RESUMO
BACKGROUND: Liver ailments are among the leading causes of death; they originate from viral infections, chronic alcoholism, and autoimmune illnesses, which may chronically be precursors of cirrhosis; furthermore, metabolic syndrome may worsen those hepatopathies or cause Non-alcoholic Fatty Liver Disease (NAFLD) that may advance to non-alcoholic steatohepatitis (NASH). Cirrhosis is the late-stage liver disease and can proceed to hepatocellular carcinoma (HCC). Pharmacological treatment options for liver diseases, cirrhosis, and HCC, are limited, expensive, and not wholly effective. The use of medicinal herbs and functional foods is growing around the world as natural resources of bioactive compounds that would set the basis for the development of new drugs. Review and Conclusion: Plant and food-derived sterols and triterpenoids (TTP) possess antioxidant, metabolic-regulating, immunomodulatory, and anti-inflammatory activities, as well as they are recognized as anticancer agents, suggesting their application strongly as an alternative therapy in some chronic diseases. Thus, it is interesting to review current reports about them as hepatoprotective agents, but also because they structurally resemble cholesterol, sexual hormones, corticosteroids and bile acids due to the presence of the steroid nucleus, so they all can share pharmacological properties through activating nuclear and membrane receptors. Therefore, sterols and TTP appear as a feasible option for the prevention and treatment of chronic metabolic-related liver diseases, cirrhosis, and HCC.
Assuntos
Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Fígado/efeitos dos fármacos , Síndrome Metabólica/tratamento farmacológico , Fitosteróis/uso terapêutico , Triterpenos/uso terapêutico , Animais , Antioxidantes/química , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/prevenção & controle , Humanos , Fígado/metabolismo , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/metabolismo , Cirrose Hepática/prevenção & controle , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/prevenção & controle , Síndrome Metabólica/metabolismo , Síndrome Metabólica/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Fitosteróis/química , Fitosteróis/farmacologia , Triterpenos/química , Triterpenos/farmacologiaRESUMO
Apesar das evidências do efeito dos esteróis vegetais entre adultos dislipidêmicos , dados sobre o uso de cápsulas com fitosteróis em crianças são limitados. O presente estudo teve como objetivo avaliar o efeito de suplemento dietético à base de fitosterol associado à dieta Passo II no NCEP no LDL de crianças e adolescentes dislipidêmicos em um hospital universitário no Rio de Janeiro. Deste modo, foi realizado um ensaio clínico randomizado cruzado, duplo cego com uso de placebo durante vinte semanas utilizando como critério de inclusão valores de lipoproteína de baixa densidade (LDL) maoir que 110mg/dL. Cinquenta e três crianças com idade entre 7 e 14 anos foram recrutadas, das quais 40 eram elegíveis para participar do estudo, sendo submetidas ao período do run in durante quatro semanas onde receberam orientações para seguir as recomendações da dieta Passo II do NCEP. Ao final do run in trinta e uma crianças e adolescentes permaneceram com LDL superior a 110mg/dL e foram randomizados para participar do estudo. O grupo intervenção recebeu cápsulas contendo 1,5mg/dia de fitosteróis na forma livre e esterificada e o grupo controle recebeu cápsulas contendo 2g/dia de óleo de girassol durante o período de oito semanas. Os participantes foram submetidos ao período do wash out durante quatro semanas. Foram coletados bioquímicos incluindo glicose, colesterol total, LDL, lipoproteína de alta densidade (HDL), triglicerídeos e dados antropométricos nas semanas 0, 8, 12 e 20. Foi realizada análise por intenção de tratar através dos modelos generalizados lineares mistos, usando o software SAS. Ao final do run in 9 participantes reduziram o LDL à menos 110 mg/dL, representando 25% da amostra. Foi observado ainda a prevalência de obesidade em 66,7% dos participantes que reduziram o LDL no run in. Após oito semanas, os participantes do grupo intervenção reduziram o LDL em 6,5%, enquanto o grupo controle apresentou redução de 1,7%. O HDL aumentou em 15,2% no grupo intervenção e 0,1% no grupo controle. 35% dos participantes do grupo intervenção alcançaram os valores considerados desejáveis para o LDL. Contudo, nenhuma destas variações foi significativamente diferente entre os grupos. Apesar do estudo não observar diferença estatisticamente significativa nas reduções do LDL entre os grupos o uso de suplementos a base de fitosteróis por meio de cápsulas mostrou-se seguro no tratamento das dislipidemias na infância e adolescência. Nota-se ainda que a dieta Passo II do NCEP mostrou-se efetiva na redução do LDL nas crianças e adolescentes obesos, sendo este um resultado relevante para redução do risco cardiovascular. Os resultados apresentados no presente estudo reforçam a necessidade de novos estudos envolvendo suplementação de fitosterol por meio de cápsulas, para que estes possam ser comparados.
