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Nutrients Sep 2022Obesity and dyslipidemia are the main features of metabolic syndrome, expressed mainly by adipose tissue dysfunction and connected by similar pathways and... (Review)
Review
Obesity and dyslipidemia are the main features of metabolic syndrome, expressed mainly by adipose tissue dysfunction and connected by similar pathways and pharmacotherapy. Conventional drugs used in these two associated disorders are limited due to poor drug efficiency, non-specificity, and toxic side effects. Therefore, novel solutions for tackling obesity-associated diseases and providing insights into the development of innovative or improved therapies are necessary. Targeted nanotherapy is a revolutionary technology, offering a promising solution for combatting the disadvantages of currently available therapies for treating obesity and dyslipidemia due to its superior features, which include specific cell targeting, the protection of drugs against physiological degradation, and sustained drug release. This review presents a brief assessment of obesity and dyslipidemia, their impacts on human health, current treatment, and limitations, and the role and potential use of nanotechnology coupled with targeted drug delivery and nutraceuticals as emerging therapies. To the best of our knowledge, this paper presents, for the first time in the literature, a comparison between obesity and dyslipidemia nano-formulations based on drugs and/or natural extracts applied in experimental studies.
Topics: Anti-Obesity Agents; Drug Delivery Systems; Dyslipidemias; Humans; Nanotechnology; Obesity
PubMed: 36145147
DOI: 10.3390/nu14183774 -
Indian Heart Journal Mar 2024Lowering of cholesterol containing atherogenic particles through lipid lowering therapies is of outmost important in both in the elderly age group and younger age group... (Review)
Review
Lowering of cholesterol containing atherogenic particles through lipid lowering therapies is of outmost important in both in the elderly age group and younger age group in reducing the cardiovascular risk. This chapter summarizes the current existing knowledge regarding the factors which affects the key decision-making process in patients with older age, and also in special circumstance where the direct evidence of benefit for cholesterol lowering is lacking. Effort has been made to briefly summarize the recommendations to the patient and his/her family based on risk stratification of atherosclerotic versus non-atherosclerotic cardiovascular disease, comorbidity burden, quality of life, survival prognosis, lifestyle/socioeconomic status and presence of frailty. Here in this chapter, we have collated and presented the available robust clinical trial evidence which is very much necessary for the assessment of risk versus benefit for hypolipidemic drugs in the elderly age group. While plethora of pharmacological interventions has evolved including statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, Inclisiran etc., but it is essential to establish lipid-lowering therapy goals based on the stroke subtype and the presence of comorbidities. Here in this section we have reviewed the collated clinical evidences for optimal drug regimen recommendation for elderly stroke patients for both primary and secondary prevention.
Topics: Female; Male; Humans; Aged; Proprotein Convertase 9; Anticholesteremic Agents; Quality of Life; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Cholesterol; Dyslipidemias; Stroke; Atherosclerosis; Cardiovascular Diseases
PubMed: 38309469
DOI: 10.1016/j.ihj.2024.01.013 -
Jornal Brasileiro de Pneumologia :... Oct 2008This article aims to review the physiopathology, diagnosis and treatment of cystic fibrosis-related dyslipidemia (CFD). Bibliographic searches of the Medline and Latin... (Review)
Review
This article aims to review the physiopathology, diagnosis and treatment of cystic fibrosis-related dyslipidemia (CFD). Bibliographic searches of the Medline and Latin American and Caribbean Health Sciences Literature databases were made (year range, 1987-2007), and the most representative papers on the theme were selected. The characteristic symptoms of CFD are hypertriglyceridemia-with or without hypocholesterolemia-and essential fatty acid deficiency. The principal CFD risk factors are pancreatic insufficiency, high-carbohydrate diet, liver diseases, inflammatory state and corticosteroid therapy. There are no specific recommendations regarding screening, which is typically performed based on the diagnosis, and at regular intervals, and more frequently in individuals belonging to high-risk groups. Treatment includes a balanced diet, micronutrient supplementation, and regular physical exercise according to individual tolerance. In the great majority of the cases, CFD-related hypertriglyceridemia does not reach values for which the use of hypolipidemic drugs is indicated. We conclude that there are few articles in the literature regarding the frequency, etiology and management of CFD. Preventive and therapeutic recommendations for hypertriglyceridemia are extrapolated from studies in individuals without cystic fibrosis. Further research is necessary to investigate the association of essential fatty acid deficiency and the physiopathology of cystic fibrosis . Since hypertriglyceridemia is an important risk factor for coronary artery disease, prospective studies will contribute for a better understanding of the natural history of this condition and define how to prevent and treat it.
