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Hypertriglyceridemia: HELP
Articles from Scotland
Based on 13 articles published since 2010
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These are the 13 published articles about Hypertriglyceridemia that originated from Scotland during 2010-2020.
 
+ Citations + Abstracts
1 Review Familial combined hyperlipidemia: An overview of the underlying molecular mechanisms and therapeutic strategies. 2019

Taghizadeh, Eskandar / Esfehani, Reza Jafarzadeh / Sahebkar, Amirhossein / Parizadeh, Seyed Mostafa / Rostami, Daryoush / Mirinezhad, Mohammadreza / Poursheikhani, Arash / Mobarhan, Majid Ghayour / Pasdar, Alireza. ·Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. · Medical Genetics Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. · School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. · Metabolic Syndrome Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of School Allied, Zabol University of Medical Sciences, Zabol, Iran. · Division of Applied Medicine, Medical School, University of Aberdeen, Aberdeen, UK. ·IUBMB Life · Pubmed #31271707.

ABSTRACT: Among different types of dyslipidemia, familial combined hyperlipidemia (FCHL) is the most common genetic disorder, which is characterized by at least two different forms of lipid abnormalities: hypercholesterolemia and hypertriglyceridemia. FCHL is an important cause of cardiovascular diseases. FCHL is a heterogeneous condition linked with some metabolic defects that are closely associated with FCHL. These metabolic features include dysfunctional adipose tissue, delayed clearance of triglyceride-rich lipoproteins, overproduction of very low-density lipoprotein and hepatic lipids, and defect in the clearance of low-density lipoprotein particles. There are also some genes associated with FCHL such as those affecting the metabolism and clearance of plasma lipoprotein particles. Due to the high prevalence of FCHL especially in cardiovascular patients, targeted treatment is ideal but this necessitates identification of the genetic background of patients. This review describes the metabolic pathways and associated genes that are implicated in FCHL pathogenesis. We also review existing and novel treatment options for FCHL. © 2019 IUBMB Life, 71(9):1221-1229, 2019.

2 Clinical Trial Design and rationale of the ODYSSEY DM-DYSLIPIDEMIA trial: lipid-lowering efficacy and safety of alirocumab in individuals with type 2 diabetes and mixed dyslipidaemia at high cardiovascular risk. 2017

Müller-Wieland, Dirk / Leiter, Lawrence A / Cariou, Bertrand / Letierce, Alexia / Colhoun, Helen M / Del Prato, Stefano / Henry, Robert R / Tinahones, Francisco J / Aurand, Lisa / Maroni, Jaman / Ray, Kausik K / Bujas-Bobanovic, Maja. ·Department of Internal Medicine I, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. dirmueller@ukaachen.de. · Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. · Institut du Thorax, CHU Nantes, Nantes, France. · Biostatistics and Programming Department, Sanofi, Chilly-Mazarin, France. · University of Edinburgh, Edinburgh, Scotland, UK. · Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. · University of California San Diego School of Medicine, Center for Metabolic Research, Veterans Affairs, San Diego Healthcare System, San Diego, CA, USA. · CIBERobn, Hospital Virgen de la Victoria, Málaga University, Málaga, Spain. · Sanofi, Bridgewater, NJ, USA. · Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA. · Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College, London, UK. · Sanofi, Paris, France. ·Cardiovasc Diabetol · Pubmed #28545518.

