Diagnostic lipid changes in patients with visceral leishmaniasis.

Background: Visceral leishmaniasis (VL) has been associated with the increase in triglyceride (TG) levels and the decrease in high-density lipoprotein cholesterol (HDL-C) concentration. The aim of the study was to evaluate whether there is a diagnostic cut-off point in these lipid profile changes.

Materials And Methods: We included 100 patients with febrile infections.

Uric acid and cardiovascular risk: What genes can say.

Background: Although the relationship of elevated serum uric acid levels and cardiovascular disease has been established in a great number of studies, the causal relevance of this finding remains ambiguous. An approach to evaluate the causal relevance of biomarkers is to exploit the natural randomised allocation of allelic variation in genes affecting their level, also known as Mendelian randomisation.

Aim: The aim of this paper is to review the current literature regarding serum uric acid levels and cardiovascular and renal disease risk in Mendelian randomisation studies.

Anacetrapib, a New CETP Inhibitor: The New Tool for the Management of Dyslipidemias?

Cholesteryl ester transfer protein (CETP) inhibitors significantly increase serum high-density lipoprotein cholesterol (HDL) cholesterol levels and decrease low-density lipoprotein cholesterol (LDL) cholesterol concentration. However, three drugs of this class failed to show a decrease of cardiovascular events in high-risk patients. A new CETP inhibitor, anacetrapib, substantially increases HDL cholesterol and apolipoprotein (Apo) AI levels with a profound increase of large HDL2 particles, but also pre-β HDL particles, decreases LDL cholesterol levels mainly due to increased catabolism of LDL particles through LDL receptors, decreases lipoprotein a (Lp(a)) levels owing to a decreased Apo (a) production and, finally, decreases modestly triglyceride (TRG) levels due to increased lipolysis and increased receptor-mediated catabolism of TRG-rich particles.

Effects of PCSK9 Inhibitors on Other than Low-Density Lipoprotein Cholesterol Lipid Variables.

Low-density lipoprotein cholesterol (LDL-C) is a major cardiovascular risk factor, but other lipid variables such as triglycerides (TRGs), high-density lipoprotein cholesterol (HDL-C) and lipoprotein a [Lp(a)] also affect cardiovascular risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors significantly lower LDL-C concentration but also modestly improve the concentrations of TRGs and HDL-C and more robustly decrease Lp(a) levels. The review presents the associated mechanisms of the beneficial effects of PCSK9 inhibitors on the other than LDL-C lipid variables, including the effects on lipid/apolipoprotein secretion and clearance and the heteroexchange between lipoproteins, as well as the possible effects on other variables involved in lipid metabolism such as sortilin.

The current role of thiazolidinediones in diabetes management.

Among the epidemics of modern time, type 2 diabetes mellitus (T2DM) is one of the main contributors to overall morbidity as well as mortality. A number of different treatment options are available for the management of diabetes. Among them thiazolidinediones (TZDs) is an interesting drug class since it does not target the result of T2DM, i.

The safety of ezetimibe and simvastatin combination for the treatment of hypercholesterolemia.

Introduction: In the light of the most recent and stricter dyslipidemia treatment guidelines, the need for combination hypolipidemic therapy is increasing. Ezetimibe plus simvastatin is available as a fixed dose therapy offering an efficient hypolipidemic treatment choice. Based on the positive results of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial, the use of this drug combination is expected to increase in the next years.

Statin use in prediabetic patients: rationale and results to date.

Prediabetes increases the risk for new-onset diabetes mellitus in patients receiving statins and this risk is dose- and time- dependent. Explanations for the conversion of a predisposed individual to diabetes are ambiguous including reductions in ubiquinone and adiponectin levels. However, the risk of new-onset diabetes mellitus is far outweighed by the statin-induced considerable decrease in cardiovascular events.

Dysbetalipoproteinemia: Two cases report and a diagnostic algorithm.

Dysbetalipoproteinemia is a rare familial dyslipidemia characterized by approximately equally elevated serum cholesterol and triglyceride levels due to accumulated remnant lipoproteins in apolipoprotein E2/E2 homozygotes. It is associated with an increased risk for premature cardiovascular disease. Thus, making a diagnosis of dysbetalipoproteinemia aids in assessing cardiovascular risk correctly and allows for genetic counseling.

No effect of switching to high-dose rosuvastatin, add-on nicotinic acid, or add-on fenofibrate on serum vitamin D levels in patients with mixed dyslipidemia.

Background: Low 25-hydroxy-vitamin D [25(OH)VitD] levels may represent a novel cardiovascular disease risk factor. Several statins may increase 25(OH)VitD concentration. The effect of other lipid-lowering drugs is unknown.

Emerging drugs for hyperlipidaemia: an update.

Introduction: Hypercholesterolaemia is a significant risk factor for cardiovascular disease (CVD), a major cause of morbidity and mortality. Up to now, the appropriate management has been aggressive hypolipidaemic therapy, particularly with statins, aiming at certain low-density lipoprotein cholesterol (LDL-C) levels for each patient population. This strategy has reduced CVD-related morbidity and mortality.

Nicotinic acid/laropiprant reduces platelet count but increases mean platelet volume in patients with primary dyslipidemia.

Introduction: Nicotinic acid (NA) has been associated with reduced cardiovascular morbidity and mortality. Of note, beyond its lipid-modifying actions, NA possesses a number of not yet thoroughly defined pleiotropic actions including anti-inflammatory and antithrombotic effects. As a growing body of evidence points towards mean platelet volume (MPV) and platelet distribution width (PDW) as independent risk factors for cardiovascular disease, it would be interesting to evaluate the effect of NA on these platelet indices.

