Dyslipidemia

Androgenic-Anabolic Steroids (AAS) abuse is known to play an important role in causing the systemic inflammatory response and multiple-organ dysfunction in healthy individuals. Although many of the undesirable effects of steroid abuse have been reported, at present, little is known about the effect of anabolic supplements and the correlation between cardiac and metabolic pathology. This paper presents a case of a 25 year old patient with a complex medical history after 6 months of steroid administration. Myocardial infraction, dyslipidemia, obesity, hyperuricemia, secondary diabetes, and chronic renal disease were identified after clinical and para-clinical examinations. The particularities of this case were interpreted in the context of a literature review, highlighting the effect of multi-organ damage as a result of the uncontrolled use of anabolic steroid supplements.

Metabolic syndrome (MetS) is a cluster of diseases comprising of obesity, diabetes mellitus, dyslipidemia, and hypertension. There are numerous pre-clinical as well as human studies reporting the protective effects of honey against MetS. Honey is a nutritional food low in glycemic index. Honey intake reduces blood sugar levels and prevents excessive weight gain. It also improves lipid metabolism by reducing total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and increasing high-density lipoprotein (HDL), which leads to decreased risk of atherogenesis. In addition, honey enhances insulin sensitivity that further stabilizes blood glucose levels and protects the pancreas from overstimulation brought on by insulin resistance. Furthermore, antioxidative properties of honey help in reducing oxidative stress, which is one of the central mechanisms in MetS. Lastly, honey protects the vasculature from endothelial dysfunction and remodelling. Therefore, there is a strong potential for honey supplementation to be integrated into the management of MetS, both as preventive as well as adjunct therapeutic agents.

Recent studies have reported that globally, more than 1.9 billion adults are overweight and 650 million
are obese. Approximately 2.8 million deaths are reported as a result of being overweight or obese. Due to
the consumption of energy dense food (i.e. unhealthy food habits), sedentary life style, lack of health care
services and financial support, the developing countries are facing high risk of obesity and their adverse
consequences (i.e. diabetes, ischemic heart disease, etc). In India, more than 135 million individuals were
affected by obesity. The prevalence of obesity in India varies due to age, gender, geographical environment,
socio-economic status, etc. According to ICMR-INDIAB study 2015, prevalence rate of obesity and
central obesity are varies from 11.8% to 31.3% and 16.9%e36.3% respectively. In India, abdominal obesity is
one of the major risk factors for cardiovascular disease (CVDs). Various studies have shown that the
prevalence of obesity among women were significantly higher as compared to men. Obesity is one of the
main medical and financial burdens for the government. This problem of obesity can be preventable by
spreading public awareness about obesity and its health consequences. Governmental agencies should
promote the benefits of healthy life style, food habits and physical activity. The aim of this article is to
report the prevalence of obesity in different regions of India and highlight the problem areas.

OBJECTIVE:
Overproduction of hepatic apolipoprotein B (apoB)-100 containing very low-density lipoprotein particles and intestinal apoB-48 containing chylomicrons contributes to hypertriglyceridemia seen in conditions such as obesity and insulin resistance. Some, but not all, preclinical and clinical studies have demonstrated that the polyphenol resveratrol ameliorates insulin resistance and hypertriglyceridemia. Here, we assessed intestinal and hepatic lipoprotein turnover, in humans, after 2 weeks of treatment with resveratrol (1000 mg daily for week 1 followed by 2000 mg daily for week 2) or placebo.
APPROACH AND RESULTS:
Eight overweight or obese individuals with mild hypertriglyceridemia were studied on 2 occasions, 4 to 6 weeks apart, after treatment with resveratrol or placebo in a randomized, double-blinded, crossover study. Steady-state lipoprotein kinetics was assessed in a constant fed state with a primed, constant infusion of deuterated leucine. Resveratrol treatment did not significantly affect insulin sensitivity (homeostasis model of assessment of insulin resistance), fasting or fed plasma triglyceride concentration. Resveratrol reduced apoB-48 production rate by 22% (P=0.007) with no significant effect on fractional catabolic rate. Resveratrol reduced apoB-100 production rate by 27% (P=0.02) and fractional catabolic rate by 26% (P=0.04).
CONCLUSIONS:
These results indicate that 2 weeks of high-dose resveratrol reduces intestinal and hepatic lipoprotein particle production. Long-term studies are needed to evaluate the potential clinical benefits of resveratrol in patients with hypertriglyceridemia, who have increased concentrations of triglyceride-rich lipoprotein apoB-100 and apoB-48