Even with the evidence of lipid-lowering effect of plant sterols among dyslipidemic adults, the use of capsules with phytosterols in children is limited. The objective of the present study was evaluate the effect of phytosterol-based dietary supplementation associated with the Step II diet NCEP, in LDL of dyslipidemic children and adolescents at university hospital in Rio de Janeiro. A randomized, double-blind, crossover clinical trial with placebo was realized for 20 weeks. Thirty-one children and adolescents between seven and fourteen years old participated in the study. The intervention group received capsules containing 1.5g / day of phytosterols in the free and esterified form and the control group received capsules containing 2g / day of sunflower oil during the eight-week period. The partitipants were submited to wash out during four weeks. Biochemical data were collected including glucose, total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides; anthropometric measures at weeks 0, 8, 12 and 20. Intention-to-treat analysis were performed, using the proc mixed procedure in SAS. In the end of run in 9 participats reduced LDL above 110mg/dL, representing 25% sample size. The prevalence of obesity was also observed in 66.7% of the participants who reduced LDL in the run-in. Intention-to-treat analysis were performed, using the proc mixed procedure in SAS. After eight weeks, participants in the intervention group reduced LDL by 6.48%, while the control group had a reduction of 1.68%. HDL increased by 15.2% in the intervention group and 0.07% in the control group. 35% of participants in the intervention group achieved values considered desirable for LDL. However, none of these variations was significantly different between groups. Even the study did not achieve significantly statistic diference on reduction of LDL between the groups, the intake of phytosterol´s capsule showed safe on dislipidemic in child and youth treatment. It is also noted that the step II diet of the NCEP proved to be effective in reducing LDL in obese children and adolescents, which is a revealing result for reducing cardiovascular risk.The results presented in the present study reinforce the need for new studies involving supplementation of phytosterol with capsules, so that they can be compared.
Assuntos
Humanos , Criança , Adolescente , Fitosteróis/uso terapêutico , Dislipidemias/epidemiologia , LDL-Colesterol , Ensaios Clínicos Controlados como AssuntoRESUMO
Specialty oils differ in fatty acid, phytosterol and antioxidant content, impacting their benefits for cardiovascular health. The lipid (fatty acid, phytosterol) and antioxidant (total phenolics, radical scavenging capacity) profiles of grapeseed (GSO), corn (CO) and coconut (CNO) oils and their physiological (triacylglycerides, total and HDL-cholesterol and antioxidant capacity (FRAP) in serum and fatty acid and phytosterol hepatic deposition) and genomic (HL, LCAT, ApoA-1 and SR-BP1 mRNA hepatic levels) responses after their sub-chronic intake (10% diet for 28 days) was examined in healthy albino rats. Fatty acid, phytosterol and antioxidant profiles differed between oils (p ≤ 0.01). Serum and hepatic triacylglycerides and total cholesterol increased (p ≤ 0.01); serum HDL-Cholesterol decreased (p < 0.05); but serum FRAP did not differ (p > 0.05) in CNO-fed rats as compared to CO or GSO groups. Hepatic phytosterol deposition was higher (+2.2 mg/g; p ≤ 0.001) in CO- than GSO-fed rats, but their fatty acid deposition was similar. All but ApoA-1 mRNA level increased in GSO-fed rats as compared to other groups (p ≤ 0.01). Hepatic fatty acid handling, but not antioxidant response, nor hepatic phytosterol deposition, could be related to a more efficient reverse-cholesterol transport in GSO-fed rats as compared to CO or CNO.
