A remarkable increase in high-density lipoprotein-cholesterol by alcohol intake in a homozygous patient with cholesteryl ester transfer protein deficiency

Effect of Synthetic Truncated Apolipoprotein C-I Peptide on Plasma Lipoprotein Cholesterol in Nonhuman Primates

The present studies were conducted to determine whether a synthetic truncated apoC-I peptide that inhibits CETP activity in baboons would raise plasma HDL cholesterol levels in nonhuman primates with low HDL levels. We used 2 cynomolgus monkeys and 3 baboons fed a cholesterol- and fat-enriched diet. In cynomolgus monkeys, we injected synthetic truncated apoC-I inhibitor peptide at a dose of 20 mg/kg and, in baboons, at doses of 10, 15, and 20 mg/kg at weekly intervals. Blood samples were collected 3 times a week and VLDL + LDL and HDL cholesterol concentrations were measured. In cynomolgus monkeys, administration of the inhibitor peptide caused a rapid decrease in VLDL + LDL cholesterol concentrations (30%–60%) and an increase in HDL cholesterol concentrations (10%–20%). VLDL + LDL cholesterol concentrations returned to baseline levels in approximately 15 days. In baboons, administration of the synthetic inhibitor peptide caused a decrease in VLDL + LDL cholesterol (20%–60%) and an increase in HDL cholesterol (10%–20%). VLDL + LDL cholesterol returned to baseline levels by day 21, whereas HDL cholesterol concentrations remained elevated for up to 26 days. ApoA-I concentrations increased, whereas apoE and triglyceride concentrations decreased. Subcutaneous and intravenous administrations of the inhibitor peptide had similar effects on LDL and HDL cholesterol concentrations. There was no change in body weight, food consumption, or plasma IgG levels of any baboon during the study. These studies suggest that the truncated apoC-I peptide can be used to raise HDL in humans.

The French paradox: possible involvement of ethanol in the protective effect against cardiovascular diseases

OBJECTIVES

This review surveyed the literature on the cardioprotective effects of moderate alcohol consumption.

METHODS

The putative cardioprotective effects of alcohol and other substances in alcoholic beverages are discussed by taking "the French paradox" as a starting point. A survey of the literature highlighted various hypotheses explaining the protective effects of moderate alcohol consumption.

RESULTS

The positive effects of moderate quantities of alcohol have been attributed in part to increased plasma levels of high-density lipoprotein, an inhibition of platelet aggregation, and improved endothelial function. Many investigators have claimed that wine is the significant factor explaining the French paradox. Red wine has been shown ex vivo to inhibit low-density lipoprotein oxidation, increase antioxidant capacity in humans, and reduce susceptibility of human plasma to lipid peroxidation. The non-alcoholic fraction of wine, represented mainly by phenolic compounds, may be the primary factor responsible for this protective effect. However, the protective effects are not restricted to a particular type of alcoholic drink, suggesting that alcohol per se rather than compounds specific to certain beverages reduces mortality risk.

CONCLUSIONS

It is difficult to explain the effect of alcohol on risk factors associated with cardiovascular diseases by a uniform biochemical mechanism. Moreover, its protective effects are counterbalanced by its addictive properties.

Alcohol consumption had no beneficial effect on serum lipids in a substantial proportion of patients with primary hyperlipidemia

The cardioprotective effect of moderate alcohol consumption, which is mediated largely by an elevation of high-density lipoprotein (HDL) levels, may be absent in patients with primary disorders of lipid metabolism. In 881 untreated, unrelated patients with primary hyperlipidemia, we estimated the effect of alcohol on fasting serum HDL cholesterol concentration adjusted for age, gender, diet, and smoking with a multiple linear regression model. The number of abstainers, moderate users (1-30 g daily), and heavy alcohol consumers (> or = 30 g daily) was not different between three types of hyperlipidemia. Among hypercholesterolemic (n = 514) and combined hyperlipidemic (n = 227) patients, consumers of alcohol had higher HDL levels compared to abstainers (P(for trend) = 0.0001 and 0.0002, respectively). Heavy drinkers with combined hyperlipidemia had higher triglyceride levels compared to moderate drinkers and abstainers (P(for trend) = 0.008). Alcohol consumption had no effect on the lipid profiles in 140 patients with hypertriglyceridemia. In conclusion, combined hyperlipidemic and hypertriglyceridemic patients may profit from an encouragement to stop consuming alcohol. On the other hand, moderate use of alcohol may delay the development of coronary artery disease in hypercholesterolemic patients by an elevation of HDL levels.

Determination of biological markers for alcohol abuse

Alcoholism is one of the most frequent addictions and an important subject in forensic medicine and clinical toxicology. Several laboratory abnormalities are associated with excessive alcohol consumption. They are useful in the diagnosis of alcoholism especially during the follow-up of various treatment programs. The biological markers mostly used for diagnosis of alcoholism are presented. Especially, methods for the determination of the following diagnostic tools are reviewed: congener alcohols, gamma-glutamyltransferase, aspartate and alanine aminotransferase, beta-hexosaminidase, erythrocyte aldehyde dehydrogenase, alpha-amino-n-butyric acid to leucine ratio, macrocytosis, carbohydrate-deficient transferrin, (apo)lipoproteins, fatty acid ethyl esters, blood acetate, acetaldehyde adducts, 5-hydroxytryptophol, dolichol and condensation products. No laboratory test exists that is reliable enough for the exact diagnosis of alcoholism. The combination of physician interview, questionnaire and laboratory markers is necessary for the diagnosis of alcoholism.