Treatment of cognitive disorders is a challenging task in neurology since long time. Crataegus oxyacantha, also known as hawthorn belongs to family Rosaceae grew in colder areas and is one of the most widely used herb for the treatment of heart disorders. Traditionally Crataegus oxyacantha has also been used to treat Alzheimer disease, nervousness, stress, pain, and sleep disorders. In this study nootropic activity of petroleum ether, chloroform and methanol extract of Crataegus oxyacantha leaves was assessed using elevated plus maze model. Scopolamine (1 mg/kg) was used as amnesia-inducing agent and piracetam (120 mg/ kg) as standard nootropic drug. On the last day of the experiment, biochemical parameters like acetylcholinesterase, lipid peroxidase, and superoxide dismutase were measured in brain homogenate.EffectofCrataegusoxyacanthaonmonoamines mediated behaviour was assessed through lithium-induced head twitches and haloperidol-induced catalepsy model in rats. Among all three extracts, methanol extract of Crataegus oxyacantha caused the highest reduction in transfer latency time significantly as measured on the 7th and 14th day and on 8th and 15th day on elevated maze and also decreased acetylcholinesterase and lipid peroxidase level and increased superoxide dismutase content as compared to scopolamine group. Methanol extract of Crataegus oxyacantha (200 mg/kg and 400 mg/kg) decreased number of head twitches and duration of catalepsy in rats significantly compared to vehicle-treated group. So our study showed promising effect of Crataegus oxyacantha in enhancing learning and memory due to the presence of certain phytoconstituents.

BACKGROUND: Elevated apolipoprotein C-III (apoC-III) has been postulated to contribute to the atherogenic dyslipidemia seen in obesity and insulin-resistant states, mainly by impairing plasma triglyceride-rich lipoprotein (TRL) metabolism. Bariatric surgery is associated with improvements of several obesity-associated metabolic abnormalities, including a reduction in plasma triglycerides (TGs) and an increase in plasma high-density lipoprotein cholesterol (HDL-C). OBJECTIVES: We investigated the specific effect of bariatric surgery on apoC-III concentrations in plasma, non-HDL, and HDL fractions in relation to lipid profile parameters evolution. METHODS: A total of 132 obese subjects undergoing bariatric surgery, gastric bypass (n 5 61) or sleeve gastrectomy (n 5 71), were studied 1 month before surgery and 6 and 12 months after surgery. RESULTS: Plasma apoC-III, non-HDL-apoC-III, and HDL-apoC-III concentrations were markedly reduced after surgery and strongly associated with reduction in plasma TG. This decrease was accompanied by a redistribution of apoC-III from TRL to HDL fractions. In multivariate analysis, plasma apoC-III was the strongest predictor of TG reduction after surgery, and the increase of HDL-C was positively associated with plasma adiponectin and negatively with body mass index. CONCLUSION: Marked reduction of apoC-III and changes in its distribution between TRL and HDL consistent with a better lipid profile are achieved in obese patients after bariatric surgery. These apoC-III beneficial modifications may have implications in dyslipidemia improvement and contribute to car-diovascular risk reduction after surgery.

Bisphenol-A (BPA) and its analog are extensively utilized in the production of plastics which are rather ubiquitous in our environment. At high temperatures, BPA is leached into water and food packed in plastic containers. This research investigated the ameliorative effects of CMSO on adipokines dysfunction and dyslipidemia in male Wistar rats exposed to Bisphenol-A. thirty-six (36) albino rats weighing 100 - 200 g were randomly assigned into six (6) different experimental groups of controls (1, 2, and 3) and the tests (4, 5, and 6). Group 1 was given only 1 ml of olive oil, group 2 received 100 mg/Kg body weight (b.w) of BPA, group 3 was given 7.5 ml/Kg b.w of CMSO, groups 4, 5, and 6 received 100 mg/Kg b.w of BPA and 7.5, 5 and 2.5 mg/Kg b.w of CMSO respectively. CMSO and BPA were concurrently administered via oral intubation for periods of 42 days. Lipid profile and adipokines levels were determined in plasma and adipose tissue. BPA in male rats significantly (p<0.05) elevated...

Background and Aims: Androgen deprivation has been shown to be associated with dyslipidemia. Ameliorative
effect of Vitamin C on dyslipidemia has also been reported. This study aimed at investigating the role of Vitamin
C supplementation in castration‑induced dyslipidemia.
Materials and Methods: Twenty male rats were randomly divided in a blinded fashion into 4 groups (n = 5 each):
Groups I and II were sham‑castrated and received normal saline (1 ml/kg) and 1.25 g/kg Vitamin C, respectively,
whereas Groups III and IV were rendered bilaterally castrated and received normal saline (1 ml/kg) and 1.25 g/kg
Vitamin C for 4 weeks.
Results and Conclusions: Castrated rats had reduced high‑density lipoprotein, testosterone, estradiol, but
increased low density lipoprotein, triglycerides, total cholesterol, and Castelli index and had no effect on
follicle stimulating hormone when compared to sham‑operated rats. Vitamin C supplements improved these
parameters in normal and castrated rats. This study showed that castration‑associated dyslipidemia and
atherogenic risk in male rats is dependent on testosterone and estradiol. In addition, Vitamin C improves
these parameters in normal and castrated rats by increasing testosterone and estradiol production, possibly
from extra‑testicular sites. However, there is a need for further study to ascertain the actual extra‑testicular
testosterone and estradiol production site.