ABSTRACT: BACKGROUND: Type 2 diabetes mellitus (T2DM) is often associated with mixed dyslipidaemia, where non-high-density lipoprotein cholesterol (non-HDL-C) levels may more closely align with cardiovascular risk than low-density lipoprotein cholesterol (LDL-C). We describe the design and rationale of the ODYSSEY DM-DYSLIPIDEMIA study that assesses the efficacy and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, versus lipid-lowering usual care in individuals with T2DM and mixed dyslipidaemia at high cardiovascular risk with non-HDL-C inadequately controlled despite maximally tolerated statin therapy. For the first time, atherogenic cholesterol-lowering with a PCSK9 inhibitor will be assessed with non-HDL-C as the primary endpoint with usual care as the comparator. METHODS: DM-DYSLIPIDEMIA is a Phase 3b/4, randomised, open-label, parallel group, multinational study that planned to enrol 420 individuals. Main inclusion criteria were T2DM and mixed dyslipidaemia (non-HDL-C ≥100 mg/dl [≥2.59 mmol/l], and triglycerides ≥150 and <500 mg/dl [≥1.70 and <5.65 mmol/l]) with documented atherosclerotic cardiovascular disease or ≥1 additional cardiovascular risk factor. Participants were randomised (2:1) to alirocumab 75 mg every 2 weeks (Q2W) or lipid-lowering usual care on top of maximally tolerated statin (or no statin if intolerant). If randomised to usual care, investigators were able to add their pre-specified choice of one of the following to the patient's current statin regimen: ezetimibe, fenofibrate, omega-3 fatty acids or nicotinic acid, in accordance with local standard-of-care. Alirocumab-treated individuals with non-HDL-C ≥100 mg/dl at week 8 will undergo a blinded dose increase to 150 mg Q2W at week 12. The primary efficacy endpoint is non-HDL-C change from baseline to week 24 with alirocumab versus usual care; other lipid levels (including LDL-C), glycaemia-related measures, safety and tolerability will also be assessed. Alirocumab will be compared to fenofibrate in a secondary analysis. RESULTS: Recruitment completed with 413 individuals randomised in 14 countries worldwide. Results of this trial are expected in the second quarter of 2017. CONCLUSIONS: ODYSSEY DM-DYSLIPIDEMIA will provide information on the efficacy and safety of alirocumab versus lipid-lowering usual care in individuals with T2DM and mixed dyslipidaemia at high cardiovascular risk using non-HDL-C as the primary efficacy endpoint. Trial registration NCT02642159 (registered December 24, 2015).

3 Article Apolipoprotein B48 metabolism in chylomicrons and very low-density lipoproteins and its role in triglyceride transport in normo- and hypertriglyceridemic human subjects. 2019

Björnson, E / Packard, C J / Adiels, M / Andersson, L / Matikainen, N / Söderlund, S / Kahri, J / Hakkarainen, A / Lundbom, N / Lundbom, J / Sihlbom, C / Thorsell, A / Zhou, H / Taskinen, M-R / Borén, J. ·Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden. · Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. · Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland. · Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland. · Department of Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, Finland. · Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. · Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland. · Proteomics Facility, University of Gothenburg, Gothenburg, Sweden. · Merck Research Laboratories, Merck & Co. Inc., Kenilworth, NJ, USA. · Sahlgrenska University Hospital, Gothenburg, Sweden. ·J Intern Med · Pubmed #31846520.

ABSTRACT: BACKGROUND: Renewed interest in triglyceride-rich lipoproteins as causative agents in cardiovascular disease mandates further exploration of the integrated metabolism of chylomicrons and very low-density lipoproteins (VLDL). METHODS: Novel tracer techniques and an integrated multi-compartmental model were used to determine the kinetics of apoB48- and apoB100-containing particles in the chylomicron and VLDL density intervals in 15 subjects with a wide range of plasma triglyceride levels. RESULTS: Following a fat-rich meal, apoB48 appeared in the chylomicron, VLDL CONCLUSION: The intestine secretes apoB48-containing particles not only as chylomicrons but also directly into the VLDL

4 Article Dietary Fructose and the Metabolic Syndrome. 2019

Taskinen, Marja-Riitta / Packard, Chris J / Borén, Jan. ·Research Program for Clinical and Molecular Medicine Unit, Diabetes and Obesity, University of Helsinki, 00029 Helsinki, Finland. · Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK. · Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden. jan.boren@wlab.gu.se. ·Nutrients · Pubmed #31443567.

