Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy. However, all lipoproteins containing apolipoprotein B (apo B) appear to be atherogenic. Preferred targets of therapy therefore may include either the cholesterol in all apo B-containing lipoproteins (non-high-density lipoprotein cholesterol [non-HDL-C]) or total apo B itself. Apo B can be measured by three methods: chemically, by nuclear magnetic resonance (NMR), and by immunoassay. This study compares the first two methods as a function of the number of metabolic risk factors in patients with metabolic syndrome. Plasma lipid, lipoprotein cholesterol, and apo B levels were measured in 274 adults with varying numbers of metabolic syndrome components. Low-density lipoprotein (LDL) particle sizes were measured by gel electrophoresis and by NMR. Total apo B was estimated chemically and by conversion of NMR lipoprotein particle number, assuming one apo B molecule per lipoprotein particle. As the number of metabolic syndrome components increased, apo B rose by both chemical and NMR methods, but by chemical methods, increases were in the triglyceriderich fraction, whereas by NMR, they were in LDL. The correlation between total apo B measured by the two methods was only moderate (r 5 .73). Further, non-HDL-C was more highly correlated with total apo B measured chemically than either LDL-C or total apo B by NMR. Non-HDL-C correlates highly with total apo B in patients with metabolic syndrome and had advantages as a target of therapy over LDL-C or NMR apo B.
Introducción. Uno de los principales factores de riesgo del carcinoma hepatocelular es el consumo crónico de alcohol. Estudios en diferentes poblaciones sugieren que variantes genéticas de las enzimas que participan en el metabolismo del alcohol, como alcohol deshidrogenasa (ADH) y el citocromo P450 CYP2E1, estarían asociadas al riesgo de hepatopatías terminales.Objetivo. Identificar y caracterizar las variantes alélicas de los genes ADH1B, ADH1C y CYP2E1 en pacientes colombianos con diagnóstico de cirrosis y/o CHC. Materiales y métodos. Se incluyeron muestras de pacientes atendidos entre 2005-2007 y 2014-2016 en la unidad de hepatología en un hospital en Medellín. Las muestras fueron genotipificadas mediante PCR – RFLP. Los resultados fueron comparados con dos grupos controles y con lo reportado en la base de datos 1000 genomas.Resultados. En total se recolectaron 97 muestras de pacientes con diagnóstico de cirrosis y/o CHC. Los dos factores de riesgo más frecuentes fueron el consumo crónico de alcohol (18,6%) y colangiopatías (17,5%). Los genotipos más frecuentes en la población de estudio fueron ADH1B*1/1 (82%), ADH1C*1/1 (59%) y CYP2E1*C/C (84%). Conclusiones. El primer estudio de polimorfimos realizado en pacientes colombianos con diagnóstico de cirrosis y/o CHC permitió identificar que los genotipos más frecuentes son ADH1B*1/1, ADH1C*1/1 y CYP2E1*C/C. No se observaron diferencias con significancia estadística en la frequencia de los genotipos entre casos y controles. Se requieren estudios adicionales en población colombiana para evaluar el riesgo de enfermedad hepática terminal por consumo crónico de alcohol y la asociación con polimorfismos.
Treatment with the 3-drug regimen was associated with a significant reduction in triglyceride levels compared with simvastatin monotherapy. However, there was not a significant incremental reduction in triglyceride levels when nicotinic acid was added to the 2-drug treatment, suggesting that the triglyceride-lowering effect of fenofibrate + nicotinic acid is not cumulative. To obtain clinically meaningful responses, particularly for the treatment of elevated HDL-C, higher doses of nicotinic acid might be required.
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