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niacin and cholesterol

Dick C Chan, P Hugh R Barrett, Gerald F Watts
PURPOSE OF REVIEW: Dysregulated lipoprotein metabolism leads to increased plasma concentrations of atherogenic lipoproteins. We highlight the findings from recent studies of the effect of lipid-regulating therapies on apolipoprotein metabolism in humans employing endogenous labelling with stable isotopically labelled isotopomers. RECENT FINDINGS: Fish oil supplementation and niacin treatment both reduce fasting and postprandial triglyceride levels by decreasing the hepatic secretion of VLDL-apoB-100 (apoB) and apoB-48-containing chylomicron particles in obese and/or type 2 diabetes...
October 5, 2016: Current Opinion in Lipidology
Pamela A Kushner, Michael E Cobble
This review aims to explain risk factors, consequences, and management strategies recommended for patients with hypertriglyceridemia. A search of PubMed was performed: "Hypertriglyceridemia"[Majr], limited to English-language and published in the 5 years up to April 2016. Abstracts of the 680 results were screened for inclusion. Reference lists of publications included were also screened for inclusion. Approximately 25% of the United States population has elevated (≥150 mg/dL) triglycerides (TG) putting them at an increased risk of cardiovascular disease, non-alcoholic fatty liver disease, and pancreatitis...
October 6, 2016: Postgraduate Medicine
Gro-Ingunn Hemre, Erik-Jan Lock, Pål Asgeir Olsvik, Kristin Hamre, Marit Espe, Bente Elisabeth Torstensen, Joana Silva, Ann-Cecilie Hansen, Rune Waagbø, Johan S Johansen, Monica Sanden, Nini H Sissener
Aiming to re-evaluate current recommendations for nutrient supplementations when Atlantic salmon are fed diets based on plant ingredients, two regression experiments, with parr and post-smolt, were conducted. A control diet was included to evaluate if ingredients supplied sufficient nutrients without any added nutrient package (NP). The nutrient package consisted of vitamins B, C, E, minerals, cholesterol, methionine, taurine and histidine. This paper focus on B-vitamins. In parr, growth, health and welfare parameters responded on NP additions, but this was not observed in the seawater stage...
2016: PeerJ
Xue-Qiao Zhao, Binh An P Phan, Joseph Davis, Daniel Isquith, Alice A Dowdy, Suzanne Boltz, Moni Neradilek, Erik A Monick, Andrew Brockenbrough, Ellen E Hus-Frechette, John J Albers, B Greg Brown
BACKGROUND: Cardiovascular disease (CVD) begins early in life and is associated with both the number of risk factors present and length of exposure to these risk factors including hyperlipidemia. OBJECTIVES: The clinical benefit of intensive lipid therapy over 25 years was investigated in the Familial Atherosclerosis Treatment Study-Observational Study. METHODS: Of 175 coronary artery disease subjects with mean low-density lipoprotein cholesterol (LDL-C) of 191 mg/dL and mean age of 50 years, who completed the randomized and placebo-controlled Familial Atherosclerosis Treatment Study, 100 chose receiving lipid management by their physicians (usual care [UC]) and 75 elected to receive an intensive treatment [IT] for lipid management with lovastatin (40 mg/d), niacin (2...
September 2016: Journal of Clinical Lipidology
Michael G Silverman, Brian A Ference, Kyungah Im, Stephen D Wiviott, Robert P Giugliano, Scott M Grundy, Eugene Braunwald, Marc S Sabatine
IMPORTANCE: The comparative clinical benefit of nonstatin therapies that reduce low-density lipoprotein cholesterol (LDL-C) remains uncertain. OBJECTIVE: To evaluate the association between lowering LDL-C and relative cardiovascular risk reduction across different statin and nonstatin therapies. DATA SOURCES AND STUDY SELECTION: The MEDLINE and EMBASE databases were searched (1966-July 2016). The key inclusion criteria were that the study was a randomized clinical trial and the reported clinical outcomes included myocardial infarction (MI)...
September 27, 2016: JAMA: the Journal of the American Medical Association
Peer Abdul Hannan, Jamshaid Ali Khan, Irfan Ullah, Safi Ullah
BACKGROUND: Hyperlipidemia, a major pathological condition associated with disrupted lipid levels and physiological redox homeostasis. The excessive release of reactive oxygen species (ROS) leads to enhanced lipid peroxidation, aggravated atherosclerosis and oxidative stress. Integration of natural antioxidant blends in alone or with conventional treatments can alleviate these issues synergistically contributing least side effects. Published literature reported the efficacy of natural antioxidants as individual and in combinations in various conditions but less data is available on their evaluation in low dose ratio blends particularly in hypercholesterolemic diet...