Assuntos
Antioxidantes/uso terapêutico , Gorduras Insaturadas na Dieta/uso terapêutico , Regulação da Expressão Gênica , Hiperlipidemias/prevenção & controle , Metabolismo dos Lipídeos , Fígado/metabolismo , Óleos de Plantas/uso terapêutico , Animais , Antioxidantes/efeitos adversos , Antioxidantes/análise , Antioxidantes/química , Biomarcadores/sangue , Biomarcadores/metabolismo , HDL-Colesterol/agonistas , HDL-Colesterol/antagonistas & inibidores , HDL-Colesterol/sangue , Óleo de Coco , Óleo de Milho/efeitos adversos , Óleo de Milho/química , Óleo de Milho/uso terapêutico , Gorduras Insaturadas na Dieta/efeitos adversos , Ácidos Graxos/efeitos adversos , Ácidos Graxos/análise , Ácidos Graxos/metabolismo , Ácidos Graxos/uso terapêutico , Hiperlipidemias/sangue , Hiperlipidemias/etiologia , Masculino , Capacidade de Absorbância de Radicais de Oxigênio , Fenóis/efeitos adversos , Fenóis/análise , Fenóis/uso terapêutico , Fitosteróis/efeitos adversos , Fitosteróis/análise , Fitosteróis/metabolismo , Fitosteróis/uso terapêutico , Óleos de Plantas/efeitos adversos , Óleos de Plantas/química , Óleos de Plantas/metabolismo , Distribuição Aleatória , Ratos Wistar , Sementes/química , Organismos Livres de Patógenos Específicos , Vitis/químicaRESUMO
Background: Characterization of food lipids has triggered the development of applications for the food and health industries. Thus, the lipid profiles of an increasing number of fruits and their seeds have been characterized and numerous bioactive components have been isolated. The bitter gourd seed oil has aroused great interest because it contains relevant amounts of conjugated fatty acid α-eleostearic acid (C18:3 9c11t13t), a positional and geometric isomer of α-linolenic acid. The aim of this paper was to evaluate the phytochemical composition and quality parameters of the seed oil of bitter gourd grown in Brazil. Methods: Bitter gourd was purchased from CEAGESP (Brazilian company of fresh food storages and warehouses). Seeds were lyophilized, and their oil was extracted using the Soxhlet and Folch extraction methods. The profiles of fatty acids and phytosterols were analyzed by gas chromatography, and the acidity and peroxide values were evaluated by methods of the American Oil Chemists' Society (AOCS). Results: The Soxhlet extraction (40 % w / w ) resulted in a higher yield of bitter gourd seed oil than the Folch extraction (16 % w / w). For both methods, α-eleostearic acid (56 and 58 %) was the major lipid in bitter gourd seed oil, followed by stearic acid (C18:0; 32 and 27 %). The oil displayed high content of phytosterols (886 mg/100 g), mainly ß-sitosterol, and low acidity and peroxide values. Conclusions: Bitter gourd seed oil from Brazil is an oil of good quality and its high contents of α-eleostearic acid and phytosterols with potential health-beneficial properties make it an attractive plant byproduct.
Assuntos
Momordica charantia/química , Fitosteróis/uso terapêutico , Preparações de Plantas/uso terapêutico , Gorduras Insaturadas na DietaRESUMO
Cycloeucalenone (1) and 24-oxo-31-norcycloartanone (2) obtained from Solanum cernuum Vell. were assayed to explore their pharmacologic roles. Previous studies showed that (2) has selective activity against lung tumor cell line (NCIH460) which expresses high levels of COX-2, suggesting its role in inflammatory process, and also a link between chronic inflammation and cancer-associated process. Dichloromethane crude extract (DCE) significantly reduced writhing and stretching induced by 0.8 % acetic acid at a dose of 100, 300, and 600 mg/kg, po; oral administration of different doses of (1) and (2) also displayed significant analgesic and anti-inflammatory effects in the writhing acetic acid test (p < 0.0001). Selected oral doses of both compounds (100 and 50 mg/kg) were assayed in the carrageenan-induced paw edema model. Compound (2) showed significant activity during the early phase (1.5-6 h) and also in the late phase (48 h) (p < 0.01). The anti-nociceptive activity observed for the compounds (1) and (2) and DCE was found to be related to the inhibition of different mediators involved in inflammation and nociceptive process. Both compounds decrease COX-2 protein expression, although only compound (2) reached a significant response (p < 0.05 vs control). However, in vitro Sirtuin 1 activity and TNF-α production in THP-1 macrophages were not affected.
