• Title, Summary, Keyword: Hypercholesterolemia

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Combining Potent Statin Therapy with Other Drugs to Optimize Simultaneous Cardiovascular and Metabolic Benefits while Minimizing Adverse Events

  • Koh, Kwang Kon;Sakuma, Ichiro;Shimada, Kazunori;Hayashi, Toshio;Quon, Michael J.
    • Korean Circulation Journal
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    • v.47 no.4
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    • pp.432-439
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    • 2017
  • Hypercholesterolemia and hypertension are among the most important risk factors for cardiovascular (CV) disease. They are also important contributors to metabolic diseases including diabetes that further increase CV risk. Updated guidelines emphasize targeted reduction of overall CV risks but do not explicitly incorporate potential adverse metabolic outcomes that also influence CV health. Hypercholesterolemia and hypertension have synergistic deleterious effects on interrelated insulin resistance and endothelial dysfunction. Dysregulation of the renin-angiotensin system is an important pathophysiological mechanism linking insulin resistance and endothelial dysfunction to atherogenesis. Statins are the reference standard treatment to prevent CV disease in patients with hypercholesterolemia. Statins work best for secondary CV prevention. Unfortunately, most statin therapies dose-dependently cause insulin resistance, increase new onset diabetes risk and exacerbate existing type 2 diabetes mellitus. Pravastatin is often too weak to achieve target low-density lipoprotein cholesterol levels despite having beneficial metabolic actions. Renin-angiotensin system inhibitors improve both endothelial dysfunction and insulin resistance in addition to controlling blood pressure. In this regard, combined statin-based and renin-angiotensin system (RAS) inhibitor therapies demonstrate additive/synergistic beneficial effects on endothelial dysfunction, insulin resistance, and other metabolic parameters in addition to lowering both cholesterol levels and blood pressure. This combined therapy simultaneously reduces CV events when compared to either drug type used as monotherapy. This is mediated by both separate and interrelated mechanisms. Therefore, statin-based therapy combined with RAS inhibitors is important for developing optimal management strategies in patients with hypertension, hypercholesterolemia, diabetes, metabolic syndrome, or obesity. This combined therapy can help prevent or treat CV disease while minimizing adverse metabolic consequences.

Prediction model of hypercholesterolemia using body fat mass based on machine learning (머신러닝 기반 체지방 측정정보를 이용한 고콜레스테롤혈증 예측모델)

  • Lee, Bum Ju
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.413-420
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    • 2019
  • The purpose of the present study is to develop a model for predicting hypercholesterolemia using an integrated set of body fat mass variables based on machine learning techniques, beyond the study of the association between body fat mass and hypercholesterolemia. For this study, a total of six models were created using two variable subset selection methods and machine learning algorithms based on the Korea National Health and Nutrition Examination Survey (KNHANES) data. Among the various body fat mass variables, we found that trunk fat mass was the best variable for predicting hypercholesterolemia. Furthermore, we obtained the area under the receiver operating characteristic curve value of 0.739 and the Matthews correlation coefficient value of 0.36 in the model using the correlation-based feature subset selection and naive Bayes algorithm. Our findings are expected to be used as important information in the field of disease prediction in large-scale screening and public health research.

The Antithrombotic and Fibrinolytic Effect of Natto in Hypercholesterolemia Rats

  • Park, Kum-Ju;Kang, Jung-Il;Kim, Tae-Seok;Yeo, Ik-Hyun
    • Preventive Nutrition and Food Science
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    • v.17 no.1
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    • pp.78-82
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    • 2012
  • Antithrombotic and fibrinolytic activity of natto was evaluated on platelet aggregation in vitro and in vivo. Natto showed inhibitory effects on platelet aggregation induced by adenosine 5’diphosphate (ADP) and collagen. Orally administered natto also showed fibrinolytic activity in hypercholesterolemia rats. Normal levels of natto, when administered for four weeks, shortened euglobulin clot lysis time (ECLT) and prolonged partial thromboplastin time (PATT) significantly compared to non-treated group. In addition, the natto treatment decreased total cholesterol in serum. These results showed that intake of normal levels of natto can elicit antithrombotic and fibrinolytic effects, suggesting its consumption may improve blood circulation.