Topics: Adolescent; Adult; Child; Cholesterol; Cystic Fibrosis; Dietary Fats; Dyslipidemias; Fatty Acids, Essential; Humans; Hypertriglyceridemia; Lipid Metabolism; Reference Values; Triglycerides; Young Adult
PubMed: 19009217
DOI: 10.1590/s1806-37132008001000012 -
Current Atherosclerosis Reports Jul 2022Patients with non-alcoholic fatty liver disease (NAFLD), often considered as the hepatic manifestation of the metabolic syndrome, represent a population at high... (Review)
Review
PURPOSE OF REVIEW
Patients with non-alcoholic fatty liver disease (NAFLD), often considered as the hepatic manifestation of the metabolic syndrome, represent a population at high cardiovascular risk and frequently suffer from atherogenic dyslipidemia. This article reviews the pathogenic interrelationship between NAFLD and dyslipidemia, elucidates underlying pathophysiological mechanisms and focuses on management approaches for dyslipidemic patients with NAFLD.
RECENT FINDINGS
Atherogenic dyslipidemia in patients with NAFLD results from hepatic and peripheral insulin resistance along with associated alterations of hepatic glucose and lipoprotein metabolism, gut dysbiosis, and genetic factors. Since atherogenic dyslipidemia and NAFLD share a bi-directional relationship and are both major driving forces of atherosclerotic cardiovascular disease (ASCVD) development, early detection and adequate treatment are warranted. Thus, integrative screening and management programs are urgently needed. A stepwise approach for dyslipidemic patients with NAFLD includes (i) characterization of dyslipidemia phenotype, (ii) individual risk stratification, (iii) definition of treatment targets, (iv) lifestyle modification, and (v) pharmacotherapy if indicated.
Topics: Atherosclerosis; Dyslipidemias; Humans; Insulin Resistance; Liver; Non-alcoholic Fatty Liver Disease; Risk Factors
PubMed: 35507279
DOI: 10.1007/s11883-022-01028-4 -
Endokrynologia Polska 2022Nearly 30% of patients with lipid profile abnormalities suffer from secondary dyslipidaemias. Endocrine disorders are one of the most important causes of dyslipidaemia.... (Review)
Review
Nearly 30% of patients with lipid profile abnormalities suffer from secondary dyslipidaemias. Endocrine disorders are one of the most important causes of dyslipidaemia. Dyslipidaemia can be observed in the pathologies of a variety of endocrine glands, including the thyroid, the pituitary, the adrenals, and the gonads. The most common endocrinopathy causing dyslipidaemia is hypothyroidism. In this paper, we review the lipid profile alterations observed in endocrinopathies. We describe changes in classic lipid profile parameters, including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. However, we also focus on the influence of endocrine disorders on relatively new cardiovascular markers such as apolipoprotein B, apolipoprotein A1, and lipoprotein(a). While almost all endocrinopathies cause detrimental changes to the lipid profile, hyperthyroidism seems to be a disorder in which lowering of such parameters as total cholesterol, low-density cholesterol, and triglycerides can be observed. Comprehensive screening for endocrine disorders should always be included in the differential diagnostic process of secondary causes of dyslipidaemia. Early detection and treatment of endocrinopathy have a considerable impact on a patient's health. Proper treatment of those disorders plays a crucial role in modifying the cardiovascular risk and improving the lipid profile of those patients. Even though lipid-lowering therapy is usually still needed, in some cases restoration of hormonal balance might be sufficient to normalize the lipid profile abnormalities.
