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Therapeutic effects of Schistosoma mansoni soluble egg antigen in high fat diet induced dyslipidemia, hepatic and cardiovascular pathology in mice

Toulah FH, El-Aswad BEW, Harba NM, Naguib YM

Trop Biomed, 2018 Dec 01;35(4):893-907.
PMID: 33601839

High-fat diet (HFD) can cause hyperlipidemia, fatty liver and cardiovascular disorders. Herein, we evaluated therapeutic effects and possible underlying mechanisms of actions of Schistosoma mansoni soluble egg antigen (SEA) against experimental HFD induced dyslipidemia, hepatic and cardiovascular pathology. Forty Swiss albino mice were divided into four groups (10 each); mice fed standard diet (SD), mice fed HFD, mice fed HFD for 8 weeks then infected by S. mansoni cercaria (HFD+I) and mice fed HFD for 8 weeks then treated with SEA (HFD+SEA), all mice were euthanized 16 weeks after starting the experiment. HFD+SEA mice showed significantly (p<0.001) reduced total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), and significantly (p<0.05) increased high-density lipoprotein cholesterol (HDL-C) comparing to HFD mice with non-significant difference with HFD+I mice group. Doppler flowmetry showed significantly (p<0.01) lower arterial resistance and significantly (p<0.05) higher blood flow velocity in HFD+SEA and HFD+I mice groups than HFD mice. HFD+SEA mice revealed improving in liver and aortic pathology and these were better than HFD+I mice group. HFD+SEA and HFD+I mice groups had less myocardium lipid deposits, but still showing some congested blood vessels. HFD myocardium revealed strong CD34+ expression on immunohistochemistry study, while that of HFD+SEA showed weak and HFD+I mice had moderate expressions. HFD+SEA mice had significantly (p<0.01) lower serum IL-1β and vascular endothelial growth factor (VEGF) and significantly (p<0.001) higher serum transforming growth factor beta 1 (TGF-β1) and IL-10 than HFD mice with non-significant difference with HFD+I mice. In conclusion, SEA lowered serum lipids, improved aortic function, decreased liver and cardiovascular pathology in HFD mice, so, it is recommended to purify active molecules from SEA to develop anti-dyslipidemic treatment.

Matched MeSH terms: Hyperlipidemias
Liver functions in combined models of the gentamicin induced nephrotoxicity and metabolic syndrome induced by high fat or fructose diets: a comparative study

Ibraheem ZO, Farhan SS, Al Sumaidaee A, Al Sufi L, Bashir A, Balwa A, et al.

Toxicol Res, 2021 Apr;37(2):221-235.
PMID: 33868979 DOI: 10.1007/s43188-020-00059-w

Metabolic syndrome is one of the major risk factors that lead to various serious complications like cardiovascular abnormalities, hyperlipidemia and diabetes. Its co-incidence with other organs dysfunction results in further deterioration of the condition or precipitation of other dysfunctions. This study aimed at studying the changes in the hepatic functions after the co-incidence of the high fat or fructose diets induced metabolic syndrome along with the gentamicin induced nephrotoxicity. Briefly, six groups of male Sprague Daley rats (n = 10-12) were fed with different feeding protocols; viz; standard rodent's chow, an experimental high fat or high fructose diets feedings. For each, two groups were allocated that one of them was injected with normal saline and the other with 80 mg/kg/day I.P gentamicin during the last 24 days of the feeding period. The rats were monitored for changes in the metabolic data, glycemic control, lipid profile, renal and hepatic functions, oxidative stress and the inflammatory response. The study revealed stronger hepatic changes in the renal failure groups fed with the high fat diet rather than that in the groups fed with the high fructose diet. Although, the latter experienced a stronger deterioration in the glycemic control. The study suggests that the incidence of the hepatic changes is more linked to the incidence of the deterioration in the lipids profile that was observed after the high fat diet feeding. Overall, the co-incidence of the high fat diet induced metabolic syndrome along with the renal failure constitutes a risk factor for the hepatic dysfunction.