ABSTRACT:

5 Article The evolution of apolipoprotein B and its mRNA editing complex. Does the lack of editing contribute to hypertriglyceridemia? 2018

Damsteegt, Erin L / Davie, Andrew / Lokman, P Mark. ·Department of Zoology, University of Otago, 340 Great King Street, PO Box 56, Dunedin 9054, New Zealand. Electronic address: erin.damsteegt@otago.ac.nz. · Institute of Aquaculture, School of Natural Sciences, University of Stirling, Stirling FK9 4LA, United Kingdom. · Department of Zoology, University of Otago, 340 Great King Street, PO Box 56, Dunedin 9054, New Zealand. ·Gene · Pubmed #29031774.

ABSTRACT: The evolution of apolipoprotein B (Apob) has been intensely researched due to its importance during lipid transport. Mammalian full-length apob100 can be post-transcriptionally edited by the enzyme apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like complex-one (Apobec1) resulting in a truncated Apob, known as Apob48. Whilst both full-length and truncated forms of Apob are important for normal lipid homeostasis in mammals, there is no evidence for the presence of apob mRNA editing prior to the divergence of the mammals, yet, non-mammalian vertebrates appear to function normally with only Apob100. To date, the majority of the research carried out in non-mammalian vertebrates has focused on chickens with only a very limited number examining apob mRNA editing in fish. This study focused on the molecular evolution of Apobec1 and Apob in order to ascertain if apob mRNA editing occurs in eels, a basal teleost which represents an evolutionarily important animal group. No evidence for the presence of Apobec1 or the ability for eel apob to be edited was found. However, an important link between mutant mice and the evident hypertriglyceridemia in the plasma of non-mammalian vertebrates was made. This study has provided imperative evidence to help bridge the evolutionary gap between fish and mammals and provides further support for the lack of apob mRNA editing in non-mammalian vertebrates.

6 Article Association between serum cytokine concentrations and the presence of hypertriglyceridemia. 2016

Mirhafez, Seyed Reza / Tajfard, Mohammad / Avan, Amir / Pasdar, Alireza / Nedaeinia, Reza / Aghasizade, Malihe / Davari, Hafezeh / Manian, Mostafa / Mahdizadeh, Adeleh / Meshkat, Zahra / Movahedi, Ali / Amini, Nahid Ghaed / Eskandari, Nahid / Salehi, Rasoul / Ferns, Gordon A / Ghayour-Mobarhan, Majid. ·Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran; Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Division of Applied Medicine, Medical School, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK. · Student Research Committee, Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology, Deputy of Food and Drug, Isfahan University of Medical Sciences, Isfahan, Iran. · Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. · Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran. · Department of Biology, Payame Noor University of isfahan, Isfahan, Iran. · Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. · Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. · Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK. · Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: ghayourm@mums.ac.ir. ·Clin Biochem · Pubmed #27048855.

ABSTRACT: OBJECTIVE: Hypertriglyceridemia is an established risk factor for coronary-heart-disease. Inflammatory cytokines are known to be important mediators of atherogenesis; however, the relationship between the concentrations of specific inflammatory cytokines and the presence of hypertriglyceridemia has not been well established. The purpose of this study was to investigate the relationship between the serum levels of several pro- and anti-inflammatory cytokines and the presence of hypertriglyceridemia. DESIGN AND METHODS: Four hundred and eighty-four subjects with/without established hypertriglyceridemia were recruited. Anthropometric parameters and biochemical analysis (including a full fasting lipid profile) were determined. The serum levels of several cytokines and growth factors including IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, MCP-1, IFN-γ, EGF, and VEGF were measured followed by univariate and multivariate analyses. RESULTS: Individuals with hypertriglyceridemia had a significantly higher body mass index, total-cholesterol and triglyceride, compared to the group without hypertriglyceridemia. Serum levels of MCP-1, TNF-α and IL-8 were significantly higher in subjects with hypertriglyceridemia [e.g., IL-8 from 7.8ng/L (95% CI: 4.6-18.9) versus 5.7ng/L (95% CI: 3.6-11.9), P<0.05]. The multivariate analysis showed that the increased serum concentration of TNF-α was independently associated with high-density lipoprotein cholesterol (HDL-C), while the serum levels of IL-8 and MCP-1 were associated with hypertriglyceridemia. CONCLUSION: Subjects with serum triglycerides of ≥2.25mmol/L had an altered cytokine-profile, particularly with respect to serum IL-8, MCP-1 and TNF-α, which might partially account for its adverse clinical-consequences. Further-investigations in a large multi-center setting are warranted to unravel the potential functional-importance of these cytokines in individuals with hypertriglyceridemia.