2016: Lipids in Health and Disease
Kevin C Maki, John R Guyton, Carl E Orringer, Ian Hamilton-Craig, Dominik D Alexander, Michael H Davidson
BACKGROUND: Cardiovascular outcomes trials of fibrates, niacin, or omega-3 fatty acids alone, or added to a statin, have not consistently demonstrated reduced risk, but larger, statistically significant clinical benefits have been reported in subgroups with elevated triglycerides (TG) and/or elevated TG plus low high-density lipoprotein cholesterol (HDL-C). OBJECTIVE: To perform a meta-analysis of the effects of therapies targeting TG and TG-rich lipoprotein cholesterol on cardiovascular disease event risk in subjects with elevated TG or elevated TG paired with low HDL-C...
July 2016: Journal of Clinical Lipidology
Sayyed Saeid Khayyatzadeh, Mohsen Moohebati, Mohsen Mazidi, Amir Avan, Maryam Tayefi, Seyed Mohammad Reza Parizadeh, Mahmoud Ebrahimi, Alireza Heidari-Bakavoli, Mahmoud Reza Azarpazhooh, Habibollah Esmaily, Gordon A Ferns, Mohsen Nematy, Mohammad Safarian, Majid Ghayour-Mobarhan
BACKGROUND: The prevalence of metabolic syndrome (MetS) is increasing globally. It is associated with a significant risk of developing type 2 diabetes mellitus and cardiovascular disease. MATERIALS AND METHODS: The relationship between adherence to several different dietary patterns and the presence of MetS was explored in an Iranian population sample of 5764 subjects. RESULTS: We observed that the prevalence of MetS was 13% and 18% in men and women, respectively...
October 2016: European Journal of Clinical Investigation
Jennifer G Robinson
After maximizing statin and lifestyle adherence, some patients may benefit from additional low-density lipoprotein cholesterol (LDL-C) lowering. The potential for net benefit from added therapy can inform nonstatin decision-making. Considering patient risk and the LDL-C level on statin, the additional potential cardiovascular disease (CVD) risk reduction benefit from further lowering LDL-C depends on the magnitude of LDL-C lowering from the nonstatin. Ezetimibe is the only nonstatin shown to reduce atherosclerotic CVD events added to a statin, albeit modestly, since it modestly reduces LDL-C by about 20%...
September 2016: Progress in Cardiovascular Diseases
Sotirios Tsimikas
Lipoprotein(a) [Lp(a)] is a genetic, independent and likely causal risk factor for cardiovascular disease (CVD) and calcific aortic valve stenosis (CAVS). Lp(a) levels are primarily genetically determined and tend to fluctuate only mildly around a pre-determined level. In primary care settings, one Lp(a) measurement can reclassify up to 40% of patients in intermediate risk score categories. In secondary care settings, recent data from the JUPITER and AIM-HIGH trials demonstrate that elevated Lp(a) remains part of the "residual risk" despite achievement of low-density lipoprotein cholesterol levels <70 mg/dL...
September 2016: Progress in Cardiovascular Diseases
David R Saxon, Robert H Eckel
Statin intolerance is a commonly encountered clinical problem for which useful management strategies exist. Although many patients report statin-related muscle symptoms, studies indicate that the majority of these patients can tolerate a statin upon re-challenge. Alternative statin dosing strategies are an effective way to modify and reintroduce statin therapy for patients reporting adverse symptoms. Correction of vitamin D deficiency and hypothyroidism may improve statin tolerability in some patients. CoQ10 supplementation has been found to be of no benefit for statin-related muscle symptoms in most recent clinical trials...
September 2016: Progress in Cardiovascular Diseases
James R Crandell
Cardiovascular (CV) risk may remain despite statin treatment, and there is a need to address this risk with add-on therapy. The lipid effects of two different prescription omega-3 fatty acid therapies are described in a 55-year-old statin- and niacin-treated female with severe dyslipidemia and high CV risk. The patient was initially treated with omega-3-acid ethyl esters (eicosapentaenoic acid [EPA] and docosahexaenoic acid) 4 g/day. Due to persistently elevated low-density lipoprotein cholesterol (LDL-C), she was switched to icosapent ethyl (high-purity EPA ethyl ester) 4 g/day...
2016: Clinical Medicine Insights. Cardiology
Auryan Szalat, Ronen Durst, Eran Leitersdorf
Glucose-control has a modest beneficial effect on cardiovascular outcomes in patients with type 2 diabetes mellitus. Thus, managing other atherogenic risk factors including hypertriglyceridemia, low HDL-cholesterol and moderately elevated LDL-cholesterol levels with increased small dense LDL-cholesterol fraction, is crucial. Insulin resistance is a key pathophysiologic factor in this population. Treatment starts with lifestyle modifications, but current best programmes have not translated into positive cardiovascular outcomes...
June 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
Seamus Kent, Richard Haynes, Jemma C Hopewell, Sarah Parish, Alastair Gray, Martin J Landray, Rory Collins, Jane Armitage, Borislava Mihaylova
BACKGROUND: Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), but its net effects on health and healthcare costs are unknown. METHODS AND RESULTS: 25 673 participants aged 50 to 80 years with previous cardiovascular disease were randomized to 2 g of extended-release niacin with 40 mg of laropiprant daily versus matching placebo, in addition to effective statin-based low-density lipoprotein cholesterol-lowering treatment...