Assuntos
Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Fitosteróis/uso terapêutico , Extratos Vegetais/uso terapêutico , Solanum , Triterpenos/uso terapêutico , Analgésicos/isolamento & purificação , Animais , Anti-Inflamatórios/isolamento & purificação , Edema/tratamento farmacológico , Edema/patologia , Camundongos , Camundongos Endogâmicos BALB C , Dor/tratamento farmacológico , Dor/patologia , Fitosteróis/química , Fitosteróis/isolamento & purificação , Extratos Vegetais/isolamento & purificação , Triterpenos/química , Triterpenos/isolamento & purificaçãoRESUMO
In India, Azadirachta indica is typically known as 'neem tree' and its leaves has long been used in the ayurvedic medical tradition as a treatment for diabetes mellitus. In-depth chromatographic investigation on chloroform extract resulted in identification of one new tetranortriterpenoid. Structural elucidation was established on the basis of spectral data as 24,25,26,27-tetranor-apotirucalla-(apoeupha)-1α-senecioyloxy-3α,7α-dihydroxy-14,20,22-trien-21,23-epoxy named by us as meliacinolin (1). The present study investigated the effect hypoglycaemic, hypolipidemic, oxidative stress, insulin resistance, α-glucosidase and α-amylase of 1 from A. indica. Diabetic rats were treated with 1 for 28 d and a set of biochemical parameters were studied including: glucose level, total cholesterol, triglycerides, lipid peroxidation, liver and muscle glycogen, superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase. We also looked into liver function by determining glucose-6-phosphatase, glucokinase and hexokinase activities, and the effect on insulin level. While in vitro inhibition of α-glucosidase and α-amylase enzyme activities were used as indices of effect on glucose absorption. As a result we found that blood glucose level, serum biochemical parameters, hepatic enzymes, thiobarbituric acid reactive substances, and insulin level were restored in streptozotocin (STZ)-diabetic mice to normal levels with 1. Meliacinolin inhibited α-glucosidase and α-amylase activities. We conclude that meliacinolin can efficiently inhibit insulin resistance, improvement of renal function, lipid abnormalities, and oxidative stress, indicating that its therapeutic properties may be due to the interaction of meliacinolin with multiple targets involved in diabetes pathogenesis. α-Glucosidase and α-amylase inhibitors offer an effective strategy to lower the levels of post prandial hyperglycemia prevents the digestion of carbohydrates.
Assuntos
Azadirachta/química , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores de Glicosídeo Hidrolases , Fitosteróis/uso terapêutico , Fitoterapia , alfa-Amilases/antagonistas & inibidores , Animais , Biomarcadores/sangue , Glicemia/metabolismo , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/induzido quimicamente , Diabetes Mellitus Tipo 2/metabolismo , Carboidratos da Dieta/metabolismo , Dislipidemias/tratamento farmacológico , Hipoglicemiantes/isolamento & purificação , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Insulina/sangue , Resistência à Insulina , Rim/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/enzimologia , Masculino , Camundongos , Niacinamida , Estresse Oxidativo , Fitosteróis/isolamento & purificação , Fitosteróis/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Estreptozocina , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismoRESUMO
AIM: To evaluate changes on venous diameter and perimeter of lower limbs in chronic venous disorder (CVD) patients after different clinical treatments for four weeks. METHODS: Fifty-two female patients classified as C2,s or C2,3,s (CEAP classification) were allocated consecutively in three groups: Cirkan (40 mg of the root extract of Ruscus aculeatus + 100 mg of flavonoid hesperidine methylchalcone + 200 mg of vitamin C per pill); elastic compression stockings (ECS) and no treatment (NT). Diameters were determined by duplex ultrasound and perimeter with Leg-O-Meter. RESULTS: After treatment, Cirkan significantly decreased popliteal vein and great saphenous vein (GSV) diameters bilaterally and ECS decreased popliteal vein diameter bilaterally and GSV and varices only on the left limb. Perimeters changed only with ECS. Clinical scores changed between Cirkan x NT and ECS x Cirkan. Disability score varied for ECS x NT and Cirkan x NT. chi2 test detected different distribution frequency for C3 and C2 classes according to treatment: ECS (both limbs) and Cirkan (only left limb). Varices and anatomical scores did not change. CONCLUSIONS: ECS emerges as the most effective clinical treatment tested but improvements with Cirkan on vein diameter and CEAP class were also observed. Clinical scores improved due to pain relief and edema reduction (ECS). These findings point to a positive effect of Cirkan, suggesting that venotonic drugs should be taken into account in the treatment of CVD.