7 Article Utility of the hypertriglyceridemic waist phenotype in the cardiometabolic risk assessment of youth stratified by body mass index. 2016

Buchan, D S / Boddy, L M / Despres, J-P / Grace, F M / Sculthorpe, N / Mahoney, C / Baker, J S. ·Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Lanarkshire, UK. · The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. · Department of Kinesiology, Faculty of Medicine, Université Laval & Québec Heart and Lung Institute, Québec, Canada. ·Pediatr Obes · Pubmed #26251875.

ABSTRACT: BACKGROUND: It is unclear whether the hypertriglyceridemic waist phenotype (HTWP) can be used to identify those at most risk of cardiometabolic disorders. OBJECTIVES: The utility of the HTWP as a useful predictor of cardiometabolic risk in youth stratified by body mass index was assessed. METHODS: Three hundred and eighty-seven children (12-17.5 years) were used within this cross-sectional study. Participants were classified as normal weight or overweight/obese according to the International Obesity Task Force criteria. The HTWP phenotype was defined as having a waist circumference ≥90th percentile for age and gender with concomitant triglyceride concentrations ≥1.24 mmol L(-1) . Cardiometabolic risk profiles were compared using MANCOVA. RESULTS: Normal weight participants with the HTWP had significantly higher levels of C-reactive protein 2.6 ± 0.4 vs. 1.6 ± 0.3 mg L(-1) (P < 0.05) and cardiometabolic risk scores (1.3 ± 0.3 vs. -0.7 ± 0.2 and 2.1 ± 0.4 vs. -0.5 ± 0.2; both P < 0.05) compared with those of a normal weight without the HTWP. Overweight/obese participants with the HTWP had significantly higher C-reactive protein levels (3.5 ± 0.6 vs. 2.6 ± 0.5; P < 0.05) as well as both cardiometabolic risk scores (1.6 ± 0.6 vs. 0.9 ± 0.2 and 2.2 ± 0.6 vs. 0.8 ± 0.2; both P < 0.001) when compared with overweight/obese participants without the HTWP. CONCLUSIONS: The HTWP may serve as a simple and clinically useful approach to identify youth at increased cardiometabolic risk.

8 Article Elevated interleukin-10: a new cause of dyslipidemia leading to severe HDL deficiency. 2015

Moraitis, Andreas G / Freeman, Lita A / Shamburek, Robert D / Wesley, Robert / Wilson, Wyndham / Grant, Cliona M / Price, Susan / Demosky, Stephen / Thacker, Seth G / Zarzour, Abdalrahman / Hornung, Ronald L / Pucino, Frank / Csako, Gyorgy / Yarboro, Cheryl / McInnes, Iain B / Kuroiwa, Takashi / Boumpas, Dimitrios / Rao, V Koneti / Illei, Gabor G / Remaley, Alan T. ·Metabolism, Endocrinology & Diabetes, Endocrine Oncology Program, University of Michigan, Ann Arbor, MI, USA. · Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. · Hospital Epidemiology, National Institutes of Health, Bethesda, MD, USA. · National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. · ALPS Unit, Laboratory of Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. · Clinical Services Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA. · National Institutes of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA. · Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, USA. · National Institutes of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA; College of Medicine, Veterinary Medicine and Life Sciences, University of Glasgow, Glasgow, Scotland. · National Institutes of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA; Medical School University of Athens, Affiliate Member IMBB, Heraklion and BRFAA Athens, Greece. · Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA; Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, USA. Electronic address: aremaley1@cc.nih.gov. ·J Clin Lipidol · Pubmed #25670364.