Polycystic ovary syndrome (PCOS) is a diagnosis of exclusion and an important interdisciplinary problem. New recommendations for PCOS management were presented to the world in 2018. These recommendations have been developed by the CREPCOS (Australia), ESHRE, ASRM, and more than 30 other organizations. This document based on evidence-based medicine data and replaces previous recommendations for the PCOS management 2011. This article presents a translation of only one section of recommendations on the PCOS pharmacotherapy. It is also presents the results of the combined oral contraceptive Belara used for hyperandrogenic conditions.

The advantages of chlormadinone acetate, as a part of this drug, are that this progestin is a derivative of natural progesterone, and it is the only progestin with antiandrogenic effects with no cumulative dose (i.e., chlormadinone acetate has long-term predicted effect). Belara has a minimal risk of thromboembolic complications among other combined oral contraceptives, even in risk groups. The clinical efficacy of Belara in acne, seborrhea, and hyperandrogeny has been confirmed in numerous studies. In women taking this drug, a free testosterone decreased to the physiological level. The drug safety is also noted for fat and carbohydrate metabolism, which is reflected in a decrease of visceral fat.

Every day there is an increasing data on the approaches in the PCOS diagnosis, treatment and prevention, therefore the strategies will be changed in the near future; it is possible that the name of this state will change in the future. A thorough study of PCOS is the key to resolving issues related to metabolic syndrome, diabetes mellitus and intermediate-vascular diseases, i.e. conditions that directly affect the life duration and quality.

"Background. Treatment of hyperlipidemia is helpful in both primary and secondary prevention of coronary heart disease and stroke. Aim. To compare lipid-lowering efficacy of rosuvastatin with atorvastatin. Methodology. This open-label randomized controlled trial was carried out at 1 Mountain Medical Battalion from September 2012 to August 2013 on patients with type 2 diabetes, hypertension, myocardial infarction, or stroke, meriting treatment with a statin. Those with secondary causes of dyslipidemia were excluded. Blood samples for estimation of serum total cholesterol, triglycerides, HDL-C, and LDL-C were collected after a 12-hour fast. Patients were randomly allocated to receive either atorvastatin 10 mg HS or rosuvastatin 5 mg HS daily. Lipid levels were rechecked after six weeks. Results. Atorvastatin was used in 63 patients and rosuvastatin in 66. There was a greater absolute and percent reduction in serum LDL-C levels with rosuvastatin as compared to atorvastatin (0.96 versus 0.54 mg/dL; P= 0.011and 24.34 versus 13.66%;P = 0.045), whereas reduction in all other fractions was equal. Myalgias were seen in 5 (7.94%) patients treated with atorvastatin and 8 (12.12%) patients treated with rosuvastatin (P: 0.432). Conclusion. Rosuvastatin produces a greater reduction in serum LDL-C levels and should therefore be preferred over atorvastatin."

Lipid abnormalities are major risk factors for premature coronary artery diseases. We investigated serum lipids and
the prevalence of dyslipidemia in urban adult population in Warangal district of Andhra Pradesh. We studied 1496
individuals 20–90 years of age. Health status was determined by questionnaires and physical check-ups. Total
cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and total triglycerides (TGs) were measured. TC
>5.7 mmol/L, LDL-C >3.6 mmol/L, TGs >1.7 mmol/L, and HDL-C <0.9 mmol/L were defined as abnormal. Mean
serum TC, LDL-C, and TG concentrations were increased. 52.7% of males and 42.9% of females having at least one
abnormal lipid concentration. HDL-C was abnormally low in 7% of males and in 1.6% of females. The prevalence of
hypercholesterolemia, hypertriglyceridemia and abnormally low HDL-C, especially the presence of slight
hypertriglyceridemia, were higher in all age groups. The increase was most prominent in the middle age group (40–
59 years). Hypercholesterolemia, hypertriglyceridemia and abnormally low HDL-C have increased considerably over
the past 10 years in urban adult populations in Warangal district, Andhra Pradesh. Dietary changes and less physical
activity resulting from rapid improvements in living conditions may be the causes for the increases. Enhanced
preventive measures should be undertaken to modify these situations.