Matched MeSH terms: Hyperlipidemias
Fulltext National Stroke Registry (NSR): Terengganu and Seberang Jaya experience

Sidek NN, Azmi IK, Hamidon BB, Looi I, Zariah AA, Hanip MR

Med J Malaysia, 2012 Jun;67(3):302-4.
PMID: 23082422 MyJurnal

The National Stroke Registry (NSR) was established in 2009 under National Neurology Registry (NNeuR) . The main objectives of NSR were to describe the demographic and disease pattern of stroke patients in Malaysia, to examine the risk factors and evaluate the specified treatment and outcomes. This prospective observational study was carried out from August 2009 until December 2010 using a standardized case report form which involved two participating hospital, namely Hospital Sultanah Nur Zahirah, Kuala Terengganu and Hospital Seberang Jaya, Pulau Pinang. There were 1018 patients registered. Ischemic stroke accounted for the majority of cases (73.3%). The most common risk factor was hypertension (75.5 %), followed by diabetes mellitus, previous stroke or Transient Ischemic Attack (TIA), hyperlipidemia and active smoker: 45.6%, 25.1%, 22.4%, and 19.4%, respectively. Overall, our stroke management, based on nine stroke key performance indicators (KPI) still needs to be improved. There was a total of 121 mortality cases with the main contributing factor was massive cerebral bleed (21.6%). In conclusion, the findings highlight the important of primary and secondary stroke management. Further and continuous observation with more site date provider (SDP) involvement is needed to get a more comprehensive data on stroke in Malaysia.

Matched MeSH terms: Hyperlipidemias/epidemiology
Fulltext Non-achievement of clinical targets in patients with type 2 diabetes mellitus

Eid M, Mafauzy M, Faridah AR

Med J Malaysia, 2004 Jun;59(2):177-84.
PMID: 15559167 MyJurnal

The study was conducted to determine whether the clinical targets for the control of diabetes recommended by American Diabetes Association can be met in the context of routine diabetes practice. This cross-sectional study was undertaken on 211 type 2 diabetic patients at the Outpatients Diabetes Clinic, Hospital Universisti Sains Malaysia (HUSM) Kubang Kerian, Kelantan between the year 2001-2002. Patients' physical examination and their medical history as well as their family history were obtained by administering a structured questionnaire. Samples of patients' venous blood during fasting were taken and analysed for plasma glucose, glycated haemoglobin and lipid profile. Analysis showed that many patients had comorbidities or complications. A large number of them had poor glycaemic control (73%). Systolic and diastolic blood pressures of 75% and 85% subjects were > or = 130 and > or = 80 mmHg, respectively. Body Mass Index (BMI) values of 66% of the patients were outside the clinical target (BMI > or = 25 in male and > or = 24 kg/m2 in female). The lipid profile showed that 96% of the patients had at least one lipid value outside the clinical target level. In this study, 70% of the patients had total cholesterol > or = 5.2 mmol/L, 87% had LDL cholesterol > or = 2.6 mmol/L, 57% had HDL cholesterol less than the normal range, < or = 1.15 mmol/L in men and < or = 1.4 mmol/L in women, while 46% had triglycerides > or = 1.71 mmol/L. Complications of diabetes were observed in 48% of the total number of patients. As for the patients' systolic blood pressure, age and duration of diabetes were found to have significant effects. Older subjects with a longer duration of diabetes were more hypertensive. Variables that had significant effects on BMI were age, duration of diabetes, glycaemic control and gender. Younger females and newly diagnosed subjects with better glycaemic control (A1C < 7%) were found to have higher BMI values. The overall clinical targets were suboptimal. The prevalence of hyperlipidaemia and hypertension was high. It is imperative that better treatment strategies and methods be adopted to enhance diabetes control and reduce long-term complications of the disease.

