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Mangone LA, Kwon OS, Johnson BT, Wu Y, Pescatello LS. The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Mayo Clin Proc Innov Qual Outcomes 2024; 8:131-142. [PMID: 38384718 PMCID: PMC10878792 DOI: 10.1016/j.mayocpiqo.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Objective To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed. Results Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=-0.18; 95% CI, -0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, -0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=-1.84; 95% CI, -2.28 to -1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%). Conclusion Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training.
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Affiliation(s)
- Laura A. Mangone
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT
- UConn Center on Aging and Department of Orthopedic Surgery, University of Connecticut, School of Medicine, Farmington, CT
| | - Blair T. Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Yin Wu
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT
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Marcos-Garcés V, Merenciano-González H, Martínez Mas ML, Palau P, Climent Alberola JI, Perez N, López-Bueno L, Esteban Argente MC, Valls Reig M, Muñoz Alcover R, Pradillas Contreras I, Arizón Benito A, Payá Rubio A, Ríos-Navarro C, de Dios E, Gavara J, Chorro FJ, Sanchis J, Bodi V. Short-Course High-Intensity Statin Treatment during Admission for Myocardial Infarction and LDL-Cholesterol Reduction-Impact on Tailored Lipid-Lowering Therapy at Discharge. J Clin Med 2023; 13:127. [PMID: 38202134 PMCID: PMC10780070 DOI: 10.3390/jcm13010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
We hypothesized that a short-course high-intensity statin treatment during admission for myocardial infarction (MI) could rapidly reduce LDL-C and thus impact the choice of lipid-lowering therapy (LLT) at discharge. Our cohort comprised 133 MI patients (62.71 ± 11.3 years, 82% male) treated with atorvastatin 80 mg o.d. during admission. Basal LDL-C levels before admission were analyzed. We compared lipid profile variables before and during admission, and LLT at discharge was registered. Achieved theoretical LDL-C levels were estimated using LDL-C during admission and basal LDL-C as references and compared to LDL-C on first blood sample 4-6 weeks after discharge. A significant reduction in cholesterol from basal levels was noted during admission, including total cholesterol, triglycerides, HDL-C, non-HDL-C, and LDL-C (-39.23 ± 34.89 mg/dL, p < 0.001). LDL-C levels were reduced by 30% in days 1-2 and 40-45% in subsequent days (R2 0.766, p < 0.001). Using LDL-C during admission as a reference, most patients (88.7%) would theoretically achieve an LDL-C < 55 mg/dL with discharge LLT. However, if basal LDL-C levels were considered as a reference, only a small proportion of patients (30.1%) would achieve this lipid target, aligned with the proportion of patients with LDL-C < 55 mg/dL 4-6 weeks after discharge (36.8%). We conclude that statin treatment during admission for MI can induce a significant reduction in LDL-C and LLT at discharge is usually prescribed using LDL-C during admission as the reference, which leads to insufficient LDL-C reduction after discharge. Basal LDL-C before admission should be considered as the reference value for tailored LLT prescription.
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Affiliation(s)
- Víctor Marcos-Garcés
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
| | - Héctor Merenciano-González
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
| | - María Luz Martínez Mas
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
| | - Patricia Palau
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Josefa Inés Climent Alberola
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (J.I.C.A.); (L.L.-B.); (M.C.E.A.); (A.P.R.)
| | - Nerea Perez
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
| | - Laura López-Bueno
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (J.I.C.A.); (L.L.-B.); (M.C.E.A.); (A.P.R.)
| | - María Concepción Esteban Argente
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (J.I.C.A.); (L.L.-B.); (M.C.E.A.); (A.P.R.)
| | - María Valls Reig
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
| | - Raquel Muñoz Alcover
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
| | - Inmaculada Pradillas Contreras
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
| | | | - Alfonso Payá Rubio
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (J.I.C.A.); (L.L.-B.); (M.C.E.A.); (A.P.R.)
| | - César Ríos-Navarro
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
| | - Elena de Dios
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain;
| | - Jose Gavara
- Centre for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Francisco Javier Chorro
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain;
| | - Juan Sanchis
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain;
| | - Vicente Bodi
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (H.M.-G.); (M.L.M.M.); (P.P.); (M.V.R.); (R.M.A.); (I.P.C.); (F.J.C.); (J.S.)
- INCLIVA Health Research Institute, 46010 Valencia, Spain; (N.P.); (C.R.-N.)
