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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Synthetic progestins derived from nortestosterone provide a promising contraceptive alternative for women with contraindications for estrogens. Progesterone and synthetic progestins reduce vasodilatation and edema induced by estrogens and stop estrogen-dependent cellular multiplication in target tissue. Progestins have 2 kinds of contraceptive affect: antigonadotropic action at sufficient doses, and peripheral action at lower doses. The cervical mucus is modified in composition and volume, becoming hostile to sperm; the endometrial mucus atrophies; and tubal motility is slowed. High dose progestins are administered from the 5th or 10th to the 25th cycle day, with the earlier date preferred for women with shorter cycles. They are an ideal method for women with endometrial hyperplasia or benign breast disease or histories of breast or uterine cancer, as well as for women over 40 with dysovulatory cycles. Contraindications to high dose progestins include obesity, hypertension, lipid metabolic anomalies, and diabetes. Low dose progestin-only pills are administered at the exact same time each day including during menstruation. They are attractive for some women because they contain no estrogen, a reduced progestin dose causing fewer headaches and less somnolence, and fewer metabolic effects. Low dose progestins are indicated for lactating women, those with contraindications to estrogens such as obesity, hypertension, hyperlipidemia, and diabetes, and those with renal or cardiac insufficiency with valvulopathy. Low dose progestins are also indicated for nulliparas and other women for whom IUDS are contraindicated. Women using low dose progestins should never take drugs that act as enzymatic inductors, which speed hepatic degradation of steroids and reduce their efficiency. A resulting pregnancy is likely to be extrauterine because of slowed tubal transport. The failure rate of low dose progestins ranges from .9-3%, with higher failure rates among younger women. About 30% of users initially experience spotting, which despite its usual disappearance after 2-3 months of use is the most common reason for discontinuing the method. Low dose progestins have no metabolic or vascular effects, but they may cause a relative hyperestrogenism is some users. Other modes of administration of progestin contraception include continuous high doses, never justified solely for contraception. Trimonthly injections of medroxyprogesterone acetate of norethindrone enanthate provide contraception through a long lasting antigonadotropic effect. Metrorrhagia and amenorrhea are among possible side effects. The method is used primarily in developing countries where its ease of use is a major advantage. Subcutaneous implants releasing continuous doses of levonorgestrel provide contraceptive protection for over 5 years. The cumulative failure rate is 1.7 at 5 years. Metabolic tolerance is good. The major side effect is menstrual irregularity.
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PMID:[Progestational contraception]. 365 94

We describe a new phenotype of hyperlipoproteinemia in two members of a family with a high degree of consanguinity. Both have a history of uncontrolled diabetes mellitus without ketoacidosis, and a family history of coronary artery disease at a relatively early age. A high degree of insulin resistance was found. The abnormal lipoprotein(s) has alpha-lipoprotein mobility on cellulose acetate electrophoresis and has a relative density of less than 1.006 as determined by ultracentrifugation of serum collected after a short fast. The fraction isolated by ultracentrifugation contains about half of the serum cholesterol and triglycerides and most of the phospholipids; the major protein component is albumin. Immunoelectrophoresis showed low concentrations of beta-lipoproteins in both sera, and two abnormal precipitin bands against monospecific antiserum to antilipoprotein A; a third member of the family showed only one abnormal precipitin band against the same antibody. We tentatively propose an abnormal gene(s) as the underlying mechanism. The insulin-resistant diabetes mellitus, probably inherited separately, may aggravate the hyperlipidemia.
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PMID:Hyperlipoproteinemia with albumin-lipid complex: a novel type of hyperlipoproteinemia associated with insulin-resistant diabetes mellitus. 397 55

Treatment of rats with allylisopropylacetamide results in two related effects that occur sequentially. After one injection, serum FFA concentration increases and fatty liver develops without any decrease in lipoprotein synthesis. With repeated administration of the drug, fatty acid mobilization continues and acetate incorporation into lipids increases. However, fatty liver disappears with a concomitant increase in lipoprotein synthesis, resulting in hyperlipemia. It is postulated that accumulation of the liver lipid might be a regulating factor in the synthesis and transport of lipoproteins.
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PMID:Mechanism of fatty liver development and hyperlipemia in rats treated with allylisopropylacetamide. 554 7