Background - The concept of psychosomatic medicine has gained popularity, with yoga racing ahead in the field. The present study was conducted to assess the effectiveness of yoga as an intervention in the management of patients with Type 2 diabetes mellitus complicated with hypertension. Method - This study was carried out in 2005 in Medical College Trivandrum, Kerala, India among 100 hypertensive Type 2 diabetics. They were randomized into control and yoga groups. The yoga group practiced yoga daily for one hour and given oral hypoglycemic drugs for 3 months. The control group did not perform yogic exercises but given oral hypoglycemic drugs. Comparisons were drawn between systolic blood pressure (SBP), diastolic blood pressure (DBP), Fasting blood sugar (FBS) and post prandial blood sugar (PPBS) in both the groups at the start and at the end of 3 months. Paired and unpaired t tests were performed. Results - After intervention with yoga for 3 months the study group showed a signifi...

Background and Aim: Adropin is a hormone encoded by the Enho gene, which is associated with energy homeostasis. Preclinical studies using animal models have shown that adropin plays a role in enhancing glucose homeostasis and dyslipidemia. Lately, several studies on animal models have been performed to examine the therapeutic and pathophysiological effects of adropin in many disorders. The aim of this systematic review was to identify the ideal adropin dose in mice and rat animal models.

Materials and Methods: We systematically searched PubMed, Science Direct, and Scopus databases from 2008 to 2020. The terms used in the search were "adropin," "adropin doses in animal models," "glucose homeostasis related to adropin," and "adropin therapeutic effects on rats and mice." Articles that included non-adropin doses, in vitro studies, and factors affecting adropin levels were excluded from the study.

Results: Of the total 179 qualified studies, six studies were included. We found that a daily injection of 450 nmol/kg of adropin for 3 days might be considered the optimum dose of effect in mice, whereas injection of 2.1 μg/kg once a day for 10 successive days might be the optimal effective dose in rats.

Conclusion: Additional investigations are needed to determine the optimum dose of adropin to be used as a therapeutic intervention depending on the animal model.

We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria.
There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99mhuman
serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of
communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day)
was administered during hospitalization. Chyluria was decreased within a few days following
the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range
proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary
tract three months later. In our patient, therapeutic intervention by ezetimibe may have
resulted in a reduction of chylous lymph absorption from the intestine and the prevention of
mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe
may be an effective and safe treatment for this indication, and should be considered when
filarial patients present with chyluria and massive proteinuria before employing invasive surgical
procedures.

Even though plants containing the alkaloid berberine have been used in Ayurvedic and Chinese medicine for over 2500 years, berberine's potential cardiovascular and metabolic effects have been studied only in the recent past. The objective of this review is to summarize the effects and possible mechanisms of action of berberine when applied to various aspects of the cardiovascular system. Evidence is presented from experimental studies, clinical trials, and meta-analyses accessed via PubMed. Further research is needed, particularly clinical trials, but a growing body of evidence suggests an important role for berberine in the treatment of dyslipidemia, type 2 diabetes, and metabolic syndrome.

Dyslipidemia is a risk factor causing cardiovascular disease and compliance to dietary counselling results in an improved lipid profile. The present study aimed to assess the compliance to dietary counselling and its barriers among dyslipidemic individuals attending dietary follow-ups counselling in Diet Clinic of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A cross sectional study using the convenience sampling technique was conducted from May to June 2012. Data on food intake, lifestyle habits, physical activity level and barriers in adhering to dietary counselling were collected using interview-based questionnaires. Anthropometric measurements were conducted, while blood lipid profile and medical information were obtained from medical records. The results showed that non-compliance is prevalent among dyslipidemic patients who received dietary counselling. Most subjects (81%) were unable to achieve at least four of the therapeutic lifestyle change dietary recommendations as outlined by National Cholesterol Education Program Adult Treatment Panel III. Factors such as time, food taste and price have been reported as the main barriers to comply towards dietary counselling. A significantly higher proportion of those in non-compliance group did not meet total fat (p < 0.001) and saturated fat (p < 0.001) recommendations as compared to the compliance group. In conclusion, acknowledgements of barriers while providing dietary education are necessary to improve dyslipidemic patients' compliance with controlling blood lipid.