Assuntos
Antropometria , Ácido Ascórbico/uso terapêutico , Fármacos Cardiovasculares/uso terapêutico , Quimotripsina/uso terapêutico , Hesperidina/uso terapêutico , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/patologia , Fitosteróis/uso terapêutico , Veia Poplítea/diagnóstico por imagem , Veia Safena/diagnóstico por imagem , Meias de Compressão , Tripsina/uso terapêutico , Ultrassonografia Doppler Dupla , Doenças Vasculares/terapia , Adulto , Antropometria/instrumentação , Ácido Ascórbico/efeitos adversos , Brasil , Fármacos Cardiovasculares/efeitos adversos , Distribuição de Qui-Quadrado , Doença Crônica , Quimotripsina/efeitos adversos , Avaliação da Deficiência , Combinação de Medicamentos , Feminino , Hesperidina/efeitos adversos , Humanos , Pessoa de Meia-Idade , Dor/etiologia , Dor/prevenção & controle , Medição da Dor , Fitosteróis/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Tripsina/efeitos adversos , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/patologiaRESUMO
OBJECTIVES: To evaluate changes on cutaneous microangiopathy in chronic venous disorder (CVD) after use of Cirkan [venotonic drug containing Ruscus aculeatus (plant extract), hesperidine methylchalcone (flavonoid) and vitamin C], elastic compression stockings (ECS) or no treatment for four weeks. PATIENTS AND METHODS: Fifty-five female patients (85 legs), 25 to 57 years, with at least one limb classified as C2,s or C2,3,s (CEAP classification), were allocated consecutively, according to entrance order, in these three groups. Ten healthy women age-matched were also investigated. Using orthogonal polarization spectral technique (noninvasive method), measurements of functional capillary density (FCD, number of capillaries with flowing red blood cells/mm(2)), capillary morphology (CM, % of abnormal capillaries/mm(2)) and diameters (mum) of dermal papilla (DDP), capillary bulk (DCB) and capillary limb (CD) were obtained on the medial perimalleolar region and later analyzed using CapImage software. RESULTS AND CONCLUSIONS: CVD patients showed significant changes on CD and CM compared to healthy subjects in agreement with our previous findings (J Vasc Surg 43:1037-1044, 2006). On Cirkan-treated patients, after 4 weeks, CD decreased on both limbs and CM improved on the left one, suggesting an amelioration of the chronic venous hypertension. No significant changes could be detected on other patient groups. These results confirm the existence of microcirculatory dysfunction in early stages of CVD, probably due to post-capillary hypertension, and further support the venotonic action of Cirkan.