Study site: Outpatients Diabetes Clinic, Hospital Universisti Sains Malaysia (HUSM)

Matched MeSH terms: Hyperlipidemias/complications; Hyperlipidemias/epidemiology
Fulltext Health status of senior civil servants in Kuala Lumpur

Liew YM, Zulkifli A, Tan H, Ho YN, Khoo KL

Med J Malaysia, 1997 Dec;52(4):348-66.
PMID: 10968112

733 senior civil servants comprising 520 males and 213 females with a mean age of 44 years (range 25-56 years) were screened for their health status. The sample population comprised of 67.9% Malays, 22.5% Chinese, 9.1% Indians and 0.4% other ethnic origins. The subjects' medical histories were recorded and a full medical examination including anthropometric measurements (weight, height, waist and hip circumference), blood biochemistry and urine analysis, chest X-ray and electrocardiograms were done. The results obtained showed that 36.0% of the study population were overweight with 6.5% being obese. Of this 32.0% had central obesity. 15.2% of the subjects had systolic hypertension (systolic BP > or = 140 mmHg) whilst 27.6% had diastolic hypertension (diastolic BP > or = 90 mmHg). Hyperlipidaemia was common, with 75.2% subjects having raised cholesterol, 19.9% raised triglycerides, 50.2% raised LDL-C, 74.6% raised TC:HDL-C and 26.6% raised LDL:HDL-C. An elevated blood glucose was found in 8.4% subjects, whilst urine sugar was detected in only 2.6%, and a raised uric acid was found in 2.8% subjects. The prevalence of hypertension, raised blood glucose and hyperlipidaemia increased with age with more males affected than females. Although hypercholesterolaemia appeared more frequently amongst the Malays, the Indians, by comparison had the highest prevalence for a raised LDL:HDL-C ratio, a reflection of the increase in LDL-C and a concomitant decrease in HDL-C. The latter findings indicate that the Indians are at greater risk for the development of coronary heart disease than the Chinese and Malays. In addition, the mean levels of serum cholesterol found in this study seemed to have exceeded the levels found in populations in the industrialised countries such as the USA. There is thus an urgent need for more public health campaigns aimed at the reduction and control of such coronary risk factors.

Matched MeSH terms: Hyperlipidemias/epidemiology
Fulltext The ethnic characteristics and prevalence of diabetes mellitus, hypertension and hyperlipidaemia in patients who underwent coronary artery bypass grafting in Hospital Universiti Kebangsaan Malaysia

Chiam P, Abdullah F, Chow HK, Adeeb SMSJ, Yousafzai MS

Med J Malaysia, 2002 Dec;57(4):460-6.
PMID: 12733171

A retrospective study was done on 302 patients who had undergone coronary artery bypass grafting (CABG) in Hospital Universiti Kebangsaan Malaysia--46.0% were Chinese, 40.1% were Malays and 11.6% were Indians. Overall and irrespective of race and sex, the prevalence of diabetes mellitus, hypertension and hyperlipidaemia was 45.7%, 78.8% and 89.1% respectively indicating that hyperlipidaemia was the most prevalent risk factor amongst this cohort. The Indians had the highest prevalence of the three risk factors. The Chinese and the Malays most frequently presented with the combination of hypertension and hyperlipidaemia.

Matched MeSH terms: Hyperlipidemias/ethnology*; Hyperlipidemias/epidemiology*; Hyperlipidemias/surgery
Fulltext Serum lipids and their relationship with other coronary risk factors in healthy subjects in a city clinic