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain;
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Miao X, Ye H, Cui X, Guo X, Su F. Resveratrol attenuates efavirenz-induced hepatic steatosis and hypercholesterolemia in mice by inhibiting pregnane X receptor activation and decreasing inflammation. Nutr Res 2023; 119:119-131. [PMID: 37826994 DOI: 10.1016/j.nutres.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023]
Abstract
Efavirenz (EFV), a widely prescribed antiviral medication, has been implicated in dyslipidemia and can activate the pregnane X receptor (PXR), leading to hepatic steatosis and hypercholesterolemia in mice. Resveratrol (RES) can ameliorate hepatic steatosis and functions as a partial PXR agonist, capable of mitigating PXR expression induced by other PXR agonists. Therefore, we hypothesized that RES could attenuate EFV-induced hepatic steatosis and hypercholesterolemia by downregulating PXR expression and suppressing inflammatory cytokine production. Here, we conducted an in vivo study involving 6-week-old male mice, which were divided into 4 groups for a 7-day intervention: control (carrier solution), EFV (80 mg/kg), RES (50 mg/kg), and RES + EFV groups. Serum and hepatic tissue samples were collected to assess cholesterol and triglyceride concentrations. Hepatic lipid accumulation was evaluated through hematoxylin-eosin and oil red O staining. Polymerase chain reaction and western blot were performed to quantify hepatic inflammatory factors, lipogenic gene, and PXR expression. Our results indicated that hepatic lipid droplet accumulation was reduced in the RES + EFV group compared with the EFV group. Similarly, the expressions of hepatic inflammatory factors were attenuated in the RES + EFV group relative to the EFV group. Furthermore, RES counteracted the upregulation of hepatic lipid-metabolizing enzymes induced by EFV at both the transcriptional and protein levels. Importantly, PXR expression was downregulated in the RES + EFV group compared with the EFV group. Conclusively, our findings suggest that RES effectively mitigates EFV-induced hepatic steatosis and hypercholesterolemia by inhibiting PXR activation and decreasing inflammation.
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Affiliation(s)
- Xingguo Miao
- Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 325000, China; Department of Infectious Diseases, the Sixth People's Hospital of Wenzhou, Zhejiang, 325000, China; Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China
| | - Hui Ye
- Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 325000, China; Department of Infectious Diseases, the Sixth People's Hospital of Wenzhou, Zhejiang, 325000, China
| | - Xiaoya Cui
- Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 325000, China; Department of Infectious Diseases, the Sixth People's Hospital of Wenzhou, Zhejiang, 325000, China
| | - Xiuxiu Guo
- Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 325000, China; Department of Infectious Diseases, the Sixth People's Hospital of Wenzhou, Zhejiang, 325000, China
| | - Feifei Su
- Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 325000, China; Department of Infectious Diseases, the Sixth People's Hospital of Wenzhou, Zhejiang, 325000, China.
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Tabansi D, Dahiru D, Patrick AT, Jahng WJ. Anti-Atherosclerosis and Anti-Hyperlipidemia Functions of Terminalia catappa Fruit. ACS OMEGA 2023; 8:35571-35579. [PMID: 37810701 PMCID: PMC10552119 DOI: 10.1021/acsomega.3c00685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
Background: Atherosclerosis is a chronic pathological condition that has remained clinically silent for decades, and the epidemic has continued to be on the rise due to risk factors, including diet, lifestyle, hyperlipidemia, pathogenic microorganisms, and aging. Using various synthetic drugs in treating atherosclerosis is associated with a high risk of myositis, angioedema, myoglobinuria, and acute renal failure. Various side effects of the available drugs have been reported; attempts are underway to explore natural sources with antiatherosclerotic activity. Aim and objective: Using a diet-induced atherosclerosis rat model, the current study tested the hypothesis of antiatherosclerotic and antihyperlipidemic roles of Terminalia catappa fruit extracts. Materials and Methods: Atherosclerosis in Wistar rats was induced using an atherogenic diet. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (AP), creatine kinase (CK), and lactate dehydrogenase (LDH) were determined using analytical kits. Results: Quantitative phytochemical analysis of the extracts demonstrated that the plant had flavonoids, saponins, tannins, terpenoids, alkaloids, cardiac glycosides, sterols, phenols, and anthraquinones. Diet-induced atherogenic Wistar rats showed a significant (p < 0.05) increase in total cholesterol, triglyceride, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol compared to the healthy control group; however, the atherogenic lipid profile was reversed by the treatment of T. catappa fruit extracts. The biochemical experiments demonstrate that T. catappa fruit extracts have an antihyperlipidaemic effect, shown by a decreased coronary risk index and the atherogenic index, and an increased cardioprotective index, compared to disease control. Conclusion: The current study indicates that T. catappa fruit extracts may contain bioactive molecules to treat atherosclerosis.
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Affiliation(s)
- Doris Tabansi
- Department
of Biochemistry, Faculty of Life Sciences, Modibbo Adama University of Technology, Yola 640101, Nigeria
| | - Daniel Dahiru
- Department
of Biochemistry, Faculty of Life Sciences, Modibbo Adama University of Technology, Yola 640101, Nigeria
| | - Ambrose Teru Patrick
- Department
of Cellular and Molecular Medicine, Chosun
University, Gwangju 61452, Korea
- Department
of Ophthalmology, Julia Laboratory, Suwon 16232, Korea
| | - Wan Jin Jahng
- Department
of Ophthalmology, Julia Laboratory, Suwon 16232, Korea
- Department
of Drug Discoveries, Julia Eye Institute, Suwon 16243, Korea
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