Low dose estrogen tablets, containing less than 50 mcg of ethinyl estradiol, were formulated because of the recognized dose response relationship with the steroid content of the tablet and side effects. These new oral contraceptives (OCs) are as effective as the older high-dose OCs, and available evidence reports fewer side effects. This discussion reviews pharmacology of these new OCs, the mechanism of action, contraindications, side effects, and problems with the low-dose estrogen OC. Ethinyl estradiol is the only estrogen used in the low-dose combination OC. There are several synthetic progestins: norethindrone, norethindrone acetate, norgestrel, levonorgestrel, and ethynodiol diacetate. These progestins have different potencies so the pharmacologic activity cannot be accurately predicted based on the amount present in the tablet. The synthetic steroids in OCs are absorbed in the small intestine, metabolized in the liver, excreted in the bile and feces with a half-life of 24 hours. The low-dose estrogen combination preparation is taken 3 out of every 4 weeks. Its contraceptive effect is primarily a result of hypothalamic mediated gonadotropin suppression with subsequent inhibition of ovulation. Contraindications to taking the low-dose OC are the same as for the higher dose OC: thromboembolic or cardiovascular disease, estrogen dependent neoplasia, markedly impaired liver function, undiagnosed genital bleeding, congenital hyperlipidemia, pregnancy, and women over age 30 who smoke. Relative contraindications include hypertension, diabetes mellitus, migraine headaches, uterine myomas, and epilepsy. The often quoted 2-5-fold increased incidence of thromboembolic disease, myocardial infarction, and stroke is based on large epidemiologic studies involving patients taking the older higher dose OCs. Current data from patients taking the newer low-dose medication demonstrate minimal if any increased incidence of these problems in young women who do not smoke. The low-dose estrogen OCs have minimal effect on lipid levels. Early reports of patients using the low-dose OC have shown little if any increased incidence of hypertension. The low-dose contraceptives have little effect on glucose tolerance, and there is no evidence to show an increased incidence of overt diabetes in OC users. There is no evidence that use of the combination OC causes an increase in cancer of the cervix, uterus, or ovaries. Clinical complaints of nausea, breast discomfort, chloasma, weight changes, and depression are reduced with the low-dose estrogen preparation. Hypomenorrhea while taking the OC occasionally occurs because the lower dose of estrogen is insufficient to stimulate the endometrial growth in face of the predominant progestin-atrophy effect.
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PMID:Oral contraceptives in 1984. 649 Mar 38

With the view of examining the serum lipid metabolism-improving action of a new compound, ethyl-2-(4-chlorophenyl)-5-ethoxy-4-oxazole acetate (Y-9738), 900 mg was administered to 47 patients with various diseases associated with hyperlipidemia and/or hypo-HDL (high density lipoprotein)-emia for successive 16 weeks. Serum HDL-cholesterol increased significantly 4 weeks after the administration (mean 11.8%, p less than 0.01). In the patients with hypo-HDL-emia who showed the initial level of 50 mg/dl or less, the degree of increase was more remarkable (mean 16,4%, p less than 0.01), and a significant increase was noted until 12 weeks later. Further, a similar change was noted in respect to serum HDL-phospholipid. The main apoprotein of HDL, apoprotein A (I + II) began to increase significantly 4 weeks after the institution of the administration. At the end of the trial, it increased by mean 31% (p less than 0.01). Y-9738 did not exert any significant effect on serum total cholesterol, triglyceride and phospholipid, but it caused a reduction in so-called atherogenic indexes.
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PMID:Effects of ethyl-2-(4-chlorophenyl)-5-ethoxy-4-oxazole acetate (Y-9738) on the serum lipids of patients with hyperlipidemia and/or hypo-HDL-emia. 654 94

The effects of ethanol, acetaldehyde, acetate and lactate on lipoprotein lipase (LPL) activity and regulation have been investigated. None of the substances had any direct effect on the enzyme or enzyme-substrate complex. Ethanol and acetate interfered with LPL regulation studied in vitro using rat adipose tissue. Acetate administration to humans did not influence the activity of LPL and hepatic lipase in post-heparin plasma, nor was the intravenous fat tolerance test affected. Ethanol administration markedly increased and prolonged the hyperlipidemia induced by oral triglyceride intake; the effect of acetate was much less pronounced. Thus, acetate does not seem to interfere with LPL regulation in man. The previously described impairment in LPL activity and regulation after ethanol intake is probably mediated by ethanol itself.
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PMID:Acute effects of ethanol and its metabolites on plasma lipids and lipoprotein lipase activity. 688 18