Khoo KL, Tan H, Liew YM

Med J Malaysia, 1997 Mar;52(1):38-52.
PMID: 10968052

Over a thousand subjects who visited a city private medical clinic for health screening and advice were examined for their lipid profile and other cardiovascular risk factors. The mean TC, TG, LDL-C and HDL-C were 5.43, 1.45, 3.61 and 1.15 mmol/l. Their derived ratios viz, TC:HDL-C and LDL:HDL-C were 5.11 and 3.43 respectively. The prevalence of hyperlipidaemia was moderately high. Of the subjects studied 58.5% had elevated serum cholesterol, 14.8% had raised triglycerides, 64.9% had raised LDL-C and 20.8% had low HDL-C. Male subjects generally showed higher mean values and abnormality frequency in TC, TG, LDL-C, TC:HDL-C and LDL:HDL-C as compared to female subjects. Although significant ethnic differences were not detected for certain lipid parameters (e.g. TC, TG and HDL-C), the Indians appeared to have higher mean lipid values (except HDL-C), and higher percentage abnormality for all the lipid parameters as compared to the Chinese and the Malays. In correlation studies, the following lipid parameters:- TC versus TG, LDL-C, TC:HDL-C; TG versus TC:HDL-C and LDL:HDL-C; LDL-C versus TC:HDL-C and LDL:HDL-C; were positively correlated. On the other hand, TC versus HDL-C, TG versus HDL-C, LDL-C and HDL-C, and HDL-C versus TC:HDL-C and LDL:HDL-C were negatively correlated. The coronary risk factors which generally showed positive correlations with lipid parameters were BMI and blood pressure. Positive correlations were also recorded between fasting blood glucose and TG; uric acid with TG, TC:HDL-C and LDL:HDL-C. In contrast, risk factors of negative correlations were observed between HDL-C and the coronary risk factors of BMI, diastolic blood pressure and uric acid. Smoking showed raised per cent lipid abnormality for TG, HDL-C, TC:HDL-C and LDL:HDL-C. Alcohol consumption also increased the mean level and abnormality frequency for TG. The implication of this investigation is discussed.

Matched MeSH terms: Hyperlipidemias/complications
Fulltext The effect of pravastatin in patients with primary hyperlipidaemia

Mafauzy M, Mokhtar M, Wan Mohamad WB, Musalmah M

Med J Malaysia, 1995 Sep;50(3):272-7.
PMID: 8926908

Thirty-four (34) subjects with primary hyperlipidaemia were enrolled for this study. After low fat dietary therapy for 6 weeks, subjects' whose serum total cholesterol fell to below 6.2 mmol/l (11 subjects) were excluded from the study and those whose serum total cholesterol were 6.2 mmol/l or more (23 subjects) were started on pravastatin 10 mg nocte. After 8 weeks of treatment, there was a significant decrease in the mean total cholesterol and LDL-cholesterol. However 13 of the subjects still had serum total cholesterol 6.2 mmol/l or more and their pravastatin dose was increased to 20 mg nocte. After 12 weeks, there was a significant reduction in triglyceride, total cholesterol and LDL-cholesterol. There was also a significant increase in HDL-cholesterol. The triglyceride fell by a mean of 15.7%, total cholesterol by a mean of 18.1% and LDL-cholesterol by a mean of 26.3%. HDL-cholesterol on the other hand, increased by 19.4%. The subjects whose total cholesterol fell below 6.2 mmol/l at week 8 had significantly lower total cholesterol to begin with than those whose total cholesterol failed to do so and hence were commenced on 20 mg pravastatin. This suggests that the optimum dose of the drug is dependent on the initial level of total cholesterol. We conclude that pravastatin is effective as a lipid lowering agent.

Matched MeSH terms: Hyperlipidemias/blood; Hyperlipidemias/drug therapy*
Serum tocopherol (vitamin E) status of Malaysians

Ng TK, Chong YH

Med J Malaysia, 1975 Mar;30(3):169-74.
PMID: 169458
Matched MeSH terms: Hyperlipidemias/blood
Prevalence, factors influencing and knowledge about adherence to lipid-lowering therapy among hyperlipidemia patients

