I Diretriz sobre o consumo de Gorduras e Saúde Cardiovascular Definição do grau dos níveis de evidência Recomendações Classe I: Condições para as quais há evidências conclusivas e, na sua falta, consenso geral de que o procedimento é seguro útil/eficaz. Classe II: Condições para as quais há evidências conflitantes e/ou divergência de opinião sobre segurança e utilidade/ eficácia do procedimento. Classe IIa: Peso ou evidência/opinião a favor do procedimento. A maioria aprova. Classe IIb: Segurança e utilidade/eficácia menos bem estabelecidas, não havendo predomínio de opniões a favor. Classe III: Condições para as quais há evidências e/ou consenso de que o procedimento não é útil/eficaz e, em alguns casos, pode ser prejudicial. Evidências Nível A: Dados obtidos a partir de múltiplos estudos randomizados de bom porte, concordantes e/ou de Metanálise robusta de estudos clínicos randomizados. Nível B: Dados obtidos a partir de Metanálise menos robusta, a partir de um único estudo randomizado ou de estudos não randomizados (observacionais). Nível C: Dados obtidos de opiniões consensuais de especialistas.
Objective: To verify the effects on the lipid pro®le of a product of fermented milk (Gaio 1 ) in patients with mild to moderate primary hypercholesterolemia. Design: The study was prospective, randomized, double-blinded and placebo controlled, with a crossover design. Subjects: Thirty-two patients (21 women and 11 men) with ages ranging between 36 and 65 years old were included in the study. All of them were on a controlled diet for at least 8 weeks. Intervention: Patients began, after clinical and laboratory analysis, in a randomized and double-blind manner to take 200 g daily of Gaio 1 or its placebo. After 8 weeks blood was collected again for lipid pro®le evaluation and the crossover was made. After an additional 8 weeks blood was collected for another lipid pro®le determination. Results: All patients included completed the study. Comparisons were made between means of lipid pro®le constituents after the placebo and active product periods. These showed signi®cant mean reduction of 5.3% (P 0.004) for total cholesterol, 6.15% (P 0.012) for LDL-cholesterol and no signi®cant variation for HDLcholesterol and triglycerides. The majority of patients presented no variation or had a decrease in their total cholesterol level. However, during the active product period, three patients showed an increase in cholesterol level by more than 5%. Conclusion: The fermented milk (Gaio 1 ) produced a small but statistically signi®cant decrease in total and LDL-cholesterol mean. However, not all subjects seem to respond to the product, and a few subjects showed a cholesterol increment. Further investigations are necessary to clarify this aspect.
AimsThe relationship between variants in SLCO1B1 and SLCO2B1 genes and lipid-lowering response to atorvastatin was investigated.Material and MethodsOne-hundred-thirty-six unrelated individuals with hypercholesterolemia were selected and treated with atorvastatin (10 mg/day/4 weeks). They were genotyped with a panel of ancestry informative markers for individual African component of ancestry (ACA) estimation by SNaPshot® and SLCO1B1 (c.388A>G, c.463C>A and c.521T>C) and SLCO2B1 (−71T>C) gene polymorphisms were identified by TaqMan® Real-time PCR.ResultsSubjects carrying SLCO1B1 c.388GG genotype exhibited significantly high low-density lipoprotein (LDL) cholesterol reduction relative to c.388AA+c.388AG carriers (41 vs. 37%, p = 0.034). Haplotype analysis revealed that homozygous of SLCO1B1*15 (c.521C and c.388G) variant had similar response to statin relative to heterozygous and non-carriers. A multivariate logistic regression analysis confirmed that c.388GG genotype was associated with higher LDL cholesterol reduction in the study population (OR: 3.2, CI95%:1.3–8.0, p < 0.05).ConclusionSLCO1B1 c.388A>G polymorphism causes significant increase in atorvastatin response and may be an important marker for predicting efficacy of lipid-lowering therapy.
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