Relative and Attributable Risks of Obesity, Hypertension and Hyperglycemia to Hypercholesterolemia in Korean Adult Males (한국 성인 남자의 고콜레스테롤혈증에 대한 비만, 고혈압 및 고혈당의 상대적 위험도 및 기여도)

  • 허영란;임현숙
    • Korean Journal of Human Ecology
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    • v.2 no.1
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    • pp.80-88
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    • 1999
  • Hypercholesterolemia is a well known major risk factor for cardiovascular disease, now the leading cause of death in Korea. This study was carried out to examine the relationships of hypercholesterolemia(HC$\geq$240 mg/dL) with obesity, blood pressure and blood glucose level in 649 male subjects aged 20-69 in Kwangju, Korea. The mean plasma total cholesterol level was 212${\pm}$43 mg/dL, and 25.3% of the subjects was diagnosed as HC and 39.3% as nomorcholesterolemia(NC〈200 mg/dL). The prevalence of HC seemed to increase with age. The subjects with HC were highly overweighted and had higher body mass index(BMI) than the NC subjects. The incidence of overweight(25$\leq$BMI〈30) and obesity(BMI$\geq$30) among the HC subjects were 44.5%, and 1.8%, respectively. The HC subjects had higher systolic(SBP) and diastolic blood pressure(DBP) than the NC subjects. The incidence of borderline hypertension (160/95〉SBP/DBP$\geq$140/90) and hypertension(SBP/DBP$\geq$160/95) among the HC subjects were 18.3%, and 9.1%, respectively. However, there was no difference in blood glucose level between the HC and NC subjects. The plasma total cholesterol level had positive relationships with BMI(P〈0.001), weight(P〈0.001), DBP(P〈0.001), SBP(P〈0.01), and age(P〈0.01), whereas inverse relationships with height/weight ratio(P〈0.001), and height(P〈0.01). The relative risks on HC were 1.99 for obesity, 1.53 for overweight, 1.82 for hypertension, 1.44 for borderline hypertension and 1.08 for hyperglycemia. Attributable risks on HC were 0.25 for obesity, 0.11 for overweight, 0.20 for hypertension, 0.10 for borderline hypertension and 0.02 for hyperglycemia. The results indicate that the level of plasma total cholesterol was closely associated with the incidences of obesity and hypertension. (Korean J of Human Ecology 2(1) : 80-88, 1999)

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Comparisons of Food Consumption and Food Sources of Nutrients in the Diets of Postmenopausal Women with Normocholesterolemia and Hypercholesterolemia in Seoul, Korea

  • Kim, Sangyeon;Kyungah Jung;Yukyung Chang
    • Nutritional Sciences
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    • v.7 no.3
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    • pp.174-182
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    • 2004
  • Women have a greater incidence of coronary heart disease (CHD) after menopause. This relates to hormone imbalance-induced changes in known CHD risk factors, especially hyperlipidemia. The purpose of this study was to explore d1e differences in food consumption and food sources of nutrients in the Korean diet between postmenopausal women aged 50-74 years with normocholesterolemia(NC) and those with hypercholesterolemia(HC). Each subject was either classified as part of the NC group (n=39, serum total cholesterol con. <200 mg/$dl$) or the HC group (n=31, serum total cholesterol con. $\geq$240 mg/dl) based on the Guideline for Korean Hyperlipidemia.l Diet was assessed through a validated semi-quantitative food frequency questionnaire. Consumption of foods such as biscuits and/or crackers, squid and eggs was significantly (p<0.05) higher in the HC group than in the NC group. On the other hand, consumption of potatoes/starches and carrots was significantly (p<0.05) lower in the HC group than in the NC group. There was no significant difference between the two groups in terms of the consumption of legumes and legume products containing phytoestrogen and we could not find a relationship between legumes and legume products and serum cholesterol levels. Consumption of green tea tended to be lower in the HC group than in the NC group. Major sources of cholesterol, cholesterol-saturated index and vitamin A in the diets of the HC group consisted of foods high in cholesterol. Our results confirm that postmenopausal women with hypercholesterolemia in Korea tend to consume cholesterol-rich foods and dishes.