Devaraj NK, Mohamed M, Hussein N

Med J Malaysia, 2017 06;72(3):157-164.
PMID: 28733563 MyJurnal

BACKGROUND: Hyperlipidaemia is a significant risk factor for cardiovascular disease. However, adherence to lipidlowering therapy is often unsatisfactory due to a combination of patient factors, therapy, socio-economic and health system-related factors.
AIMS: to identify the prevalence of adherence to lipidlowering therapy, the factors contributing to non-adherence and knowledge regarding hyperlipidaemia and its' treatment among Malaysian patients with hyperlipidemia.
METHODS: A quantitative study using a cross-sectional survey was carried out in an urban primary care clinic in August 2015. Patients on lipid-lowering therapy for ≥ 1 year aged ≥ 18 years were selected using simple random sampling. consenting patients answered a selfadministered questionnaire (in Malay/English) which included socio-demographic profile, hyperlipidaemia profile, adherence to lipid-lowering therapy (using the Morisky Medication Adherence scale-8; score ≥ 6 taken as adherent), reasons leading to non-adherence, knowledge regarding hyperlipidaemia and its' treatment, and use of non-allopathic medicine.
RESULTS: the response rate was 90.7%. the prevalence of adherence to lipid-lowering therapy was 82.4%. "the most common reasons for non-adherence was being worried about side effect of lipid-lowering agent (71.4%), followed by the need to take too many drugs in a day (61.4%) and negative influences by friends, relative and mass media (60%)". Factors associated with non-adherence include male gender, on longer duration of therapy, less frequency of follow-up, less number of follow-up clinics, taking medication at night/random timing and having lower knowledge scores.
CONCLUSION: Overall the prevalence of adherence was high in patients with hyperlipidaemia. Interventions to boost adherence should target those who were identified as nonadherent.

Matched MeSH terms: Hyperlipidemias/drug therapy*; Hyperlipidemias/psychology
Familial type II hyperlipoproteinaemia in a Chinese family

Khoo KL, Chong YH, Pillay RP

Med J Aust, 1973 May 26;1(21):1048-50.
PMID: 4718497
Matched MeSH terms: Hyperlipidemias/complications; Hyperlipidemias/genetics*; Hyperlipidemias/therapy
A pilot study on pattern B lipoprotein profile in Malaysia

Thambiah CS, Mohamed Pesri NA, Mazalan N, Samsudin IN, Mohamad Ismuddin S, Appannah G, et al.

Malays J Pathol, 2020 Aug;42(2):215-225.
PMID: 32860374

INTRODUCTION: Dyslipidaemia is a recognised conventional risk factor for cardiovascular disease (CVD). However, even when traditional lipid parameters are normal, CVD risk can exist. Small dense lowdensity lipoprotein cholesterol (sdLDL) has appeared as a significant risk marker for CVD. This study aimed to determine the prevalence and associated factors of atherogenic lipoprotein Pattern B in the Malaysian population.
MATERIALS AND METHODS: This cross-sectional study included 150 subjects aged 30 years and above who attended a health screening in a Malaysian tertiary institution. Sociodemographics, clinical characteristics and laboratory parameters (lipids, glucose, and sdLDL) were obtained. Lipoprotein subfraction was analysed using the polyacrylamide gel electrophoresis method.
RESULTS: Malays and females made up the majority of subjects and the median age was 37 years. Normolipidaemic Pattern B was signiﬁcantly higher in women (p=0.008). Signiﬁcant independent predictors of Pattern B were gender (p=0.02), race (p=0.01), body mass index (BMI) [p=0.02] and lipid status (p=0.01). Triglyceride was the only independent predictor of sdLDL (p=0.001).
CONCLUSION: The prevalence of Pattern B of 33% in this study was comparatively high, of which 6.7% were normolipidaemic. Chinese males with dyslipidaemia and increased BMI independently predicted Pattern B. Differences in triglyceride levels alone among these ethnic groups do not fully explain the differences in the prevalence of Pattern B although it was the only lipid parameter to independently predict sdLDL. Individuals with atherogenic normolipidaemia are at greater risk for a CVD event as they are not included in the protective measures of primary CVD prevention.

