-C or by abnormal levels of serum total cholesterol, triglycerides, low-density lipoprotein-C (LDL-C) or vitamin E, (ii) suicidal attempts are related to lower serum HDL-C and (iii) there are significant associations between serum HDL-C and immune/inflammatory markers. A total of 36 subjects with major depression, of whom 28 patients showed treatment resistance, as well as 28 normal control subjects, had blood sampled for the assay of the above lipids, serum zinc (Zn), albumin (Alb) and flow cytometric determination of the T-helper/T-suppressor (CD4+/CD8+) T-cell ratio. In total, 28 depressed subjects had repeated measures of these variables both before and after treatment with antidepressants. Serum HDL-C and total cholesterol, as well as the HDL-C/cholesterol ratio, were significantly lower in subjects with major depression than in normal controls. Serum HDL-C levels were significantly lower in depressed men who had at some time made serious suicidal attempts than in those without such suicidal behaviour. Treatment with antidepressants for 5 weeks did not significantly alter either serum HDL-C or other lipid variables. Serum HDL-C levels were significantly and negatively correlated with the (CD4+/CD8+) T-cell ratio, and positively correlated with serum Alb and Zn. These results suggest that (i) lower serum HDL-C levels are a marker for major depression and suicidal behaviour in depressed men, (ii) lower serum HDL-C levels are probably induced by the immune/inflammatory response in depression and (iii) there is impairment of reverse cholesterol transport from the body tissues to the liver. |
| Lower serum high-density lipoprotein-cholesterol concentration in patients undergoing maintenance hemodialysis with acetate than with bicarbonate Jung, K., A. Scheifler, et al. (1995), Am J Kidney Dis 25(4): 584-8. Abstract: The authors studied the effect of dialysate buffer composition on the serum lipid values in male patients undergoing maintenance hemodialysis. Twenty patients on acetate and 21 patients on bicarbonate hemodialysis were investigated. The serum concentrations of high-density lipoprotein (HDL)-, HDL2- and HDL3-cholesterol were significantly lower in patients on acetate than in those on bicarbonate dialysis. The results of this study suggest possible adverse effects of acetate hemodialysis on serum HDL-cholesterol compared with bicarbonate hemodialysis. Other possibly contributory factors such as age and time on dialysis could be excluded. However, a possible role of differences in drug therapy between acetate- and bicarbonate-treated dialysis patients could not be entirely excluded. |
| Lowered cholesterol beneficial for vascular endothelium Strandberg, T. and M. J. Tikkanen (1996), Nord Med 111(1): 10-2. Abstract: Although it is logical that coronary artery plaque is reduced, or at least the stenotic process is inhibited, when blood lipid concentrations are normalised, this does not suffice to explain the beneficial outcome of treatment in cases of hypercholesterolaemia. Several recent studies have yielded manifest evidence of the effects of cholesterol on endothelial function. Via chemical mechanisms the endothelium exerts significant regulatory effects-e g, on vascular contractility, and intervention in this process offers several possibilities of treating and preventing coronary artery disease. |
| Lowered serum cholesterol and low mood Brown, S. L. (1996), Bmj 313(7058): 637-8. |
| Lowering cholesterol Lewis, R. R. and M. A. Crook (1999), J R Coll Physicians Lond 33(6): 586-7. |
| Lowering cholesterol Pattison, J. (1993), Med J Aust 158(8): 580. |
| Lowering cholesterol 1998. Cholesterol synthesis inhibitors compared Kostner, K. M. and G. M. Kostner (1998), Wien Klin Wochenschr 110(18): 625-30. Abstract: Large scale primary and secondary prevention trials in recent years have revealed that the effective lipid reducing therapy with statins can reduce mortality of coronary heart disease by up to 30%. For the first time it has become possible to reduce LDL-cholesterol pharmacologically by more than 50%, a reduction that was only achieved by LDL-apheresis so far. Cost-effectiveness is becoming an important issue since this varies widely between patients according to the coronary risk. Treating the patients with the highest coronary risk is most cost effective. Currently, there are six statins on the market. Reduction of LDL-cholesterol is mainly mediated by the induction of LDL-receptor activity in the liver. In addition, some statins at high doses also reduce LDL-cholesterol synthesis. Due to variations in the molecular structure of the active compounds these 6 statins have important pharmacological differences, such as their capacity to reduce plasma triglycerides, their interaction with other drugs. The daily recommended doses of the statins range from 0.1 mg (cerivastatin) to 80 mg (atorvastatin). In this review the differences in the pharmacological and clinical actions of the statins are analyzed. |
| Lowering cholesterol and death due to accidents, suicides: unresolved issues Vasan, R. S. (1992), Arch Intern Med 152(2): 414, 417. |
| Lowering cholesterol and lowering costs Bachman, K. H. (1996), Arch Intern Med 156(13): 1476, 1479. |
| Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials Muldoon, M. F., S. B. Manuck, et al. (1990), Bmj 301(6747): 309-14. Abstract: OBJECTIVE--To determine the effects of lowering cholesterol concentrations on total and cause specific mortality in randomised primary prevention trials. DESIGN--Qualitative (meta-analytic) evaluation of total mortality from coronary heart disease, cancer, and causes not related to illness in six primary prevention trials of cholesterol reduction (mean duration of treatment 4.8 years). PATIENTS--24,847 Male participants; mean age 47.5 years. MAIN OUTCOME MEASURES--Total and cause specific mortalities. RESULTS--Follow up periods totalled 119,000 person years, during which 1147 deaths occurred. Mortality from coronary heart disease tended to be lower in men receiving interventions to reduce cholesterol concentrations compared with mortality in control subjects (p = 0.06), although total mortality was not affected by treatment. No consistent relation was found between reduction of cholesterol concentrations and mortality from cancer, but there was a significant increase in deaths not related to illness (deaths from accidents, suicide, or violence) in groups receiving treatment to lower cholesterol concentrations relative to controls (p = 0.004). When drug trials were analysed separately the treatment was found to reduce mortality from coronary heart disease significantly (p = 0.04). CONCLUSIONS--The association between reduction of cholesterol concentrations and deaths not related to illness warrants further investigation. Additionally, the failure of cholesterol lowering to affect overall survival justifies a more cautious appraisal of the probable benefits of reducing cholesterol concentrations in the general population. |
| Lowering cholesterol for prevention of myocardial infarct and stroke? MRC/BHF Heart Protection Study Krone, W. (2003), Internist (Berl) 44(6): 753-4. |