• Health Policy and Management
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• v.9 no.3
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• pp.70-94
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• 1999

This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ￦31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(￦33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ￦90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ￦23,200 per percent reduction, followed by lovastatin(20mg/d) at ￦28,000. Gemfibrozil was least efficient at ￦77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ￦39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ￦514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.

• 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.

• Journal of Nutrition and Health
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• v.40 no.3
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• pp.242-248
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• 2007

It is known that onion increases antioxidative and antibiotic capacity, and decreases blood pressure and cholesterol levels. The study was carried out to investigate whether ethanol extract of onion can enhance blood lipid profiles in hypercholesterolemic patients. Foully three hypercholesterolemic patients were randomly divided into 2 groups; 25 in controls and 18 in experimental group. The control group was offered to take placebo for 4 weeks (200 ml/day), and experimental group was offered to consume ethanol extract of onion for 8 weeks (200 ml/day that corresponds to 500 g of onion). There were no differences in sex, age, body mass index (BMI) and educational levels between groups before treatment. After 8 weeks of onion extract consumption, plasma triglycerides level was significantly decreased in experimental group compared to control (p<0.05). Total cholesterol level was tended to decrease in experimental group, but there was no significant difference of change between control and experimental group. The levels of plasma glucose and LDL-cholesterol were not changed significantly after onion extract consumption. In summary, alcohol extract of onion may have a positive effect on the lipid profiles of hypercholesterolemia patients through decreasing plasma triglyceride concentration.

• The Korean Journal of Food And Nutrition
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• v.12 no.3
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• pp.279-289
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• 1999

This study was conducted to investigate the physical characteristics and risk factors for hyperchol-esterolemia (HC) in Korean. 344 adult men who took the annual health check-ups at D or J hospitals were participated in this cross-sectional study. The subjects were grouped by plasma total cholesterol level in to three groups: normal cholesterolemic (n=139) borderline hypercholesterolemic(n=93) and hypercholesterolemic (n=112) groups. The data of height weight and plasma cholesterol level were col-lected from medical records. Body circumferences(midarm, waist, hip, and thight) skinfold thicknesses (biceps, triceps, subcostal, abdomen, and suprailic), and body composition (fat mass and fat free mass) were measured. Body mass index (BMI) height/weight ratio (HWR) waist/hip circumference ratio (WHR) waist/ thigh circumference ratio (WTR) central skinfold thickenss (CSF) and peripheral skin-fold thickness were calculated. The subjects with HC had significantly higher weight BMI waist cir-cumference skinfold thickness and body fat mass than those of the normal subjects. The relative and attributable risks on HC were 1.61 and 0.17 for obesity (BMI$\geq$25) 1,30 and 0.11 for upper body obesity (WTR$\geq$1.30) and 1.54 and 0.18 for central body obesity (CSF$\geq$95.7). Plasma total cholesterol level was positively correlated with several antropometric parameters: BMI (p<0.001) weight(p<0.001) waist circumference(p<0.001) and skinfold thickness of abdomen (p<0.001) spraillic (p<0.01) triceps(p<0.01) subcostal (p<0.01) and biceps (p<0.05) In conclusion the major influencing factors to plasma cholesterol level was BMI. Among the each physical parameters the circumference of waist the skinfol-d thickness of abdomen and the percentage of body fat were closely related to plasma cholesterol level. The important risk factor for hypercholesterolemia was obesity specially upper body obesity and central body obesity.

• Preventive Nutrition and Food Science
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• v.16 no.3
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• pp.202-209
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• 2011

This study was initiated to investigate the effects of lyophilized purslane (Portulaca oleracea) powder (5% and 10%) on lipid levels in rats fed a hypercholesterolemia-inducing diet (1% cholesterol). During the four week study, there were no significant differences in either weight change or the food efficiency ratio between the group fed the hypercholesterol diet alone (HC) and the groups fed the purslane powder (HCPO-I and HCPO-II, 5% and 10% purslane, respectively). In serum, the levels of total lipid, total cholesterol and LDL-C decreased significantly for the group fed the 10% purslane powder (HCPO-II) in comparison with the group fed the 5% purslane powder (HCPO-I). The atherogenic index (AI) was reduced by about 51% for the group fed the 10% purslane powder (1.47) in comparison with the HC group (3.03). The activities of GOT, GPT, ALP and LDH decreased significantly for the groups fed the purslane powder in comparison with the HC group. Regarding liver tissue, the levels of total lipid, total cholesterol and triglyceride decreased significantly for the purslane powder-fed rats compared to the HC group. The fecal lipid profiles increased significantly as the amount of purslane powder was increased. Compared to the HC group, the fecal total cholesterol and triglyceride levels were higher in the group fed the 10% purslane powder by about 2.8 times and 2.3 times, respectively. For the serum and liver tissue, the content of lipid peroxide decreased significantly in the groups fed purslane powder compared to the HC group. The data from this experiment show an increase in the lipid levels discharged in feces, suggesting that the supplementation of purslane powder to a hypercholesterolemia-inducing diet reduces lipid levels.