Topics: Humans; Endocrine System Diseases; Hypothyroidism; Cholesterol, LDL; Triglycerides; Dyslipidemias
PubMed: 35971925
DOI: 10.5603/EP.a2022.0059 -
Nutrients Aug 2021Dyslipidaemias result in the deposition of cholesterol and lipids in the walls of blood vessels, chronic inflammation and the formation of atherosclerotic plaques, which... (Review)
Review
Dyslipidaemias result in the deposition of cholesterol and lipids in the walls of blood vessels, chronic inflammation and the formation of atherosclerotic plaques, which impede blood flow and (when they rupture) result in acute ischaemic episodes. Whilst recent years have seen enormous success in the reduction of cardiovascular risk using conventional pharmaceuticals, there is increasing interest amongst patients and practitioners in the use of nutraceuticals to combat dyslipidaemias and inflammation in cardiovascular disease. Nutraceutical is a portmanteau term: 'ceutical' indicate pharmaceutical-grade preparations, and 'nutra' indicates that the products contain nutrients from food. Until relatively recently, little high-quality evidence relating to the safety and efficacy of nutraceuticals has been available to prescribers and policymakers. However, as a result of recent randomised-controlled trials, cohort studies and meta-analyses, this situation is changing, and nutraceuticals are now recommended in several mainstream guidelines relating to dyslipidaemias and atherosclerosis. This article will summarise recent clinical-practice guidance relating to the use of nutraceuticals in this context and the evidence which underlies them. Particular attention is given to position papers and recommendations from the International Lipid Expert Panel (ILEP), which has produced several practical and helpful recommendations in this field.
Topics: Dietary Supplements; Dyslipidemias; Humans
PubMed: 34578834
DOI: 10.3390/nu13092957 -
Diabetologia May 2015Cardiovascular disease is a major cause of morbidity and mortality in patients with type 2 diabetes mellitus, with a two- to fourfold increase in cardiovascular disease... (Review)
Review
Cardiovascular disease is a major cause of morbidity and mortality in patients with type 2 diabetes mellitus, with a two- to fourfold increase in cardiovascular disease risk compared with non-diabetic individuals. Abnormalities in lipid metabolism that are observed in the context of type 2 diabetes are among the major factors contributing to an increased cardiovascular risk. Diabetic dyslipidaemia includes not only quantitative lipoprotein abnormalities, but also qualitative and kinetic abnormalities that, together, result in a shift towards a more atherogenic lipid profile. The primary quantitative lipoprotein abnormalities are increased triacylglycerol (triglyceride) levels and decreased HDL-cholesterol levels. Qualitative lipoprotein abnormalities include an increase in large, very low-density lipoprotein subfraction 1 (VLDL1) and small, dense LDLs, as well as increased triacylglycerol content of LDL and HDL, glycation of apolipoproteins and increased susceptibility of LDL to oxidation. The main kinetic abnormalities are increased VLDL1 production, decreased VLDL catabolism and increased HDL catabolism. In addition, even though LDL-cholesterol levels are typically normal in patients with type 2 diabetes, LDL particles show reduced turnover, which is potentially atherogenic. Although the pathophysiology of diabetic dyslipidaemia is not fully understood, the insulin resistance and relative insulin deficiency observed in patients with type 2 diabetes are likely to contribute to these lipid changes, as insulin plays an important role in regulating lipid metabolism. In addition, some adipocytokines, such as adiponectin or retinol-binding protein 4, may also contribute to the development of dyslipidaemia in patients with type 2 diabetes.
