Lipid Education Service
January / February 2003
Newsbrief
J. David Schnatz, M.D.
Among the abstracts presented at the November 2002 annual meeting of the American
Heart Association were the following:�
Abstract #225:� Low HDL is Characterized by Endothelial Dysfunction, Which
is Reversible upon HDL-Increase�� Besides its well known role in reverse
cholesterol transport, HDL was shown to exert a beneficial effect on the arterial
wall, providing another reason to increase HDL.�����������
Abstract #370:� Cholesteryl Ester Transfer Protein (CETP) Concentration
is Associated with Progression of Atherosclerosis and Response to Pravastatin
in Men with Coronary Artery Disease (REGRESS)�� CETP was shown to be an
important factor in response to statin treatment in that men with coronary artery
disease (CAD) have more rapid progression when CETP is high.� These men obtain
the best cholesterol and angiographic response to Pravastatin.� �����������
Abstract #372:� Statin Pretreatment Improves Prognosis Following Percutaneous
Coronary Intervention in Patients with History of Unstable Angina�� Patients
with a history of unstable angina did better with respect to incidence of MI,
death and revascularization after percutaneous coronary intervention, when pretreated
with statins.�����������
Abstract #373:� Efficacy and Safety of Simvastatin in Children with Familial
Hypercholesterolemia�� Whereas little information has been available on
the use of statins in children, this 48 week study showed that in 173 children,
cholesterol was reduced without effects on growth, pubertal development or on
baseline adrenal, gonadal and pituitary hormones.� �����������
Abstract #377:� Dyslipidemia of Insulin Resistance and Obesity:� Gender
Differences�� Women had greater increases in cholesterol, LDL and non-HDL
cholesterol than men when obesity and insulin resistance were present, possibly
leading to the increase in cardiovascular risks seen in these women.� �����������
Abstract #387:� Macrophage Scavenger Receptor B1 (SRB1) Deficiency Promotes
Atherosclerotic Lesion Development�� SRB1 is an HDL receptor located in
the liver and promotes uptake of HDL cholesterol in the reverse cholesterol
transport system.� It also exists in macrophages where, in mice, a deficiency
was shown to promote atherosclerosis.� The receptor in macrophages may facilitate
cholesterol efflux.� �����������
Abstract #389:� An Oral Synthetic Phospholipid (DGP) Raises HDL-Cholesterol
Levels, Improves HDL Function, and Dramatically Reduces Atherosclerosis in Apo
E Null Mice�� Oral DGP stimulated Apo A1 synthesis, increased HDL levels
and function, and induced atherosclerotic lesion regression.����������
Abstract #922:� A Novel Mutation Causing Complete Hepatic Lipase Deficiency
among French-Canadians and Its Impact on Lipoprotein Metabolism�� Hepatic
Lipase (HL) is important in the metabolism of beta VLDL and HDL.� A complete
deficiency of HL, in contrast to control subjects, was associated in this study
with beta VLDL, increased triglyceride and cholesterol as well as larger triglyceride-enriched
LDL and HDL particles.� These observations from a unique human model of HL
deficiency highlight the critical role of HL in the intravascular remodeling
of remnant and HDL particles.�����������
Abstract #2406:� Impaired Reversed Cholesterol Transport in Asian Indian
Males Compared to Framingham Offspring Study Population�� Compared to Caucasians,
AIs exhibit significantly more impaired reverse cholesterol transport as reflected
by reduced levels of LHDL, higher levels of small size HDL, and smaller HDL
size despite similar levels of HDL and LDL.� This may explain the higher incident
of CHD among AIs.�� (AIs = Asian Indians, LDHL = large size HDL).
Abstract #3341:� Effect of a High Protein, Energy Restricted Diet on Body
Composition and Lipid Levels in Hyperinsulinemic Subjects�� In two energy
restricted diets, high protein (27%) with 44% carbohydrate, compared to standard
protein (16%) with 57% carbohydrate there was greater preservation of lean mass
in females, a greater decrease in triglyceride and lower plasma glucose values.�
Abstract #3582:� Effect of a Low Carbohydrate Ketogenic Diet Program on
Fasting Lipid Subfractions�� A low carbohydrate (LC), ketogenic, Atkins
type� diet in 36 patients for six months, compared to a low fat (LF) diet in
27 patients, produced weight loss, VLDL reduction, an increase in HDL and a
change from small to large LDL.� The LF group had a 1% decrease in HDL while
the LC group had an 8% increase in HDL-C.� The authors suggest the LC diet may
be useful in treating metabolic syndrome.� Because of the potential for misinterpretation,
the AHA issued a statement at the meeting, pointing out the short time frame,
few patients, potential for high fat to increase cardiovascular risk and the
fact that no long-term health benefit has been shown.� Lifestyle changes of
exercise, reduced caloric intake and a balanced diet remain the AHAs recommendation.�����������
Abstract #3646:� Medium Chain Triglyceride Consumption for 28 Days Improves
Blood Lipid Profile, Increases Energy Expenditure, and leads to Smaller Body
Fat Compartments Compared to Olive Oil Consumption in Overweight Men�� Medium
chain triglycerides (MCT) have been used, previously, for treatment of exogenous
hypertriglyceridemia.� In this 4 week study of 24 healthy men with BMI=28.2,
a diet rich in MCT led to significant decreases in cholesterol, LDL and total
adipose tissue, compared to a diet rich in olive oil.������
Abstract #3685:� Adherence to National Guidelines in Lipid Management:�
The Importance of a Lipid Clinic�� ��A lipid clinic with dedicated staff
achieved NCEP III goals for LDL, HDL and triglyceride in 66.43%, 60.12% and
56.75% of cases, respectively, and the patients were more likely to have their
lipid levels at targets set by national guidelines irrespective of the statin
utilized.� | 