Currently, statins are the first-line therapies for dyslipidemia and atherosclerotic cardiovascular disease, however, their hypolipidemic effects have not been satisfactory. We performed a meta-analysis to compare lipid-lowering efficacy and safety of ezetimibe and statin combination therapy with double-dose statin monotherapy in patients with high cardiovascular risk. Fourteen studies involving 3105 participants were included in the final analysis; 1558 (50.18%) participants received ezetimibe and statin combination therapy and 1547 (49.82%) received double-dose statin monotherapy. Eight studies reported the percentages of changes in several lipid parameters from baseline to endpoint in both groups. Lipid parameters changed more significantly in patients coadministered with ezetimibe and statin (low-density lipoprotein cholesterol [LDL-C]: MD =-9.39, 95% CI-13.36 to-5.42; non-high-density lipoprotein cholesterol [non-HDL-C]: MD =-10.36, 95% CI-14.23 to-6.50; total cholesterol [TC]: MD =-8.11, 95% CI-10.95 to-5.26; and triglyceride [TG]: MD =-5.96, 95% CI-9.12 to-2.80), with moderate to high heterogeneity among the studies. Two out of fourteen studies investigated several different statins. Our subgroup analysis showed that, compared with double-dose atorvastatin monotherapy, ezetimibe and atorvastatin combination therapy significantly decreased LDL-C, non-HDL-C, TC, and TG levels by 14.16%, 14.01%, 11.06%, and 5.96%, respectively (p < 0.001). No significant difference was found in the incidence of laboratory-related adverse events (AEs) between statin combination therapy and monotherapy. Overall, ezetimibe and statin combination therapy significantly decreased LDL-C, non-HDL-C, and TC levels in patients with high cardiovascular risk, among which ezetimibe combined with atorvastatin had the best therapeutic effect. Compared with ezetimibe and statin combination therapy, double-dose statin monotherapy did not increase the risk of AEs.

Background: Atherosclerosis is a chronic, multifactorial and insidious disease that can begin in childhood and adolescence, and whose major consequences appear during adulthood. Serum levels of lipoproteins, such as LDL-c, total cholesterol (TC), HDL-c, and non-HDL-c can be used as a screening method for disease diagnosis. In Brazil, few studies have correlated the serum levels of those lipoproteins with age.

Background: The aim of this study was to examine the role of C-peptide as a biological marker of cardiometabolic risk in polycystic ovary syndrome (PCOS).

Methods: This case-control study enrolled 385 PCOS patients and 240 normal cycling women. Anthropometric and clinical variables were taken at first visit. Fasting C-peptide, glucose, lipids, and hormone measurements were performed. Simple and multiple correlations between C-peptide and other variables associated with dysmetabolism and cardiovascular disease were examined.

Results: C-peptide was well correlated with several anthropometric, metabolic, and endocrine parameters. In PCOS patients, stepwise multiple regression including C-peptide as the criterion variable and other predictors of cardiovascular disease risk provided a significant model in which the fasting C-peptide/glucose ratio, glucose, body weight, and free estrogen index (FEI) were retained (adjusted R2 = 0.988, F = 7.161, P = 0.008).

Conclusion: C-peptide levels alone or combined with C-peptide/glucose ratio, glucose, body weight, and FEI provided a significant model to identify PCOS patients with higher risk of future cardiometabolic diseases.

Background: Subclinical hypothyroidism is defined as a serum TSH concentration above the upper limit of the reference range when serum T3 and T4 concen-trations are within reference ranges. Subclinical thy-roid disease is a laboratory diagnosis. Patients with subclinical disease have few or no definitive clinical signs or symptoms of thyroid dysfunction. It has been associated with higher levels of some cardiovascular risk factors. Despite some conflicting results, many studies have found that subjects with subclinical hy-pothyroidism have total cholesterol and low density li-poprotein cholesterol levels higher than euthyroid sub-jects. The association between subclinical hypothyroid-ism and dyslipidemia is well known. Aims and Objec-tives: This study is an attempt to find the importance of Low Density Lipoprotein – Cholesterol / Higher Den-sity Lipoprotein- Cholesterol (LDL-C/HDL-C) ratio rather than measurement of individual lipid profile pa-rameters in bringing to light the dysli...

Background: Diabetes is an important public health problem as global prevalence of diabetes has nearly doubled reflecting an increase in risk factors like overweight or obesity and dyslipidemia. Both obesity and dyslipidemia share a common pathogenesis associated with “insulin resistance”. Thus the aim of this study is to find out correlation between BMI and lipid profile in type 2 diabetics. Materials and Methods: A cross-sectional study was conducted among 136 type 2 diabetes patients visiting the Diabetes Clinic of College of Medical Sciences, Bharatpur, Nepal during Jan-Dec 2017 and who went through lipid profile testing. The informations were taken from hospital records. To find the significant association between categorical variables chi-square test was used. P-value less than 0.05 were considered as statistically significant. To find the association between continuous variables correlation was used. Results: Out of 136 diabetic patients 77.2% of patients were either overweight or obese. 92.6% of patients had dyslipidemia. Among which 58.1% had high TG levels, 56.6% had high LDL levels, 34.6% had high TC levels and 44.9% had low HDL levels. The overall mean ± SD of age was 54.54±12.03 years and of BMI was 28.54±4.57. Positive correlation was seen between BMI with LDL levels and negative correlation with HDL levels. The correlation with other lipid profile parameters were negative. These correlations were found to be statistically not significant. But statistically significant association was seen between gender with weight, total cholesterol and HDL levels. Conclusions: Obesity and dyslipidemia were highly prevalent. As BMI increases LDL levels increases and HDL levels decreases. Also increased weight and abnormal lipid levels of total cholesterol and HDL were found significantly higher among females than males.