Assuntos
Microcirculação/fisiopatologia , Insuficiência Venosa/fisiopatologia , Insuficiência Venosa/terapia , Adulto , Ácido Ascórbico/uso terapêutico , Capilares/patologia , Capilares/fisiopatologia , Quimotripsina/uso terapêutico , Terapia Combinada , Combinação de Medicamentos , Edema/patologia , Edema/terapia , Feminino , Hesperidina/uso terapêutico , Humanos , Perna (Membro)/patologia , Perna (Membro)/fisiopatologia , Pessoa de Meia-Idade , Fitosteróis/uso terapêutico , Extratos Vegetais/uso terapêutico , Meias de Compressão , Resultado do Tratamento , Tripsina/uso terapêutico , Insuficiência Venosa/patologia , Trombose Venosa/patologia , Trombose Venosa/terapiaRESUMO
OBJECTIVE: To examine the effect of plant stanols on lipids and endothelial function in pre-pubertal children with familial hypercholesterolemia (FH). STUDY DESIGN: Children with FH (n=42), aged 7-12 years, were enrolled in a double-blind crossover trial, in which they consumed 500 mL of a low-fat yogurt enriched with 2.0 g of plant stanols and 500 mL of a low-fat placebo yogurt for 4 weeks, separated by a 6-week washout period. Lipid profiles and endothelial function were assessed after both consumption periods. Endothelial function was measured as flow-mediated dilation (FMD) of the brachial artery. RESULTS: This daily intake of 2.0 g of stanols significantly decreased the levels of total cholesterol (TC) by 7.5% and low-density lipoprotein cholesterol (LDL-C) by 9.2% as compared with placebo. High-density lipoprotein cholesterol and triglyceride levels remained unaltered. The reduction of LDL-C levels did not improve FMD, which was 10.5%+/-5.1% after plant stanol consumption and 10.6%+/-5.0% after placebo consumption, respectively (P=.852). CONCLUSION: This study demonstrates that plant stanols reduce LDL-C levels in children with FH without improving endothelial function.
Assuntos
Anticolesterolemiantes/farmacologia , LDL-Colesterol/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Fitosteróis/farmacologia , Vasodilatação/efeitos dos fármacos , Anticolesterolemiantes/uso terapêutico , Criança , Colesterol/sangue , LDL-Colesterol/sangue , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Fitosteróis/uso terapêutico , Triglicerídeos/sangueRESUMO
OBJECTIVE: To assess causes for insufficient cholesterol-lowering response to pravastatin and plant stanol esters in children with heterozygous familial hypercholesterolemia (HeFH). STUDY DESIGN: Nine of 16 children with HeFH who had not reached normocholesterolemia (< or =194 mg/dL [< or =5 mmol/L]) by 1 year after treatment (40 mg pravastatin and plant stanol ester) were called nonresponders. The 7 remaining children were responders. Serum noncholesterol sterol ratios (10(2) x mmol/mol of cholesterol), surrogate estimates of cholesterol absorption (cholestanol, campesterol, sitosterol) and synthesis (desmosterol and lathosterol), were studied at study baseline (on plant stanol esters) and during combination therapy with pravastatin and plant stanol esters. RESULTS: Pravastatin decreased the serum levels of cholesterol and cholesterol synthesis markers, and increased the ratios of cholesterol absorption markers. Compared with the responders, the nonresponders had higher study baseline (on plant stanol esters) serum cholesterol concentrations (299 +/- 39 vs 251 +/- 35 mg/dL [7.7 +/- 1.0 vs 6.5 +/- 0.9 mmol/L]; P <.001) and higher respective ratios of campesterol (371 +/- 99 vs 277 +/- 67 10(2) x mmol/mol of cholesterol; P = .049) and sitosterol (176 +/- 37 vs 126 +/- 24 10(2) x mmol/mol of cholesterol; P = .008). The higher the ratio of cholestanol at study baseline, the smaller the 1-year percent reduction in cholesterol (r = .556; P = .025). CONCLUSIONS: Pravastatin treatment increases the markers of cholesterol absorption and decreases those of cholesterol synthesis in HeFH during simultaneous inhibition of cholesterol absorption. Combined inhibition of cholesterol absorption and synthesis may not normalize serum lipids in those patients with the highest cholesterol levels, especially if signs of enhanced cholesterol absorption are detectable.