Matched MeSH terms: Hyperlipidemias/epidemiology
Fulltext Absence of Apo B R3500Q Mutation among Kelantanese Malays with Hyperlipidaemia

Kyi WM, Isa MN, Rashid FA, Osman JM, Mansur MA

Malays J Med Sci, 2000 Jan;7(1):16-21.
PMID: 22844210

Familial defective apolipoprotein B-100 (FDB) is an autosomal dominant genetic disorder associated with hypercholesterolaemia and premature coronary heart disease. FDB is caused by mutations in and around the codon 3500 of the apolipoprotein B (apo B) gene. Apo B R3500Q mutation is the first apo B mutation known to be associated with FDB and it is the most frequently reported apo B mutation in several different populations. The objective of the present study was to determine the association of apo B R3500Q mutation with elevated plasma cholesterol concentration in Kelantanese population in which both hypercholesterolaemia and coronary heart disease are common. Sixty-two Malay subjects with hyperlipidaemia, attending the lipid clinic at Hospital Universiti Sains Malaysia, Kelantan, were selected for this study. The DNA samples were analysed for the presence of apo B R3500Q mutation by polymerase chain reaction-based restriction fragment analysis method using mutagenic primers. This mutation was not detected in the subjects selected for this study. Apo B R3500Q mutation does not appear to be a common cause of hypercholesterolaemia in Kelantanese Malays.

Matched MeSH terms: Hyperlipidemias
Fulltext Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Lim SC, Rahman A, Yaacob NM

Malays J Med Sci, 2019 Jan;26(1):87-98.
PMID: 30914896 MyJurnal DOI: 10.21315/mjms2019.26.1.8

Background: Pre-hospital delay is currently a major factor limiting early reperfusion among ST-elevation myocardial infarction (STEMI) patients worldwide. This study aims to determine pre-hospital factors affecting symptom-to-door time among STEMI patients in Malaysia.
Methods: This cross-sectional study included 222 STEMI patients admitted to two tertiary hospitals in Malaysia. By determining symptom-to-door time, the study population was categorised into two definitive treatment seeking groups: early (≤ 3 h) and delayed (> 3 h). Data was collected focusing on socio-demographical data, risk factors and comorbidities, clinical presentation, situational factors and action taken by patients.
Results: The mean age of our patients was 58.0 (SD = 11.9) years old, and the population consisted of 186 (83.8%) males and 36 (16.2%) females. Our study found that the median symptom-to-door time was 130.5 (IQR 240) min, with 64% of subjects arriving early and 36% arriving late. Pre-hospital delays were found to be significant among females (adj OR = 2.42; 95% CI: 1.02, 5.76; P = 0.046), patients with recurrence of similar clinical presentations (adj OR = 2.74; 95% CI: 1.37, 5.46; P = 0.004), patients experiencing atypical symptoms (adj OR = 2.64; 95% CI: 1.11, 6.31; P = 0.029) and patients who chose to have their first medical contact (FMC) for their symptoms with a general practitioner (adj OR = 2.80; 95% CI: 1.20, 6.56; P = 0.018). However, patients with hyperlipidaemia (adj OR = 0.46; 95% CI: 0.23, 0.93; P = 0.030), self-perceived cardiac symptoms (adj OR = 0.36; 95% CI: 0.17, 0.73; P = 0.005) and symptoms that began in public places (adj OR = 0.21; 95% CI: 0.06, 0.69; P = 0.010) tended to seek treatment earlier.
Conclusion: The symptom-to-door time among the Malaysian population is shorter in comparison to other developing countries. Nevertheless, identified, modifiable pre-hospital factors can be addressed to further shorten symptom-to-door time among STEMI patients.

Matched MeSH terms: Hyperlipidemias
Fulltext Do Singapore patients require lower doses of statins? The SGH Lipid Clinic experience

