Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242339 (dyslipidemia)
 13,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Type 2 diabetes mellitus (T2DM) and its complications must be managed by using a comprehensive, or global, approach to treatment. The author describes the case of a white man, aged 51 years, with T2DM that was diagnosed 3 years earlier. The patient was obese and had a history of chronic low back pain. He also had diagnosed hypertension, decreased vibratory sensation in the feet, an S4 atrial gallop, trace ankle edema, degenerative joint disease in the knees, and decreased range of motion in the lumbar spine. Other findings at the patient's initial visit included hyperglycemia, microalbuminuria, and lipid abnormalities. Initial treatment included metformin; a nonsteroidal anti-inflammatory drug (naproxen); a thiazolidinedione (rosiglitazone maleate); a thiazide diuretic (hydrochlorothiazide); an angiotensin-converting enzyme inhibitor (enalapril); and low-dose aspirin. At 6-month follow-up, the patient continued to have elevated glycosylated hemoglobin, hypertension, dyslipidemia, and excess weight. Additional treatment strategies consisted of pioglitazone hydrochloride; metformin in combination with the dipeptidyl peptidase IV inhibitor sitagliptin phosphate; a statin (atorvastatin hydrochloride); and enrollment in a diet and exercise program. Results at 12-month follow-up included a substantial decrease in glycosylated hemoglobin and improved hypertension and dyslipidemia. The patient was successfully treated across the full range of global cardiovascular risk reduction.
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PMID:Reducing global cardiovascular risk in patients with type 2 diabetes mellitus. 1851 38

Increased prevalence of type 2 diabetes mellitus and its close clustering with obesity, arterial hypertension, dyslipidemia and other pathologies commonly referred to as metabolic or insulin resistance syndrome, represents one of the major health problem worldwide. The side effects of most of oral antidiabetics and insulin include increase in body weight and/or hypoglycemia that may limit its use in some patients. GLP-1 agonists are medicaments stimulating GLP-1 receptor similarly as endogenous GLP-1. These substances are in contrast to endogenous GLP-1 resistant to inactivation by ubiquitous enzyme dipeptidyl-peptidase 4 which enables its administration once or twice daily. GLP-1 agonists not only significantly improve diabetes compensation with minimal risk of hypoglycemia but also decrease body weight, blood pressure and improve numerous parameters of cardiovascular risk. The aim of this review is to summarize current knowledge with respect to use of GLP-1 agonists in the treatment of type 2 diabetes and its future perspectives. We will focus mostly on the two drugs that are currently available in Czech Republic--exenatide and liraglutide.
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PMID:[Treatment of type 2 diabetes mellitus with GLP-1 agonists]. 2161 70

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome, which includes dyslipidemia, central obesity, hypertension, and insulin resistance. These diseases collectively and individually increase the risk of cardiovascular disease. Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD that can progress to cirrhosis in up to 30% of patients and lead to decompensated liver disease requiring liver transplantation in many patients. Insulin resistance is the pathophysiological hallmark of NASH and addressing insulin resistance is an important aspect of NASH management. Lifestyle modifications with diet and exercise improve insulin sensitivity and are the cornerstone of therapy, but are often difficult to maintain long term. Not surprisingly, insulin-sensitizing agents have been a focus of pharmacologic investigation in NASH. Insulin sensitizers such as the thiazolidinediones, biguanides, glucagon-like peptide-1 receptor agonists, and the dipeptidyl peptidase IV inhibitors, also known as incretins, will be discussed with respect to their mechanism of action and how these drugs might target aspects of NASH pathophysiology. Finally, we will summarize the available clinical data and review both the risks and benefits of insulin sensitizers in the treatment of NASH.
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PMID:The role of insulin-sensitizing agents in the treatment of nonalcoholic steatohepatitis. 2176 69

The increasing epidemic of diabetes mellitus around the globe is increasing the risk of various other chronic diseases i.e. coronary artery diseases, myocardial infarction, hypertension, dyslipidemia and number of other complicated disorders. Diabetes mellitus is clinically characterized by a marked increase in blood glucose levels and is associated with mild hyperlipidemia. Although the prevalence of this health ailment is increasing dramatically, various therapeutic compounds have been developed to treat this disease that is available in the market as synthetic, formulated and combined forms. Recently, various compounds have come through preclinical studies and shown the therapeutic efficacy of using multiple/ specific drug targets. Recent research approaches have been based on receptors targeting, islet cell transplantation, gene expression profiling, glucagon-like peptide-1, dipeptidyl peptidase IV inhibitors, insulin therapy, modulators of peroxisome proliferator-activated receptors (PPAR), glucagon receptor antagonists, insulin analogues, sensitizers and combination therapies. Furthermore various, latest findings claimed to identifying new anti-diabetic regimens with novel mechanism of action are being developed. This review provides an update on the use of approaches to the development of preventive and therapeutic strategies against diabetes and recent patents that could develop into novel therapeutics available to the clinical success for the management of the disease.
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PMID:Anti-diabetic compounds and their patent information: an update. 2301 23