July 2016: Circulation. Cardiovascular Quality and Outcomes
Eliot A Brinton, Joseph Triscari, Philippe Brudi, Erluo Chen, Amy O Johnson-Levonas, Christine McCrary Sisk, Rae Ann Ruck, Alexandra A MacLean, Darbie Maccubbin, Yale B Mitchel
BACKGROUND: LDL-C, non-HDL-C and ApoB levels are inter-correlated and all predict risk of atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM) and/or high TG. These levels are lowered by extended-release niacin (ERN), and changes in the ratios of these levels may affect ASCVD risk. This analysis examined the effects of extended-release niacin/laropiprant (ERN/LRPT) on the relationships between apoB:LDL-C and apoB:non-HDL-C in patients with T2DM...
2016: Lipids in Health and Disease
Yingting Cao, Gary Wittert, Anne W Taylor, Robert Adams, Sarah Appleton, Zumin Shi
BACKGROUND & AIMS: There is limited data relating to the effect of the combination of nutrients on inflammation and the interactions with lifestyle factors and chronic conditions. We examined the association between nutrient patterns and inflammatory markers C-reactive protein (CRP) and interleukin 6 (IL-6) in community dwelling middle-aged and elderly Australian men. METHODS: Participants (mean age 59.7 y) with complete data relating to diet and fasting serum inflammatory markers in the Men Androgen Inflammation Lifestyle Environment and Stress cohort were analysed (n = 1577 for CRP, n = 1557 for IL-6)...
July 1, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Said S Moselhy, I H Kamal, Taha A Kumosani, E A Huwait
OBJECTIVE: Coronary artery diseases including atherosclerosis is considered as commonest problem worldwide. Ergosterols are the main components of vegetable oils and nuts. The objective of this study was to evaluate the potential hypoplipidemic and hypocholesterolemic effects of ergosterol in combination with niacin in rats fed high fat diet (HFD). METHODS: Eighty male albino rats were included in this study divided into two main groups: Group I: Normal rats fed standard diet treated with either niacin (8...
March 2016: African Health Sciences
Changting Xiao, Satya Dash, Cecilia Morgantini, Robert A Hegele, Gary F Lewis
Notwithstanding the effectiveness of lowering LDL cholesterol, residual CVD risk remains in high-risk populations, including patients with diabetes, likely contributed to by non-LDL lipid abnormalities. In this Perspectives in Diabetes article, we emphasize that changing demographics and lifestyles over the past few decades have resulted in an epidemic of the "atherogenic dyslipidemia complex," the main features of which include hypertriglyceridemia, low HDL cholesterol levels, qualitative changes in LDL particles, accumulation of remnant lipoproteins, and postprandial hyperlipidemia...
July 2016: Diabetes
John J Albers, April Slee, Jerome L Fleg, Kevin D O'Brien, Santica M Marcovina
BACKGROUND AND AIMS: Previous results of the AIM-HIGH trial showed that baseline levels of the conventional lipid parameters were not predictive of future cardiovascular (CV) outcomes. The aims of this secondary analysis were to examine the levels of cholesterol in high density lipoprotein (HDL) subclasses (HDL2-C and HDL3-C), small dense low density lipoprotein (sdLDL-C), and LDL triglyceride (LDL-TG) at baseline, as well as the relationship between these levels and CV outcomes. METHODS: Individuals with CV disease and low baseline HDL-C levels were randomized to simvastatin plus placebo or simvastatin plus extended release niacin (ERN), 1500 to 2000 mg/day, with ezetimibe added as needed in both groups to maintain an on-treatment LDL-C in the range of 40-80 mg/dL...
August 2016: Atherosclerosis
Marija Vavlukis, Kristina Mladenovska, Arlinda Daka, Aleksandar Dimovski, Saska Domazetovska, Sonja Kuzmanovska, Sasko Kedev
BACKGROUND: There are little evidences about the therapeutic efficacy of different lipid-lowering agents in the reduction of elevated lipoprotein(a) [Lp(a)]. OBJECTIVE: testing the effect of different lipid-lowering agents on elevated Lp(a). METHODS: prospective interventional study performed in patients with CAD, or high CAD risk, with Lp(a), >50 mg/dL. Lp(a), total cholesterol (C), HDL-C, LDL-C, triglycerides (TGs), apolipoprotein (Apo) A1, Apo B, enzymes of myocyte and hepatic injury were comparatively analyzed between 4 lipid-lowering strategies: rosuvastatin (R group) 40 mg, atorvastatin (A group) 80 mg, atorvastatin 40 mg add-on micronized fenofibrate (A+F group), and atorvastatin 40 mg add-on 1 g extended-release niacin (A+ERN group)...
August 2016: Annals of Pharmacotherapy
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