Tan CE, Loh LM, Tai ES

Singapore Med J, 2003 Dec;44(12):635-8.
PMID: 14770258

A substantial number of physicians in Asian countries believe that Asian patients need lower doses of statins to achieve therapeutic lipid target because of the smaller size of patients. This belief is deep rooted and we looked at the SGH Lipid Clinic to determine if our experience bears out this belief. Between 1996 and August 2000, the Lipid Unit treated a total of 841 patients, of which 548 patients (77.5% Chinese, 12.1% Malays, 7.6% Asian Indians; 49.6% males, 50.4% females; 54.7% diabetics, 45.3% non-diabetic) were on statins alone. These patients had > or =2 coronary risk factors, diabetes mellitus or documented coronary heart disease. The pre-treatment lipid levels or the worst lipid levels available were entered as the baseline lipid values (mean LDL-C: 5.38+1.5 mmol/l). Duration of therapy ranged from six months to five years. The choice and titration of statins were determined by attending physicians. The median statin dose (Simvastatin equivalent) was 20.0 mg with 52.5% requiring 20 mg or more. Statin dose did not differ between diabetic and non-diabetic subjects. The median statin dose was 15 mg for the lower two tertiles and 20 mg for the upper tertile; this difference did not achieve statistical significance. The reduction in LDL cholesterol was 41.5% (40.1-42.8) and total cholesterol was 33.0% (32.9-34.1). Only 25% of our patients achieved LDL cholesterol of less than 2.6 mmol/l whilst 77.5% had LDL cholesterol less than 3.4 mmol/l. Our experience at the Lipid Clinic suggests that the Asian patients require similar statin doses to achieve target cholesterol levels.

Matched MeSH terms: Hyperlipidemias/drug therapy*; Hyperlipidemias/ethnology*
Fulltext Rhabdomyolysis and acute renal failure following a switchover of therapy between two fibric acid derivatives

Kamaliah MD, Sanjay LD

Singapore Med J, 2001 Aug;42(8):368-72.
PMID: 11764054

Drug induced myopathy has been reported with the use of fibric acid derivatives, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and nicotinic acid. Over the last three decades, hypolipemiants like fibric acid derivatives and statins have been increasingly recognised as causes of rhabdomyolysis and acute renal failure especially during combination therapy and in the presence of underlying renal impairment. We report two cases of bezafibrate-induced rhabdomyolysis in patients with underlying coronary artery disease and pre-existing renal impairment. Both patients developed rhabdomyolysis leading to acute renal failure soon after their hyperlipidaemia treatment was changed from gemfibrozil to bezafibrate. There were no intercurrent illnesses or co-administration of other lipid lowering drugs in both patients. Even though both drugs belong to the same fibric acid derivatives group, these patients developed the complication only after a switchover of therapy.

Matched MeSH terms: Hyperlipidemias/complications; Hyperlipidemias/drug therapy
Fulltext Blood pressure variability and arterial elasticity in hyperlipidaemic subjects

Rafidah HM, Azizi A, Noriah MN

Singapore Med J, 2008 Apr;49(4):297-303.
PMID: 18418521

It is debatable whether the assessment of low density lipoprotein or total cholesterol (TC) alone is sufficient to identify an individual's risk of having myocardial infarction. In the Framingham study, the risk of coronary artery disease was better indicated by an increase in the TC to high density lipoprotein cholesterol (TC: HDL) ratio. The aim of this study is to determine the relationship between blood pressure variability (BPV) and arterial compliances in hyperlipidaemics, which was defined as TC:HDL of more than 5.0 as compared to normolipidaemics.

Matched MeSH terms: Hyperlipidemias/complications*
Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population

Sarfraz M, Sajid S, Ashraf MA

Saudi J Biol Sci, 2016 Nov;23(6):761-766.
PMID: 27872574

In diabetes mellitus dyslipidemia is one of the major risk factors for cardiovascular disease. In type 2 diabetes mellitus early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder. The present study was carried to determine the prevalence and pattern of hyperlipidemia in patients with hyperglycemia. The cross sectional study was done in different laboratories of Pakistan, the laboratories served patients referred from different government and private hospitals between July 2014 and June 2015. All known cases of diabetes mellitus were evaluated for their lipid profile. Totally 200 diabetic patients were included in the study in which 120 (60%) were males and 80 (40%) were females. Prevalence of dyslipidemia among diabetic males was 97.18% while for females 87.15%. Among dyslipidemic male the proportion with mixed dyslipidemic patients was 17.5%, combined two parameters dyslipidemia was 47.5% and isolated single parameter dyslipidemia was 35%. In females these proportions in mixed, combined two parameters and isolated single parameter were 16.25%, 51.25% and 32.5%, respectively. Majority of hyperglycemic patients were dyslipidemic. The most prevalent pattern among male was combined dyslipidemia with high triglycerides (TG) and low High Density Lipoprotein (HDL) and in female it was high Low Density Lipoprotein (LDL) and low HDL. The most prevalent lipid abnormality in our study was low HDL followed by high TG.