Assuntos
Anticolesterolemiantes/uso terapêutico , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Fitosteróis/uso terapêutico , Pravastatina/uso terapêutico , Adolescente , Criança , Colestanol/sangue , Colesterol/análogos & derivados , Colesterol/sangue , Colesterol/metabolismo , Desmosterol/sangue , Feminino , Heterozigoto , Humanos , Masculino , Fitosteróis/sangue , Sitosteroides/sangue , Triglicerídeos/sangueRESUMO
BACKGROUND: It has been difficult to identify the appropriate bioactive substance for the development of new functional foods associated with coronary heart disease, because the results of many clinical studies are contradictory. OBJECTIVE: The objective of this study was to use the multivariate statistical approach known as principal component analysis (PCA) followed by a mixed model to process data obtained from a meta-analysis aimed at evaluating simultaneously the effect of ingestion of 1 of 3 types of bioactive substances (n-3 fatty acids, soluble fibers, and phytosterols) on 1 or more of 4 biomarkers (plasma total cholesterol, triacylglycerol, LDL cholesterol, and HDL cholesterol). DESIGN: Five independent variables (number of patients per study, dose, age, body mass index, and treatment length) and 4 dependent variables (percentage change in blood total cholesterol, LDL, HDL, and triacylglycerol) from 159 studies and substudies were organized into a matrix. The original values were converted to linear correlation units, which resulted in a new matrix. RESULTS: Two principal components were enough to explain 63.73% and 84.27% of the variance in the independent and dependent variables, respectively. Phytosterols and soluble fibers had a hypocholesterolemic effect, whereas n-3 fatty acids lowered triacylglycerol and increased total, LDL, and HDL cholesterol. The PCA and mixed model showed that this behavior was independent of dose, number of patients per study, age, and body mass index but was associated with treatment length. CONCLUSIONS: PCA is useful for summarizing available scientific information in examinations of health claims for foods and supplements.
Assuntos
Colesterol/sangue , Doença das Coronárias/prevenção & controle , Fibras na Dieta/uso terapêutico , Ácidos Graxos Ômega-3/uso terapêutico , Fitosteróis/uso terapêutico , Triglicerídeos/sangue , Fibras na Dieta/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Fitosteróis/administração & dosagemRESUMO
Plant sterol and stanol esters are called "functional" compounds due to their hypocholesterolemic properties. The objective of this review is to update recent findings concerning the effect of phytosterols in the blood cholesterol, emphasizing the results from experimental and human studies. The hypocholesterolemic effect is observed with the intake of 2.5g/day of phytosterols or phytostanols. Daily intake, usually of stanols, for 4 weeks has shown to to be effective in lowering blood total- as well as LDL-cholesterol by about 10%. The mechanism of action in lowering blood cholesterol comes from their structural similarity to cholesterol, hence they act by competing with cholesterol at the luminal absorption site. The adverse effects of a high intake of phytosterols and phytostanols are the lower absorption of some liposoluble vitamins and antioxidants.
Assuntos
Anticolesterolemiantes/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Fitosteróis/uso terapêutico , Fitoterapia , Preparações de Plantas/uso terapêutico , Colesterol na Dieta/uso terapêutico , Alimentos Fortificados , Humanos , Hipercolesterolemia/sangue , Fitoterapia/efeitos adversos , Sitosteroides/uso terapêutico , Estigmasterol/uso terapêuticoAssuntos
Humanos , Animais , Feminino , Adulto , Pessoa de Meia-Idade , Climatério , Terapias Complementares , Doença das Coronárias , Dieta , Estradiol , Fitosteróis/administração & dosagem , Fitosteróis/antagonistas & inibidores , Fitosteróis/classificação , Fitosteróis/uso terapêutico , Terapia de Reposição Hormonal , Isoflavonas , Osteoporose Pós-Menopausa , Placebos , Glycine max , Neoplasias da Mama , Cimicifuga , Neoplasias do Endométrio , Menopausa , Pós-Menopausa , Neoplasias UterinasAssuntos
Humanos , Masculino , Feminino , Fitosteróis/farmacocinética , Fitosteróis/farmacologia , Fitosteróis/história , Fitosteróis/química , Fitosteróis/uso terapêutico , Fitosteróis/economia , Colesterol , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Hiperlipidemias/terapiaRESUMO