ABSTRACT: BACKGROUND: Low high-density lipoprotein cholesterol (HDL-C) is a risk factor for coronary artery disease. Investigating mechanisms underlying acquired severe HDL deficiency in noncritically ill patients ("disappearing HDL syndrome") could provide new insights into HDL metabolism. OBJECTIVE: To determine the cause of low HDL-C in patients with severe acquired HDL deficiency. METHODS AND RESULTS: Patients with intravascular large B-cell lymphoma (n = 2), diffuse large B-cell lymphoma (n = 1), and autoimmune lymphoproliferative syndrome (n = 1) presenting with markedly decreased HDL-C, low low-density lipoprotein cholesterol (LDL-C), and elevated triglycerides were identified. The abnormal lipoprotein profile returned to normal after therapy in all 4 patients. All patients were found to have markedly elevated serum interleukin-10 (IL-10) levels that also normalized after therapy. In a cohort of autoimmune lymphoproliferative syndrome patients (n = 93), IL-10 showed a strong inverse correlation with HDL-C (R(2) = 0.3720, P < .0001). A direct causal role for increased serum IL-10 in inducing the observed changes in lipoproteins was established in a randomized, placebo-controlled clinical trial of recombinant human IL-10 in psoriatic arthritis patients (n = 18). Within a week of initiating subcutaneous recombinant human IL-10 injections, HDL-C precipitously decreased to near-undetectable levels. LDL-C also decreased by more than 50% (P < .0001) and triglycerides increased by approximately 2-fold (P < .005). All values returned to baseline after discontinuing IL-10 therapy. CONCLUSION: Increased IL-10 causes severe HDL-C deficiency, low LDL-C, and elevated triglycerides. IL-10 is thus a potent modulator of lipoprotein levels, a potential new biomarker for B-cell disorders, and a novel cause of disappearing HDL syndrome.

9 Article Lipid-modifying therapies and risk of pancreatitis: a meta-analysis. 2012

Preiss, David / Tikkanen, Matti J / Welsh, Paul / Ford, Ian / Lovato, Laura C / Elam, Marshall B / LaRosa, John C / DeMicco, David A / Colhoun, Helen M / Goldenberg, Ilan / Murphy, Michael J / MacDonald, Thomas M / Pedersen, Terje R / Keech, Anthony C / Ridker, Paul M / Kjekshus, John / Sattar, Naveed / McMurray, John J V. ·BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Pl, Glasgow G12 8TA, United Kingdom. david.preiss@glasgow.ac.uk ·JAMA · Pubmed #22910758.