A Analysis on Serum Total Cholesterol, Atherogenic Index of Medical Check-up Subjects in One University Hospital by Age and Sex (종합 건강검진자에서의 성별.연령별 혈청 총콜레스테롤, 동맥경화지수의 상호연관성 분석)

  • Suk, Sung-Ja;Yoo, Wang-Keun
    • Journal of Society of Preventive Korean Medicine
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    • v.10 no.1
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    • pp.67-74
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    • 2006
  • Objectives: This study was carried out to establish the normal values of Serum Total Cholesterol, HDL-cholesterol by age and sex for healthy adult and the frequency of dyslipidemia as a risk factor of coronary atherosclerosis. Methods: Total cholesterol, and HDL-cholesterol measured among 14,485 in general growing people (8,712 males and 5,773 females) aged 20 to 69 years and analyzed to use the auto-analyzer Hitach 7600 in enzyme method. Result: 1. The levels of total cholesterol, HDL-cholesterol and atherogenic index were slightly positively correlated with age in both sexes. The mean values of serum lipid profiles were $190{\pm}32.9mg/dl$ in men and $181{\pm}32.8mg/dl$ in women for cholesterol, $50.1{\pm}11.4mg/dl$ in men and $54.5{\pm}12.0mg/dl$ in women for HDL-cholesterol, $3.9{\pm}1.0$ in men and $3.4{\pm}0.8$ in women for atherogenic index. 2. Mean values of total cholesterol and atherogenic index higher in men than in women at the age 20-40 years but significantly higher in women than in men at the age group 60 years.(p<0.001) 3. The frequency of hypercholesterolemia(${\geq}200mg/dl$) and low HDL-cholesterol(<35mg/dl) were increased with age in both sexs, significantly higher in women at the age group 60 years. The frequency of hypercholesterolemia(${\geq}200mg/dl$) and low HDL-cholesterol(<35mg/dl) in men and women was 37.5%, 25.3%, and 5.5%, 2.8%. Their requencies were higher in men than in women. Conclusion: Theses findings suggest that the mean concentrations of total cholesterol and HDL-cholesterol in men and women vary with age. The frequency of hypercholesterolemia(${\geq}200mg/dl$) in men and women was about 31.4% and increased with age.

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Effects of Insamsansa-eum (Renshenshanzha-yin) on Hypercholesterolemia and Analysis of Its Effects according to the Pattern Identification

  • Park Seong-Uk;Jung Woo-Sang;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk;Bae Hyung-Sup;Ko Chang-Nam
    • The Journal of Korean Medicine
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    • v.27 no.2
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    • pp.253-261
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    • 2006
  • Backgrounds : Hyperlipidemia is a major cause of cardiovascular disease (CVD). Lowering serum cholesterol levels could reduce the risk of CVD. Insamsansa-eum (Renshenshanzha-yin, ISE), composed of Ginseng Radix and Crataegii Fructus, is a new medicine developed to treat hyperlipidemia and CVD. Objectives : In this study, we intended to explore the clinical effects of ISE on patients with hypercholesterolemia, and moreover we also compared its effects according to the pattern identification. Methods : Subjects were administered ISE with the dose of 600 mg three times a day for 4 weeks. Patterns of subjects were identified with diagnostic scoring system for Yin-Yang and the condition of Excess-Deficiency before treatment. Serum lipids were measured at baseline and after 4 weeks of medication. Results : ISE lowered total cholesterol(TC), triglyceride(TG), total lipid(TL), phospholipid(PL) and low density lipoprotein cholesterol(LDL) significantly. Compared with the data of our previous study, it was less effective than Atorvastatin but showed equal lipids-lowering effect to Chunghyul-dan (Qingxue-dan, CHD). In Yang pattern group, ISE was less effective in lowering TG and LDL than it was in not-Yang-not-Yinpattern group. On safety assessment, there was no adverse effect, hepatic or renal toxicity. Conclusions : We suggest that ISE is a safe and useful herbal medicine for hypercholesterolemia, and moreover it could be more useful when it is used for patients with not Yang pattern.