• Journal of the Korean Society of Food Science and Nutrition
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• v.28 no.3
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• pp.710-721
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• 1999

This study was conducted to investigate the hematological characteristics and risk factors of hypercholesterolemia(HC) in Korean. 344 adult men who took the annual health check ups at D or J hospitals were participated in this cross sectional study. The subjects were grouped by plasma total cholesterol level into three groups: normal cholesterolemic(n=139), borderline hypercholesterolemic (n=93) and hypercholesterolemic(n=112) groups. The data of systolic and diastolic blood pressure (SBP/DBP), hemoglobin, plasma glucose, albumin and cholesterol levels were collected from medical records. The levels of plasma triglyceride(TG), HDL C, phospholipid, insulin, apo A and apo B were measured. The levels of plasma LDL C, VLDL C and atherogenic index(AI) were calculated. The subjects with HC had significantly higher SBP and DBP, albumin, TG, phospholipid, HDL C, LDL C, VLDL C and apo B level than those of the normal subjects. The relative and attributable risks on HC were 1.59 and 0.18 for hypertension(SBP/DBP$\geq$160/95), 2.08 and 0.35 for hypertriglyceridemia (TG $\geq$400mg/dl). Plasma total cholesterol level was positively correlated with several hematologic parameters: age(r=0.1242, p<0.05), DBP(r=0.1194, p<0.05), albumin(r=0.2029, p<0.001), plasma TG(r= 0.3829, p<0.001), phospholipid(r=0.6036, p<0.001), LDL C(r=0.8572, p<0.001), HDL C(r=0.2399, p< 0.001), AI(r=0.3116, p<0.001), apo B(r=0.2602, p<0.05) and Lp(a)(r=0.1372, p<0.05). However, plasma total cholesterol level was negatively correlated with the levels of Apo A1(r= 0.2922, p<0.001), and ABR(r= 0.3598, p<0.001).

• Nutrition Research and Practice
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• v.13 no.4
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• pp.295-301
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• 2019

BACKGROUND/OBJECTIVES: Consumption of cholesterol-rich foods, such as eggs, has a minimal effect on circulating cholesterol levels in healthy humans. To gain insight, we investigated whether phospholipids rich in eggs (EPL) interfere with intestinal cholesterol absorption in vivo. MATERIALS/METHODS: To investigate the acute effect of EPL on intestinal cholesterol absorption, male C57BL/6J mice were orally administered with 6, 11, or 19 mg of EPL for three days. We also tested the effect of chronic EPL consumption on cholesterol metabolism in the small intestine and the liver in mice with diet-induced hypercholesterolemia. Male C57BL/6J mice were fed a high fat/high cholesterol (HF/HC; 35% fat, 0.25% cholesterol, w/w) diet for 4 weeks to induce hypercholesterolemia, and subsequently the mice were either fed 0, 0.4 or 0.8% (w/w) of EPL for 6 weeks. RESULTS: Intestinal cholesterol absorption was significantly decreased by the highest dose of acute EPL administration compared to control. Chronic EPL supplementation did not significantly alter intestinal cholesterol absorption nor plasma levels of total cholesterol and low-density lipoprotein cholesterol. In the small intestine and the liver, EPL supplementation minimally altered the expression of genes which regulate cellular cholesterol levels. CONCLUSION: Although chronic EPL consumption was not able to counteract hypercholesterolemia in HF/HC-fed mice, acute EPL administration decreased intestinal cholesterol absorption. This study provides in vivo evidence that acute administration of PLs in eggs prevent cholesterol absorption in the intestine, suggesting a mechanism for a minimal effect of egg consumption on circulating cholesterol levels.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.1
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• pp.52-58
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• 2004