Background: Previous reports showed lack of consensus on the possible etiology of coronary artery disease (CAD) between
HIV-treatment with highly active antiretroviral therapy (HAART) and HIV-infection in particular. The aim of this
study was to find out correlations of HIV-treatment and HIV-infection with CAD risk.
Method: One hundred and twenty (120) participants involving HIV-patients on treatment (n = 40), treatment-naïve (n =
40) and equal number of age- and sex-matched controls were enrolled. The total cholesterol, triglycerides and lipoprotein
(HDL-C) were analyzed using spectrophotometry. The LDL-C was calculated using Friedewald equation, TC/HDL-C and
LDL-C/HDL-C ratios were also calculated. The CD4+ cell count was determined using flow cytometry.
Result: The mean plasma total cholesterol levels in patients’ groups on treatment and treatment-naïve were significantly
reduced when compared with controls, but the mean triglyceride levels for both treatment and the treatment-naïve groups
were significantly increased when compared with controls. However, HDL-C and LDL-C values for patients on HAART
and the treatment-naive were significantly reduced when compared with controls respectively. The CAD risk predictors,
LDL-c and TC/HDL-C ratio, were significantly increased in patients on HAART when compared with the treatment-naive.
The mean CD4+ cell count in treatment-naive was significantly lowered against both groups for treatment and controls.
Conclusion: In this present study, abnormal lipid profile was associated with both HIV-infection and HAART-treatment.
However, TC/HDL-C ratio, the strong predictor of CAD events in metabolic disorder was markedly high in HAARTtreatment
and the associated difference may threaten higher risk for cardiovascular disease (CVD) during treatment.

Dysregulated lipid and cholesterol homeostasis in the body, and particularly in the brain,has been demonstrated in neurodegenerative diseases such as Alzheimer’s disease (AD), as well as Parkinson’s disease (PD) and Huntington’s disease (HD). These changes in
lipidmetabolismmay be a consequence of the disease process, or part of the pathogenic mechanism, or both. More importantly perhaps, with respect to AD, is the mounting evidence that dyslipidaemia helps to drive production or reduce clearance of Aβ, the amyloidogenic peptide believed to be central in AD pathogenesis. Furthermore, other
dyslipidaemia-related conditions have also been linked to AD pathogenesis, including obesity, hypertension, inflammation, insulin resistance, and type 2 diabetes. Apart from advancing age, the carriage of one or two copies of the APOE 𝜀4 alleles is one of the
biggest risk factors for developing late-onset (sporadic) AD. The product of this gene is apoE, a protein involved in the transport of lipids. Possession of APOE 𝜀4 alleles also predisposes individuals to a higher risk of cardiovascular disease. Here we discuss lipid
and cholesterol metabolism, and we give an overview of the various lipid and cholesterol metabolic pathways and changes that have been linked toAD, particularly the influence of the different forms of apoE on lipid, cholesterol, and Aβ metabolism.

Objective: To survey the incidence of clinical risk markers and its correlation with established clinical measurements for
cardiovascular disease (CVD) in a heterogeneous spinal cord injured (SCI) patient population.
Design: Descriptive, cross-sectional study.
Subjects: 78 patients with SCI, at different injury and functional level.
Methods: Anthropometric data, blood pressure, a blood lipid panel, blood glucose and a questionnaire were analyzed.
Results: Eighty-one percent of all patients had dyslipidemia (DL) and a majority of the patients with abdominal measures
below the recommended cut-off levels had DL. Self-reported physical activity above the cut-off level was reported by 32.1%
of the patients. There were no differences in clinical measures, serum lipid values and blood glucose between physically
active and not active patients. No differences were seen between men/women, tetraplegia/paraplegia and wheelchair dependent/not
wheelchair dependent patients.
Conclusion: DL is common and seems to be not treated or undertreated in the studied SCI patient group with different neurological
lesion and functional levels. General anthropometric clinical measures do not seem to be valid for evaluating risk
for CVD in this patient group.