Matched MeSH terms: Hyperlipidemias
Hibiscus sabdariffa linn. (roselle) protects against nicotine-induced heart damage in rats

Satirah Zainalabidin, Siti Nor Farhanah Sh Nor Shabidin, Siti Balkis Budin

Sains Malaysiana, 2016;45:207-214.

Nicotine has been identified as one of the causal factor for oxidative stress, hypertension and hyperlipidemia. Roselle has been widely studied for its potential as an antioxidant, antihyperlipidemic and antihypertensive. However, no studies have been done to investigate if roselle could diminish the oxidative stress caused by nicotine which could further lead to cardiac damages. Thus, this study was aimed to investigate the effect of roselle extract (HSE) on blood pressure, serum lipid profile, oxidative stress marker levels and histological changes to the heart in nicotine-treated rats. A total of 21 Sprague-Dawley rats were randomly divided into 3 groups (n=7 per group): Control group received normal saline (0.5 mL/day, i.p); nicotine group received 0.6 mg/kg/BW nicotine (i.p); and treated group received 100 mg/kg/b.w HSE through oral force feeding followed with 0.6 mg/kg/b.w nicotine (i.p) for 21 consecutive days. The results showed that HSE significantly (p>0.05) reduced the heart rate but no effect to the blood pressure. For lipid profile study, HSE increased the high-density lipoprotein concentration significantly (p<0.05) in rats given with nicotine, without any significant changes in total cholesterol, triglyceride and low-density lipoprotein (LDL) concentration. Besides, HSE treatment was also found to reverse malondialdehyde (MDA) level, superoxide dimustase (SOD) enzyme activity and protein concentration significantly (p<0.05) in nicotine-treated rats. In summary, these results indicated that HSE is an effective antioxidant against oxidative damage in heart caused by nicotine, but not as antihyperlipidemic and antihypertensive agent in this rat model.

Matched MeSH terms: Hyperlipidemias
Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor, Malaysia

Mahmood MI, Daud F, Ismail A

Public Health, 2016 Jun;135:56-65.
PMID: 26976488 DOI: 10.1016/j.puhe.2015.07.043

OBJECTIVES: To determine the prevalence of glycaemic control and factors associated with poor glycaemic control [glycosylated haemoglobin (HbA1c) ≥6.5%] among patients with type 2 diabetes treated in public health clinics in Johor, Malaysia.

STUDY DESIGN: Cross-sectional study.

METHODS: A review of all patients aged over 18 years and with a diagnosis of type 2 diabetes for >1 year. The National Diabetic Registry was used as the database for attendees at public health clinics in Johor Bahru between January and December 2013. A required sample of 660 was calculated, and a random sampling method was applied to acquire patient information across the 13 public health clinics in Johor Bahru. All relevant information (e.g. HbA1c, type of treatment and other parameters for glycaemic control) were abstracted from the registry.

RESULTS: Sixty-eight percent of 706 patients had HbA1c >6.5%, and mean HbA1c was 7.8%. Younger patients (72.3%) had poorer glycaemic control than older patients (63.0%), and most patients with poor glycaemic control were obese (79.2%). Approximately 31.7% of patients did not achieve the target blood pressure <130/80 mmHg, and 58.5% did not achieve the target lipid profile. Multiple logistic regression analysis revealed that age (<60 years), sex (male), duration of diabetes (>5 years), body mass index (obese), type of treatment (diet therapy vs combination therapy) and abnormal lipid profile were significantly associated with increased odds of HbA1C >6.5%.

CONCLUSIONS: More than half (68%) of the patients with diabetes had HbA1c >6.5%. This highlights the importance of providing organized care to manage patients with diabetes in the primary care setting, such as weight reduction programmes, proper prescribing treatment, and age- and gender-specific groups to ensure good glycaemic control.

Matched MeSH terms: Hyperlipidemias/epidemiology

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