Effect of switch to the highest dose of rosuvastatin versus add-on-statin fenofibrate versus add-on-statin nicotinic acid/laropiprant on oxidative stress markers in patients with mixed dyslipidemia.

Introduction: Oxidative stress plays an important role in atherosclerosis. Both F2-isoprostane (8-iso-PGF2a) and oxidized low-density lipoprotein (ox-LDL) have emerged as biomarkers of oxidative stress and have been proposed as useful biomarkers that could potentially be used as indicators of cardiovascular disease.

Methods: This is a prespecified analysis of a prospective, randomized, open-label, blinded endpoint (PROBE) study (ClinicalTrials.

Effect of hypolipidemic treatment on glycemic profile in patients with mixed dyslipidemia.

Aim: To assess the effect of different hypolipidemic treatment strategies on glycemic profile in mixed dyslipidemia patients.

Methods: This is a prespecified analysis of a prospective, randomized, open-label, blinded end point (PROBE) study (ClinicalTrials.gov identifier: NCT01010516).

No association between high-density lipoprotein levels and ventricular repolarization indexes in subjects with primary hypercholesterolemia.

Objective: Data regarding the effect of lipid parameters on repolarization are sparse. Recent data indicate that reconstituted HDL administration shortens repolarization in cardiomyocytes as well as the corrected QT (QTc) interval in human subjects. We investigated the potential association of high-density lipoprotein cholesterol (HDL-C) levels with conventional and novel electrocardiographic markers of ventricular repolarization in patients with hypercholesterolemia.

Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is a common health problem with a high mortality burden due to its liver- and vascular-specific complications. It is associated with obesity, high-fat diet as well as with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). Impaired hepatic fatty acid (FA) turnover together with insulin resistance are key players in NAFLD pathogenesis.

Antiplatelet treatment in the secondary prevention of coronary and cerebrovascular disease: is there any place for novel agents?

Ischemic heart disease and cerebrovascular disease remain major health problems with associated mortality and quality-of-life consequences. Antiplatelet agents, including thienopyridines and the new P2Y12 inhibitors, have been shown to improve survival in the secondary prevention setting. We review the available evidence on the effectiveness and safety of previous established as well as novel antithrombotic agents in the secondary prevention of cardiovascular disease with a special focus on cerebrovascular disease.

Lipid-modulating treatments for mixed dyslipidemia increase HDL-associated phospholipase A2 activity with differential effects on HDL subfractions.

The effect of lipid-modulating treatments on modification of high density lipoprotein (HDL) subfractions remains unknown. In this study, mixed dyslipidemia patients (n = 100) inadequately controlled with a standard statin dose were randomized to switch to 40 mg of rosuvastatin or add-on extended release nicotinic acid/laropiprant (ER-NA/LRPT) or add-on fenofibrate. The cholesterol concentrations of HDL (HDL-C) subfractions and HDL-associated lipoprotein-associated phospholipase A2 (HDL-Lp-PLA2) activity were assessed at baseline and 3 months later.

Effect of hypolipidemic treatment on emerging risk factors in mixed dyslipidemia: a randomized pilot trial.

Background: The effects of different hypolipidemic treatment strategies on emerging atherosclerosis risk factors remain unknown.

Materials And Methods: This is a prespecified analysis of a prospective, randomized, open-label, blinded end point (PROBE) study (ClinicalTrials.gov identifier: NCT01010516).

Comparison of switch to the highest dose of rosuvastatin vs. add-on nicotinic acid vs. add-on fenofibrate for mixed dyslipidaemia.

Background: Use of a statin at a standard dose may be insufficient for the treatment of mixed dyslipidaemia. Whether switch to the highest dose of rosuvastatin (40 mg) or add-on nicotinic acid (NA) or fenofibrate is more efficacious remains unknown.

Patients And Methods: This was a prospective, randomised, open-label, blinded end-point (PROBE) study.

Electrolyte and acid-base disorders in inflammatory bowel disease.

INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC INFLAMMATORY INTESTINAL DISORDER ENCOMPASSING TWO MAJOR ENTITIES: Crohn's disease and ulcerative colitis. Intestinal inflammatory processes reduce the absorption of sodium, chloride and calcium, while they increase potassium secretion. In addition, mild to severe metabolic alkalosis may occur in IBD patients, mainly depending on the severity of the disease and the part of the gastrointestinal tract being affected.

Colesevelam plus rosuvastatin 5 mg/day versus rosuvastatin 10 mg/day alone on markers of insulin resistance in patients with hypercholesterolemia and impaired fasting glucose.

Background: Statin use has been associated with adverse effects on insulin sensitivity and the development of new-onset diabetes. Colesevelam exhibits favorable effects on glucose metabolism. It is not known whether the combination of colesevelam plus low-dose statin has different effects on insulin resistance versus higher-dose statin in patients with impaired fasting glucose (IFG) and hypercholesterolemia.

Nicotinic acid: clinical considerations.

Introduction: Nicotinic acid (NA), the oldest hypolipidemic drug, possesses unique broad-spectrum beneficial effects on lipid profiles. Specifically, NA reduces both triglycerides and low-density lipoprotein cholesterol levels, while significantly increasing high-density lipoprotein cholesterol levels. However, NA is often avoided in the clinical setting, or prematurely discontinued by the provider or patient, due to side effects that could possibly be prevented (flushing, gastrointestinal disorders) or that are feared out of proportion to their true incidence rate (hyperglycemia, hyperuricemia).

Autoimmune manifestations in patients with visceral leishmaniasis.

Visceral leishmaniasis (VL) is a vector-borne protozoal infection caused by replication of Leishmania species in macrophages. VL is characterized by fever, hepatosplenomegaly and cytopenia. Apart from those classic clinical characteristics, VL has been associated with autoimmune clinical and laboratory features.