Objective: This study was done to assess the accuracy of Accutrend GCT meter in determining blood cholesterol levels in our setup, with an aim to recommend its use in clinical practice
Methods: This cross sectional study was conducted on 251 healthy volunteers from April to May 2013. Capillary whole blood samples were obtained using sterile lancets and cholesterol levels were measured using Accutrend GCT meter (Roche Diagnostics, Mannheim, Germany) using the standard technique. Three ml whole blood was also collected in plain tubes by the same operator without applying a tourniquet. Serum cholesterol levels were determined using Merck Microlab 300 Automated Clinical Chemistry Analyser the same day. The laboratory technician performing this test was blinded to results obtained with Accutrend GCT meter. The seven patients with readings beyond the analytic range of the Accutrend GCT meter were excluded, meaning that data analysis was performed on 244 results only.
Results: Results of 182 males and 62 females having a mean age of 38.54± 15.25 years were analysed. There was a significant difference in mean cholesterol levels measured by Accutrend GCT and Microlab-300 (4.73± 0.74mmol/l and 4.67± 0.86 mmol/l; p=0.021), producing a measurement bias of 1.43% with Accutrend GCT meter. A strong positive correlation was found between the results of the two techniques (r=0.852 ,p<0.001).
Conclusions: Accutrend GCT meter provides accurate measurement of blood cholesterol levels and its use should be encouraged for point-of-care measurements.

Amyotrophic lateral sclerosis (ALS) is typically characterized by adult-onset degeneration of the upper and lower motor neurons in mostly male patients, and is usually fatal within 2 to 5 years and is by definition a progressive disease. Only one drug, riluzole, has been approved to treat ALS, which typically provides only a gain of survival of a few months. The exact etiology of ALS isn't known. However most researchers suggest, that ALS increases inflammation and increases cellular stress so that arriving stem cells and local stem cells cannot differentiate into functional nerve cells: ALS shares on a genetic level many similarities with cancer resistance and supports the view that tissue repair and cancer are related. Deteriorating general immunity in nerve cells causes dementia, mental stress, and anxiety. A fermented soy formulation (FSWW08) has been shown to improve local and general immunity in cancer patients and reduces stress on the molecular as well as a clinical level: FSWW08 improved on the genetic molecular level MAPkinase, c-Jun, and NF-kB, which are impaired in ALS patients. A 50 year old man diagnosed two years ago with ALS in the neck was given one month later over a two year period standard therapy, standard physical care, riluzole antiinflammatory drugs, oxybutynin for urge incontinence, and additionally FSWW08. Three month before being diagnosed with ALS; the patient suffered from severe mood swings (anxiety disorders but not depression), which were treated by a psychiatrist. The patient complained about severe sleeping disorders at that time. Improvement of mental and physical well-being of FSWW08 was documented by two questionnaires specifically developed for ALS (Amyotrophic Lateral Sclerosis-Frontotemporal Dementia-Questionnaire [ALS-FTD-Q]) and a quality of life questionnaire from the ESQR questionnaires. The progress of local muscle impairment in the neck, which caused the disease, was stopped after 2 month of consumption of FSWW08, as well as breathing being stabilized at a low, but stable levels above the defined level for obstructive disease. Strong on/off fluctuations of ALS symptoms were observed and documented with the consumption of FSWW08, standard medication was continued and had no effect on on/off motor functions of ALS. When the consumption of the FSWW08 was stopped motor dysfunctions of the arms reappeared within two weeks and the patient lost his ability to speak. When consumption of FSWW08 was resumed the disturbances disappeared within 7 days. Additionally it was observed that immune disturbances, hay fever and usual infections during winter, were completely eliminated. Under FSWW08, mental stress and anxiety was reduced, accompanied by a normal sleeping pattern at night and increased energy levels, which caused increased physical activity. Patient reported improved breathing, documented by stable FVW. The patient exhibited a normalization of blood pressure (from pre diagnosed ALS and no consumption of FSWW08, similarly in the off phase, when FSWW08 was not taken) from 170/100 mm HG to 120/80 mm HG under FSWW08 consumption) within seven days, blood lipids were normalized (cholesterol, triglycerides, HDL, LDL). It is reported in the literature that unfavorable blood lipids are related to severity of ALS in Japanese and Western patients. This is the first time stabilization of ALS has been observed accompanied by improvements in blood lipids in patients. This single report corroborates studies conducted with FSWW08 in other diseases including cancer, severe mental diseases (PTSD and Schizophrenia) and severe virus infections. The FDA has granted a general unspecific Health Claim that soy improves blood lipids like cholesterol and triglycerides. This is the first time a fermented soy formulation, FSWW08, has prevent progression of ALS over a two years period and normalized blood lipids. The special fermentation of FSWW08 causes an increase in immunity, cellular stress reduction and blood lipids. Larger clinical trials in ALS patients with FSWW08 are now warranted to investigating whether these results can be confirmed, and whether FSWW08 increases survival, as well as whether blood lipids are a prognostic marker of ALS.