In psoriatic patients with hyperlipidemia we studied the hepatic lipid synthesis from (1-(14)C)-acetate in human liver biopsy specimens in vitro by a thin-layer radio-chromatography. In psoriatics type IV (according to Fredrickson) a significant increase in (1-(14)C)-acetate hepatic incorporation especially into phospholipids (25%) and triglycerides (52%) was observed; in type IIb increased lipogenesis was phospholipids (24.5%), free cholesterol (44.4%) and triglycerides (29%). Abnormal lipid metabolism often coexists with glucose intolerance in psoriasis; no correlation between hyperinsulinemia and augmented (1-(14)C)-acetate incorporation into hepatic triglycerides was found.
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PMID:Lipid synthesis from the liver in patients with psoriasis. 701 Dec 16

When deoxycorticosterone acetate (DOCA)-loaded uninephrectomized rats were fed on standard laboratory pellet diet and 1% saline for 5 weeks, caloric homeostasis became abnormal resulting in (a) hyperlipidemia, (b) cholesterol deposit in the heart, (c) significant reduction of triglycerides in the aorta, heart and liver and (d) a 60% increase in the cardiac free fatty acids (FFA) on one hand and a 50% reduction of the hepatic FFA on the other. These facts suggest that the hypertension severely reduces hepatic lipogenesis, whereas the cardiovascular system depends much more on FFA as a metabolic fuel than on glucose. This idea is supported by the deficiency in total body potassium (K) and decrease in serum immunoreactive insulin (IRI) which occur in the hypertension. These alterations were attenuated by the fungal prenylphenols, 4-0-methylascochlorin (MAC) and ascofuranone (AF). The protective effect seems to be partly attributable to the counteraction to DOCA. In addition, the agents caused a specific increase of renal water reabsorption. MAC treatment resulted in a particularly marked reduction of saline intake and excretion of unusually thick urine with 2.8 times higher sodium (Na) concentration than in the DOCA/saline control rats.
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PMID:Unusual concentration of urine and prevention of polydipsia by fungal prenylphenols in DOCA hypertensive rats. 701 11

In vitro lipogenesis was studied on the xanthoma tissue from 6 patients with normal plasma lipids and 4 patients with hyperlipidemia. Xanthoma tissue was incubated at 37 degrees C for 6 hr in Krebs-Ringer phosphate buffer containing sodium [14C]acetate. The radioactivity of each lipid class was determined after extraction and separation of lipids. The incorporation of acetate into all major lipid groups was much greater in xanthoma tissue than in control normal-appearing skin. There was no difference in the incorporation pattern of 14C between xanthomas of patients with normal plasma lipids and those of hyperlipidemic patients. The data exemplify considerable in situ lipid synthesis of xanthoma tissue. Although the lipids in xanthomas of hyperlipidemic persons may be derived from plasma, the plasma origin of xanthoma lipids in normolipidemic persons remains to be confirmed, and the contribution of local lipogenesis cannot be ignored. The lipids in cutaneous xanthomas are most likely derived from a multiple input system.
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PMID:Lipid synthesis in cutaneous xanthoma. 709 39

The platelet lipid biosynthesis in relation to platelet aggregation and lipemia was studied by 14C-acetate and mevalonate incorporation into platelets of seventeen women without medication and of eighteen women using a low estrogen oral contraceptive. The lipid biosynthesis was significantly increased by 59% (mevalonate) and 38% (acetate) in women on oral contraceptives. From mevalonate, lipid synthesis was increased mostly in the lanosterol-dihydrolanosterol fraction (p less than .01). From acetate, lipid synthesis was significantly enhanced in all the lipid classes. In the oral contraceptive group, the response of platelets to thrombin aggregation was only slightly higher, but HDL-cholesterol was significantly lower. However, in the women using oral contraceptives, the percentage of abnormal values in HDL-cholesterol, thrombin-aggregation and acetate incorporation into lanosterol was similar. Thus, more than 40% of the women studied here, using low estrogen oral contraceptives, presented an increase in platelet lipid biosynthesis, especially in the lanosterol-dihydrolanosterol fraction, which was significantly correlated (p less than .05) with the response of their platelets to thrombin-induced aggregation.
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PMID:Biosynthesis of platelet lipids in relation to aggregation in women using oral contraceptives. 711 49


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