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Thr-6Pro missense mutation in human lysosomal acid lipase (LAL) gene in patients with familial hypercholesterolemia in Korea

  • Hwang, Hye-Suk;Hwang, Jung-Hee;Kim, Hyun-Sup;Kim, Nam-Keun;Kim, Se-Jae;Lee, Chung-Choo;Chung, Ki-Wha
    • Journal of Genetic Medicine
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    • v.2 no.2
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    • pp.65-70
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    • 1998
  • Lysosomal acid lipase (LAL) plays a central role in the intracellular degradation of neutral lipids derived from plasma lipoproteins. In this study, we investigated the missense mutation within exon 2 of human LAL gene changing of codon -6 of prepeptide from threonine to proline. The Thr-6Pro mutation was detected by the HaeIII restriction fragment length polymorphism (RFLP) and single-strand conformation polymorphism (SSCP). We analyzed the mutation in subjects with 221 unrelated randomly selected control samples and 86 patients with familial hypercholesterolemia (FH) in Korea. We observed that mutation is present with high frequency in Korea compared to other populations studied previously. The frequency of PP homozygote in the FH group was observed considerably higher than that of control. However, there was no significant difference of genotype frequency between two groups. These results, together with the fact that plasma lipids and lipoproteins levels between genotypes showed no statistical difference, suggest that the Thr-6Pro mutation in the LAL gene may have no association with the increased risk of FH development.

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A Study of Hyperlipidemia in Koreans -II. Specially Related to Drinking Smoking Exercise and Environmental Characteristics and It's Risk Factors for Hypercholesterolemia- (한국인의 고지혈증에 관한 연구 -II. 고콜레스테롤혈증 소견자의 음주, 흡연, 운동 및 생활습관 특성과 그 위험인자를 중심으로-)

  • 허영란
    • The Korean Journal of Food And Nutrition
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    • v.12 no.3
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    • pp.290-299
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    • 1999
  • This study was conducted to investigate drinking smoking exercise and environmental characteristics and it's risk factors for hypercholesterolemia (HC) in Korean. 344 adult men who took the annual health check-ups at D or J hospitals were participated in this corss-sectional study. The subjects were grouped by plasma total cholesterol level into three groups: normal cholesterolemic(n=139) borderline hyper-cholesterolemic (n=93) and hypercholesterolemic (n-112) groups. The data of plasma cholesterol level in the subjects were collected from medical records. Drinking smoking and exercise habits family and disease history personality type and stress level of subjects were investigated by using questionaries. The subjects with HC had longer drinking duration and drunk more frequently. The proportion of smok-er heavy smoker($\geq$2pack/day) and longer smoker ($\geq$30yrs) showed high in the HC but there were no significancy. The subjects with HC had preference for light exercise and exercised more frequently but there were no significant difference. The family history of cardiovascular diseases was higher in the were not different among the three groups. The relative risks on HC were 1.33 for family history, 1.22 for severe stress 1.06 for smoking and 1.04 for exercise.

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Effects of Medical Nutrition Therapy on Food Habits and Serum Lipid Levels of Hypercholesterolemic Patients (영양교육이 고콜레스테롤혈증 환자의 식습관 및 혈청 지질 농도에 미치는 영향)

  • Kim, So-Yeon;Son, Jeong-Min;Jeong, U-Yeong
    • Journal of the Korean Dietetic Association
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    • v.11 no.1
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    • pp.125-132
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    • 2005
  • Hypercholesterolemia has been regarded as a major risk factor of coronary heart disease(CHD). CHD is increasing in recent years among Koreans due to westernization of lifestyle and dietary behaviors. In the United States, implementation of the National Cholesterol Education Program(NCEP) had resulted 40% decline in mortality from CHD. This study was designed to evaluate the effect of medical nutrition therapy on serum lipid levels and discuss the effective nutrition education contents. Thirty outpatients(Male 40%, female 60%) with hypercholesterolemia were educated by medical nutrition therapy(MNT) protocol. At first visit and after three months of MNT, we assessed serum lipid profile, body weight and surveyed general characteristics, lifestyle and food habits through questionnaire. After 12 weeks of MNT, there were significant reductions in serum cholesterol and low-density lipoprotein cholesterol(LDL-C). Foods habits and lifestyle were changed to the desirable patterns. These results indicate that lipid profile is improved by changes of dietary behaviors and lifestyle. Especially in case of obesity, cholesterol lowering effect of MNT was more powerful. Consequently, MNT is effective on reduction of serum lipids by behavior change in hypercholesterolemic patients.

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