Background and Aim Diabetes mellitus is one of the leading causes of death, and its prevalence is increasing
annually because of the change in lifestyle. Increased blood glucose level and dyslipidemia are the
major symptoms of this metabolic disease. Currently, the main and effective treatment for diabetes is
the use of medication such as insulin. Its control by using herbal products has received a lot of attention
in the world. The aim of this study is to evaluate the effects of bioflora (a probiotic supplement) and
aqueous extract of cinnamon in improvement of blood glucose level, dyslipidemia, and reduction of
cardiovascular diseases in diabetic rats.
Methods & Materials Thirty-five male Wistar rats were prepared and randomly divided into five groups
of negative control, positive control, probiotic (treated with bioflora 3.2×108 CFUs/day for 30 days), cinnamon
(treated with 200 mg/kg of cinnamon aqueous extract for 30 days), and probiotic + cinnamon.
Diabetes was induced by intra-peritoneally injection of streptozotocin. The rats’ weight, blood glucose
level, lipid profile, high sensitivity C-Reactive Protein (hs-CRP) and Atherogenic Index (AI) were measured
at the end of experiment to predict the risk of cardiovascular diseases.
Ethical Considerations This study ethically approved in Research Centre of Islamic Azad University of Arak
(Code: IR.IAU.ARAKREC1397.005). All interventions performed in accordance with the Guide for Care and
Use of Laboratory Animals prepared by the Institute of Laboratory Animal Resources.
Results Induction of diabetes caused severe weight lost in rats, but the weight loss was lower in groups
treated with probiotic. The blood glucose level in probiotic + cinnamon group was significantly reduced.
Bioflora reduced triglyceride, cholesterol, and Low-Density Lipoprotein Cholesterol (LDL-C) levels, while
cinnamon extract significantly reduced triglyceride and LDL-C levels compared to the positive control
group. AI and hs-CRP values were reduced in the probiotic group compared to control groups. There was
no synergistic effect by combined use of bioflora and cinnamon extract.
Conclusion Bioflora effectively prevented dyslipidemia by improving intestinal microbiota, lowering blood
glucose level, and improving lipid profile and, therefore, reduced the risk of cardiovascular diseases.

Pancreatic β-cells are sensitive to fluctuations in cholesterol content, which can damage the insulin secretion pathway, contributing to the aetiology of type 2 diabetes mellitus. Cholesterol efflux to (apo)lipoproteins, via ATP-binding cassette (ABC) transporter A1 (ABCA1), can prevent intracellular cholesterol accumulation; in some peripheral cells, ABCA1-dependent efflux is enhanced by promotion of cholesterol trafficking to, and generation of Liver X receptor (LXR) ligands by, mitochondrial sterol 27-hydroxylase (Cyp27A1 (cytochrome P450 27 A1/sterol 27-hydroxylase)) and its redox partners, adrenodoxin (ADX) and ADX reductase (ADXR). Despite this, the roles of mitochondrial cholesterol trafficking (steroidogenic acute regulatory protein [StAR] and 18-kDa translocator protein [TSPO]) and metabolising proteins in insulin-secreting cells remain wholly uncharacterised. Here, we demonstrate an increase in pancreatic expression of Cyp27A1, ADXR, TSPO and LXRα, but not ADX or StAR, in obese (fa/fa) rodents compared with lean (Fa/?) controls. Overexpression of Cyp27A1 alone in BRIN-BD11 cells increased INS2 expression, without affecting lipid metabolism; however , after exposure to low-density lipoprotein (LDL), cholesterol efflux to (apo)lipoprotein acceptors was enhanced in Cyp27A1-overexpressing cells. Co-transfection of Cyp27A1, ADX and ADXR, at a ratio approximating that in pancreatic tissue, stimulated cholesterol ef-flux to apolipoprotein A-I (apoA-I) in both basal and cholesterol-loaded cells; insulin release was stimulated equally by all acceptors in cholesterol-loaded cells. Thus, genetic obesity increases pancreatic expression of Cyp27A1, ADXR, TSPO and LXRα, while modulation of Cyp27A1 and its redox partners promotes cholesterol efflux from insulin-secreting cells to acceptor (apo)lipoproteins; this response may help guard against loss of insulin secretion caused by accumulation of excess intracellular cholesterol.