Topics: Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dyslipidemias; Humans; Lipids
PubMed: 25725623
DOI: 10.1007/s00125-015-3525-8 -
Pediatric Clinics of North America Dec 2011Cardiovascular disease is the leading cause of death in the United States despite a reduction in mortality over the past 4 decades. Much of this success is attributed to... (Review)
Review
Cardiovascular disease is the leading cause of death in the United States despite a reduction in mortality over the past 4 decades. Much of this success is attributed to public health efforts and more aggressive treatment of clinical disease. The rising rates of obesity and diabetes, especially among adolescents and young adults, raise concern for increases in mortality. National vital statistics have shown a leveling of cardiovascular disease death rates in the fifth decade of life. Public health efforts have begun to address childhood obesity. This article reviews the dyslipidemia associated with obesity in childhood and outlines a proposed approach to management.
Topics: Adolescent; Algorithms; Child; Child, Preschool; Comorbidity; Diet; Dyslipidemias; Exercise; Female; Humans; Hypolipidemic Agents; Life Style; Male; Metabolic Syndrome; Obesity; Prevalence; United States
PubMed: 22093856
DOI: 10.1016/j.pcl.2011.09.003 -
Indian Heart Journal 2017Dyslipidemia is the most important atherosclerotic risk factor. Review of population based studies in India shows increasing mean total cholesterol levels. Recent... (Review)
Review
Dyslipidemia is the most important atherosclerotic risk factor. Review of population based studies in India shows increasing mean total cholesterol levels. Recent studies have reported that high cholesterol is present in 25-30% of urban and 15-20% rural subjects. This prevalence is lower than high-income countries. The most common dyslipidemia in India are borderline high LDL cholesterol, low HDL cholesterol and high triglycerides. Studies have reported that over a 20-year period total cholesterol, LDL cholesterol and triglyceride levels have increased among urban populations. Case-control studies have reported that there is significant association of coronary events with raised apolipoproteinB, total cholesterol, LDL cholesterol and non-HDL cholesterol and inverse association with high apolipoproteinA and HDL cholesterol. Prevalence of suspected familial hypercholesterolemia in urban subjects varies from 1:125 to 1:450. Only limited studies exist regarding lipid abnormalities in children. There is low awareness, treatment and control of hypercholesterolemia in India.
Topics: Dyslipidemias; Humans; India; Lipids; Morbidity
PubMed: 28648438
DOI: 10.1016/j.ihj.2017.02.020 -
BMC Pediatrics Feb 2021Down syndrome (DS) is associated with various congenital anomalies and metabolic alterations, such as dyslipidemias, that can lead to cardiovascular disease in...
INTRODUCTION
Down syndrome (DS) is associated with various congenital anomalies and metabolic alterations, such as dyslipidemias, that can lead to cardiovascular disease in adulthood. This study was designed to describe the lipid concentrations and the frequency of dyslipidemias in children with DS.
MATERIALS AND METHODS
The sample included 386 patients, 52.4% male. The study was carried out on children with DS, aged 2-18 years old, who were patients at the Mexican National Institute of Pediatrics between May 2016 and June 2017. Their height and weight were recorded, and their serum cholesterol, HDL cholesterol, and triglyceride levels were determined.
RESULTS
Of the total patients included, 57.5% had some type of dyslipidemia, 32.6% isolated and 24.9% combined. The most common alteration, considering both isolated and combined dyslipidemias, was low HDL, in 45.9%, followed by hypertriglyceridemia, in 26.2%. Among those with combined dyslipidemia, high TG with low HDL-c was the most common, in 17.9%. A significant association was found between dyslipidemia and obesity, as well as between dyslipidemia and central obesity. The percentiles of lipid values are reported.
CONCLUSION
The presence of an unfavorable lipid profile is common in pediatric patients with Down syndrome, especially low HDL cholesterol and high triglycerides.
Topics: Adolescent; Adult; Child; Child, Preschool; Cholesterol, HDL; Down Syndrome; Dyslipidemias; Female; Humans; Lipids; Male; Mexico; Risk Factors; Triglycerides
PubMed: 33581717
DOI: 10.1186/s12887-021-02542-1