ABSTRACT: CONTEXT: Statin therapy has been associated with pancreatitis in observational studies. Although lipid guidelines recommend fibrate therapy to reduce pancreatitis risk in persons with hypertriglyceridemia, fibrates may lead to the development of gallstones, a risk factor for pancreatitis. OBJECTIVE: To investigate associations between statin or fibrate therapy and incident pancreatitis in large randomized trials. DATA SOURCES: Relevant trials were identified in literature searches of MEDLINE, EMBASE, and Web of Science (January 1, 1994, for statin trials and January 1, 1972, for fibrate trials, through June 9, 2012). Published pancreatitis data were tabulated where available (6 trials). Unpublished data were obtained from investigators (22 trials). STUDY SELECTION: We included randomized controlled cardiovascular end-point trials investigating effects of statin therapy or fibrate therapy. Studies with more than 1000 participants followed up for more than 1 year were included. DATA EXTRACTION: Trial-specific data described numbers of participants developing pancreatitis and change in triglyceride levels at 1 year. Trial-specific risk ratios (RRs) were calculated and combined using random-effects model meta-analysis. Between-study heterogeneity was assessed using the I2 statistic. RESULTS: In 16 placebo- and standard care-controlled statin trials with 113,800 participants conducted over a weighted mean follow-up of 4.1 (SD, 1.5) years, 309 participants developed pancreatitis (134 assigned to statin, 175 assigned to control) (RR, 0.77 [95% CI, 0.62-0.97; P = .03; I2 = 0%]). In 5 dose-comparison statin trials with 39,614 participants conducted over 4.8 (SD, 1.7) years, 156 participants developed pancreatitis (70 assigned to intensive dose, 86 assigned to moderate dose) (RR, 0.82 [95% CI, 0.59-1.12; P = .21; I2 = 0%]). Combined results for all 21 statin trials provided RR 0.79 (95% CI, 0.65-0.95; P = .01; I2 = 0%). In 7 fibrate trials with 40,162 participants conducted over 5.3 (SD, 0.5) years, 144 participants developed pancreatitis (84 assigned to fibrate therapy, 60 assigned to placebo) (RR, 1.39 [95% CI, 1.00-1.95; P = .053; I2 = 0%]). CONCLUSION: In a pooled analysis of randomized trial data, use of statin therapy was associated with a lower risk of pancreatitis in patients with normal or mildly elevated triglyceride levels.

10 Article A complicated pregnancy in a patient with lipodystrophic diabetes attributable to a peroxisome proliferator-activated receptor gamma (PPARG) mutation. 2012

Madhra, M / Noh, R M / Zammitt, N N / Patrick, A W / Love, C D B. ·Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK. ·Diabet Med · Pubmed #22803842.

ABSTRACT: BACKGROUND: We describe an unplanned pregnancy in a 19-year-old with lipodystrophic diabetes caused by a mutation in the peroxisome proliferator-activated receptor gamma (PPARG) gene. The pregnancy was complicated by poor compliance with treatment, severe hypertriglyceridaemia and pancreatitis. CASE REPORT: The patient presented at 6 weeks' gestation with an HbA(1c) of 140 mmol/mol (15%), cholesterol 8.1 mmol/l and triglycerides 20.1 mmol/l. She wished to continue the pregnancy so lipid-lowering therapy was discontinued. She was severely insulin resistant and poorly compliant with diet and medication. A continuous subcutaneous insulin infusion was required for efficient delivery of large doses of basal insulin, alongside injected mealtime boluses, (up to 300 units insulin per day). At 17 weeks' gestation she developed acute pancreatitis secondary to hypertriglyceridaemia (triglycerides > 100 mmol/l) and required plasmapheresis. Lipid-lowering therapy was reinstated in the third trimester and plasmapheresis was required repeatedly to maintain triglycerides < 10 mmol/l. Delivery was arranged at 32 weeks, because of deteriorating glycaemic and lipid control (blood pressure was normal). Following betamethasone for fetal lung maturation, 20 units/h of intravenous insulin were required to maintain glycaemic control. A baby boy with significant subsequent developmental delay was delivered. DISCUSSION: The features of PPARG mutations are discussed, with literature on lipodystrophy and pancreatitis in pregnancy reviewed. There are few documented cases of pregnancy in women with PPARG mutations. The notable features of this case include the consequences of non-concordance with treatment, the use of continuous subcutaneous insulin infusion to treat insulin-resistant diabetes and the need for repeated plasmapheresis during pregnancy to avert pancreatitis.

11 Article High-intensity exercise attenuates postprandial lipaemia and markers of oxidative stress. 2012

Gabriel, Brendan / Ratkevicius, Aivaras / Gray, Patrick / Frenneaux, Michael P / Gray, Stuart R. ·Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK. ·Clin Sci (Lond) · Pubmed #22435779.