Alguns componentes naturais dos alimentos estäo cada vez mais sendo utilizados para auxiliar no controle da hipercolesterolemia. Muitos estudos clínicos estäo sendo realizados no sentido de melhorar a aplicaçäo de uma dieta associada a essas substâncias, para a melhora dos lípides séricos em pacientes em prevençäo primária. A nutricionista responde algumas perguntas básicas sobre novos agentes de associaçäo no tratamento da hipercolesterolemia: os fitosteróis.(au)
Assuntos
Humanos , Fitosteróis/administração & dosagem , Fitosteróis/efeitos adversos , Fitosteróis/uso terapêutico , Hipercolesterolemia , ColesterolRESUMO
Los fitosteroles son sustancia naturales de origen vegetal cuya estructura es muy similar a la del colesterol. Son muy abundantes en las semillas, frutos y hojas de una gran variedad de vegetales, por los cual están presentes en nuestra dieta en concentraciones variables (160-500 mg/día). Se han identificado más de 25 tipos diferentes de fitosteroles pero el ß-sitosterol, el campesterol y el stigmasterol constituyen más del 95-98 por ciento de los fitosteroles dietarios. Se han descrito numerosas propiedades fisiológicas para los fitosteroles, siendo el efecto hipocolesterolémico el mejor caracterizado y que se observa en individuos con moderada hipercolesterolemia. Este efecto se ejerce sobre los valores de colesterol plamático total y colesterol-LDL, sin afectar los niveles de colesterol-HDL y los triglicéridos sanguíneos. El mecanismo de acción del efecto hipocolesterolémico se relaciona con la acción competitiva que ejercen los fitosteroles en la absorción del colesterol a nivel intestinal. Se les considera muy poco tóxicos, siendo sus niveles de absorción muy pequeños (<0,5 por ciento absorción), sin embargo existe una condición genética que determina la existencia de altos niveles de fitosteroles plasmáticos conocida como fitosterolemia. Se han desarrollado productos, especialmente margarinas, enriquecidas con fitosteroles y cuyo efecto hipocolesterolémico se ha demostrado en diferentes protocolos experimentales. Se discute la importancia nutricional de la presencia de fitosteroles en los aceites comestibles y el impacto en la salud que pueden tener esos aceites
Assuntos
Humanos , Hipercolesterolemia/dietoterapia , Fitosteróis/uso terapêutico , Anticolesterolemiantes/administração & dosagem , Fitosteróis/toxicidadeRESUMO
Eryngium foetidum L. (Apiaceae) is a Caribbean endemic plant used in folk medicine for the treatment of several antiinflammatory disorders. A preliminary phytochemical study showed that the hexane extract is rich in terpenic compounds. Chromatographic fractionation of this extract yielded: alpha-cholesterol, brassicasterol, campesterol, stigmasterol (as the main component, 95 percent) clerosterol, beta-sitosterol, delta 5-avenasterol, delta (5) 24-stigmastadienol and delta 7-avenasterol. The topical antiinflammatory activity of the hexane extract and of stigmasterol was evaluated by auricular oedema, induced by 12-0-tetradecanoylphorbol acetate (TPA), in the mouse, using single and multiple applications of the phlogistic agent. Both reduced the oedema in a similar proportion in the two model assays (acute and chronic). Meloperoxidase activity was strongly reduced by both the extract and the compound, in the acute but not the chronic model. These results indicate that the leaves of Eryngium foetidum L may be effective against topical inflammation processes. Stigmasterol also exerts a significant topical antiinflammatory activity although it cannot be considered to be a major antiinflammatory agent, therefore other bioactive components are probably involved in the activity of the hexane extract.(AU)
Assuntos
21003 , Feminino , /uso terapêutico , Inflamação/tratamento farmacológico , Fitosteróis/uso terapêutico , Plantas Medicinais/química , Doença Aguda , Região do Caribe , Doença Crônica , Inflamação/induzido quimicamente , Inflamação/enzimologia , Camundongos , Peroxidase/metabolismo , Acetato de Tetradecanoilforbol , Edema/induzido quimicamente , Edema/dietoterapiaRESUMO
Atualmente com a longevidade alcançada pela populaçao masculina, os problemas prostaticos estao cada vez mais em evidencia. Do ponto de vista microscopico, apos os 50 anos de idade, 50 por cento dos homens apresentarao alteraçoes hiperplasicas e 25 por cento necessitarao de algum procedimento cirurgico para a regressao da sintomatologia prostatica. Com o advento da endoscopia, a ressecçao transuretral da prostata passou a ser o tratamento indicado para os pacientes com sintomas exacerbados. Entretanto, nos casos de sintomatologia moderada, o tratamento clinico e de grande interesse, podendo evitar a cirurgia. Ha varios seculos sao utilizadas drogas de varias origens na tentativa de melhorar a sintomatologia prostatica; fazemos uma revisao dos agentes, nao hormonais e nao alfa-bloqueadores, que fazem parte do arsenal urologico