It is well known that patients with type 2 diabetes mellitus (T2DM) are at increased risk of cardiovascular (CV) disease. Elevated plasma glucose levels that independently lead to increased cardiovascular risk, combined with associated co-morbidities such as obesity, hypertension, and dyslipidemia, further contribute to the development of CV complications. Dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors) are a relatively new class of drugs used for the treatment of diabetes and recently have been widely used in clinical practice. They exert their actions through degradation inhibition of endogenous glucagon-like peptides (GLP-1) and glucose-dependent insulinotropic peptides (GIP), with a resulting increase in glucose mediated insulin secretion and a suppression of glucagon secretion. Since GLP-1 is known to have an impact not only on plasma glucose levels but also to have cardiovascular protective effects there is increased speculation of whether DPP-4 inhibitors will have similar effects. Though many short-term studies have been encouraging, ongoing long-term clinical trials on humans are needed to provide further clarity to the complete safety profiles of these agents in terms of cardiovascular risk, and whether they may exert potential cardiovascular benefit. This review includes available data on the cardiovascular effects of DPP-4 inhibitors as well as their overall safety profile.
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PMID:Dipeptidyl peptidase-4 inhibitors and their effects on the cardiovascular system. 2381 35

Fasting hypertriglyceridemia is positively associated with the morbidity of coronary heart disease (CHD), and postprandial (non-fasting) hypertriglyceridemia is also correlated with the risk status for CHD, which is related to the increase in chylomicron (CM) remnant lipoproteins produced from the intestine. CM remnant particles, as well as oxidized low density lipoprotein (LDL) or very low density lipoprotein (VLDL) remnants, are highly atherogenic and act by enhancing systemic inflammation, platelet activation, coagulation, thrombus formation, and macrophage foam cell formation. The cholesterol levels of remnant lipoproteins significantly correlate with small, dense LDL; impaired glucose tolerance (IGT) and CHD prevalence. We have developed an assay of apolipoprotein (apo)B-48 levels to evaluate the accumulation of CM remnants. Fasting apoB-48 levels correlate with the morbidity of postprandial hypertriglyceridemia, obesity, type III hyperlipoproteinemia, the metabolic syndrome, hypothyroidism, chronic kidney disease, and IGT. Fasting apoB-48 levels also correlate with carotid intima-media thickening and CHD prevalence, and a high apoB-48 level is a significant predictor of CHD risk, independent of the fasting TG level. Diet interventions, such as dietary fibers, polyphenols, medium-chain fatty acids, diacylglycerol, and long-chain n-3 polyunsaturated fatty acids (PUFA), ameliorate postprandial hypertriglyceridemia, moreover, drugs for dyslipidemia (n-3 PUFA, statins, fibrates or ezetimibe) and diabetes concerning incretins (dipeptidyl-peptidase IV inhibitor or glucagon like peptide-1 analogue) may improve postprandial hypertriglyceridemia. Since the accumulation of CM remnants correlates to impaired lipid and glucose metabolism and atherosclerotic cardiovascular events, further studies are required to investigate the characteristics, physiological activities, and functions of CM remnants for the development of new interventions to reduce atherogenicity.
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PMID:Postprandial Hyperlipidemia and Remnant Lipoproteins. 2782 82

Diabetes has become the second most severe disease to human health. Probiotics are important for maintaining gastrointestinal homeostasis and energy balance and have been demonstrated to play a positive role in the prevention and treatment of metabolic syndromes, such as obesity, inflammation, dyslipidemia, and hyperglycemia. The objective of this study was to screen potential antidiabetic strains in vitro and evaluate its effects in vivo. For the in vitro section, dipeptidyl peptidase IV (DPP-IV) inhibitory and antioxidant activities of 14 candidate Lactobacillus spp. strains were tested. Then hydrophobicity and acid and bile salt tolerance assays were determined. The most promising in vitro strain was further evaluated for its antidiabetic properties in vivo using type 2 diabetes mice induced by high-fat diet and intraperitoneal injection of streptozotocin (STZ). The reference strain for this study was Lactobacillus rhamnosus GG. Results showed that cell-free excretory supernatants and cell-free extracts of Lactobacillus acidophilus KLDS1.0901 had better DPP-IV inhibitory activity, antioxidative activities, and biological characteristics than other strains. At the end of the treatment, we found that L. acidophilus KLDS1.0901 administration decreased the levels of fasting blood glucose (FBG), glycosylated hemoglobin, insulin in serum and AUCglucose, and increased the level of glucagon-like peptide 1 in serum compared with diabetic mice (p < 0.05). Moreover, L. acidophilus KLDS1.0901 supplementation increased the activities of superoxide dismutase, glutathione peroxidase, the level of glutathione, and reduced the level of malondialdehyde in serum. These results indicated that L. acidophilus KLDS1.0901 could be used as a potential antidiabetic strain; its application as food supplement and drug ingredient is thus recommended.
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PMID:Screening for Potential Novel Probiotics With Dipeptidyl Peptidase IV-Inhibiting Activity for Type 2 Diabetes Attenuation in vitro and in vivo. 3199 45

Cardiovascular complications are main cause of increased mortality in patients with type 2 diabetes. Decrease of overall cardiovascular risk and subsequently cardiovascular morbidity and mortality in type 2 diabetes patients is therefore an important treatment aim. To this end, intensive intervention of classical risk factors such as dyslipidemia, arterial hypertension, smoking along with lifestyle intervention is necessary. Good diabetes control optimally with the use of antidiabetic medication and smoking with positive effect on cardiovascular complication is of high importance as well. Incretin-based therapy includes an approach based on an increase of endogenous GLP-1 concentrations by inhibition of its breakdown by dipeptidyl-peptidase 4 (DPP-4 inhibitors or gliptins) or he use of GLP-1 receptor agonists that owing to modified structure have much longer half-life than endogenous GLP-1 and act the use through stimulation of GLP-1 receptor. The aim of this paper is to summarize the use of these two groups of antidiabetic drugs - gliptins and GLP-1 receptor agonists - in patients with type 2 diabetes focusing on the their cardiovascular effects and their influence on cardiovascular complications.
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PMID:Incretin-based treatment of diabetes and cardiovascular complications. 3294 80