ABSTRACT: Regular exercise can reduce the risk of CVD (cardiovascular disease). Although moderate-intensity exercise can attenuate postprandial TAG (triacylglycerol), high-intensity intermittent exercise might be a more effective method to improve health. We compared the effects of high-intensity intermittent exercise and 30 min of brisk walking on postprandial TAG, soluble adhesion molecules and markers of oxidative stress. Nine men each completed three 2-day trials. On day 1, subjects rested (control), walked briskly for 30 min (walking) or performed 5×30 s maximal sprints (high-intensity). On day 2, subjects consumed a high-fat meal for breakfast and 3 h later for lunch. Blood samples were taken at various times and analysed for TAG, glucose, insulin, ICAM-1 (intracellular adhesion molecule-1), VCAM-1 (vascular adhesion molecule-1), TBARS (thiobarbituric acid- reactive substances), protein carbonyls and β-hydroxybutyrate. On day 2 of the high-intensity trial, there was a lower (P<0.05) incremental TAG AUC (area under the curve; 6.42±2.24 mmol/l per 7 h) compared with the control trial (9.68±4.77 mmol/l per 7 h) with no differences during day 2 of the walking trial (8.98±2.84 mmol/l per 7 h). A trend (P=0.056) for a reduced total TAG AUC was also seen during the high-intensity trial (14.13±2.83 mmol/l per 7 h) compared with control (17.18±3.92 mmol/l per 7 h), walking showed no difference (16.33±3.51 mmol/l per 7 h). On day 2 of the high-intensity trial plasma TBARS and protein carbonyls were also reduced (P<0.05) when compared with the control and walking trials. In conclusion, high-intensity intermittent exercise attenuates postprandial TAG and markers of oxidative stress after the consumption of a high-fat meal.

12 Article The frequency and severity of capecitabine-induced hypertriglyceridaemia in routine clinical practice: a prospective study. 2010

Michie, C O / Sakala, M / Rivans, I / Strachan, M W J / Clive, S. ·Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK. Caroline.Michie@luht.scot.nhs.uk ·Br J Cancer · Pubmed #20664584.

ABSTRACT: BACKGROUND: Capecitabine is known to rarely cause raised serum triglycerides (TG). In our centre, several patients receiving capecitabine developed raised TG levels corresponding to the 'very high risk' category for potentially serious acute pancreatitis. METHODS: A fasting blood lipid screening protocol was introduced into clinical practice for patients receiving capecitabine. Patients with TGs >5 mmol l(-1) were treated and followed up. An 18-month prospective audit was performed to establish the incidence and severity of capecitabine-induced hypertriglyceridaemia (CIHT). RESULTS: A total of 304 patients received capecitabine for colorectal cancer between January 2008 and June 2009. Of these, 212 patients (70%) were screened and 8 (3.7%) developed clinically significant hypertriglyceridaemia requiring lipid-lowering therapy. Two of the eight patients had diabetes and one had pre-existing dyslipidaemia. One suffered cerebral infarction during chemotherapy. There were no cases of acute pancreatitis. Follow-up showed that serum TGs safely and rapidly returned to normal with appropriate treatment without discontinuation of capecitabine. CONCLUSIONS: This is the first prospective study evaluating CIHT. These results suggest that it should be classed as a 'common' undesired effect of capecitabine. Despite this, the incidence does not justify routine screening in all patients. Targeted screening in those with diabetes or pre-existing hyperlipidaemia is recommended, together with adoption of a clear management policy.

13 Minor Treatment of severe hypertriglyceridaemia. 2014

Preiss, David / McMurray, John J / Sattar, Naveed. ·British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK. Electronic address: david.preiss@glasgow.ac.uk. · British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK. ·Lancet Diabetes Endocrinol · Pubmed #25439459.

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