The active principle responsible for lipid lowering in Chinese cabbage kimchi, 3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid, of molecular weight 226, was chemically synthesized and then used for the treatment of hypercholesterolemia in male New Zealand white rabbit. Hypercholesterolemia in rabbits were induced by feeding 0.5% cholesterol added chow diet for 5 weeks. Each experimental group has four rabbits in it. for the 1st experiment,3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid or simvastatin was injected to the ear vein of rabbit every other day for 16 days (2 mg/3 kg/2 days) while normal chow diet was provided. Blood was drawn every 4th day. For the 2nd experiment, all the experimental condition was same as the 1st trial except 0.5% cholesterol diet was provided while 16 days. Plasma cholesterol level was decreased when cholesterol in the diet was removed. Decreased in cholesterol in kimchi and simvastatin groups were 18.65 and 29.67%, respectively compared to the control when the normal diet was given, and cholesterol increase was inhibited by 33.79 and 21.81% for kimchi and simvastatin groups, respectively, when 0.5% cholesterol diet was provided. The drop in LDL-C level by the active principle of kimchi and simvastatin was not significant when normal diet was given, however the changes was significant (p<0.05), approximately 130% decrease, when 0.5% cholesterol diet was given. The 105% and 62% decreased in triglyceride concentration were observed from 0.5% cholesterol diet fed kimchi and simvastatin groups respectively HDL cholesterol levels in experimental groups were not changed significantly from the both trials. The HMG-CoA reductase activity of kimchi and simvastatin groups were found to be higher than that of control to compensate the hypercholesterolemic condition induced by 0.5% cholesterol diet in these groups. In conclusion, diet is an important factor to control the hypercholesterolemia besides drug treatment. 3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid that is the active principle in Chinese cabbage kimchi seems a beneficial to the hypercholesterolemia and its effect is comparable to that of simvastatin.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.278-290
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• 2016

The purpose of this study is to investigate the association of total cholesterol levels (TC) and the incidence of hypercholesterolemia in response to changes in BMI. The subjects included a total of 28,249 industrial workers (25,548 male and 2,701 female) aged 30-69 years old who had received regular medical check-ups at least once per year from 2002 to 2012 (over 11 years). Data from this period were categorized into a first term (2002-2005), middle term (2006-2009), and last term (2010-2012). Then, the average TC was stratified by BMI, which was obtained from the initial examination results of each individual. In addition, average changes in TC were analyzed by stratifying with changes in BMI over 10 years (starting in 2002). The annual occurrence rates of hypercholesterolemia stratified by BMI were further assessed in patients with normal ranges of TC. In all three terms, the average TC was significantly elevated in the obese group ($25.0kg/m^2$) compared to the low weight group ($18.5kg/m^2$) and the normal weight group ($18.5-25.0kg/m^2$). Similarly, the group with higher BMI presented elevated rates of hypercholesterolemia compared to the groups with low BMI. In addition, increased BMI over the 10 year period significantly influenced TC. Consequently, it is suggested that evaluation and intervention for obesity control may be needed in order to manage the risk of high serum lipid levels.

• Journal of Ginseng Research
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• v.40 no.2
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• pp.160-168
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• 2016

Background: Ginseng (Panax ginseng Meyer) is a well-characterized medicinal herb listed in the classic oriental herbal dictionary as "Shin-nong-bon-cho-kyung." Ginseng has diverse pharmacologic and therapeutic properties. Black ginseng (BG, Ginseng Radix nigra) is produced by repeatedly steaming fresh ginseng nine times. Studies of BG have shown that prolonged heat treatment enhances the antioxidant activity with increased radical scavenging activity. Several recent studies have showed the effects of BG on increased lipid profiles in mice. In this study report the effects of water and ethanol extracts of BG on hypercholesterolemia in rats. To our knowledge, this is the first time such an effect has been reported. Methods: Experiments were conducted on male Sprague Dawley rats fed with a high-cholesterol diet supplemented with the water and ethanol extracts of BG (200 mg/kg). Their blood cholesterol levels, serum white blood cell levels, and cholesterol-metabolizing marker genes messenger RNA (mRNA) expression were determined. Liver and adipose tissues were histologically analyzed. Results: We found that BG extracts efficiently reduced the total serum cholesterol levels, low-density lipoprotein (LDL) levels with increased food efficiency ratio and increased number of neutrophil cells. It also attenuated the key genes responsible for lipogenesis, that is, acetyl-coenzyme A (CoA) acetyltransferase 2, 3-hydroxy-3-methyl-glutaryl-CoA reductase, and sterol regulatory element-binding protein 2, at the mRNA level inside liver cells. Furthermore, the BG extract also reduced the accumulation of fat in adipose tissues, and inhibited the neutral fat content in liver cells stained with hematoxylin and eosin and oil red O. Conclusion: Administration of BG extracts to Sprague Dawley rats fed with high-cholesterol diet ameliorated hypercholesterolemia, which was mediated via modulation of cholesterol-metabolizing marker genes. This data throw a light on BG's cardioprotective effects.