Long term hemodialysis aggravates lipolytic activity reduction and very low density, low density lipoproteins composition in chronic renal failure patients

<p>Abstract</p> <p>Background</p> <p>Dyslipidemia, particularly hypertriglyceridemia is common in uremia, and represents an independent risk factor for atherosclerosis.</p> <p>Methods</p> <p>To investigate the effects of hemodialysis (HD) duration on very low density lipoprotein (VLDL) and low density lipoprotein (LDL) compositions and lipopolytic activities, 20 patients on 5 to 7 years hemodialysis were followed-up during 9 years. Blood samples were drawn at T0 (beginning of the study), T1 (3 years after initiating study), T2 (6 years after initiating study) and T3 (9 years after initiating study). T0 was taken as reference.</p> <p>Results</p> <p>Triacylglycerols (TG) values were correlated with HD duration (r = 0.70, P < 0.05). An increase of total cholesterol was noted at T2 and T3. Lowered activity was observed for lipoprotein lipase (LPL) (-44%) at T3 and hepatic lipase (HL) (-29%) at T1, (-64%) at T2 and (-73%) at T3. Inverse relationships were found between HD duration and LPL activity (r = -0.63, P < 0.05), and HL activity (r = -0.71, P < 0.01). At T1, T2 and T3, high VLDL-amounts and VLDL-TG and decreased VLDL-phospholipids values were noted. Increased LDL-cholesteryl esters values were noted at T1 and T2 and in LDL-unesterified cholesterol at T2 and T3.</p> <p>Conclusion</p> <p>Despite hemodialysis duration, VLDL-LDL metabolism alterations are aggravated submitting patients to a greater risk of atherosclerosis.</p

Complémentarité et équilibre de l’apport alimentaire en protéines et en lipides

The nature and level of dietary protein is liable to influence cholesterol and essential fatty acid (EFA) metabolism. Dietary vegetable protein, particularly the undigested fraction, decreases intestinal cholesterol absorption, increases the faecal excretion of steroids, and enhances the catabolism of cholesterol-carrying lipoproteins by increasing the activity or number of LDL receptors. However, the hypocholesterolemic effect of protein may be due to the presence of non-protein components and hence the purity degree of the selected protein, and the concomitant addition or not of cholesterol. Dietary proteins with different amino acid composition may modulate the secretion of hormones (e.g. glucagon and insulin), which in turn may modify the activity of enzymes responsible for cholesterol metabolism (e.g. HMG-CoA reductase, 7alpha-hydroxylase, lecithin: cholesterol acyl transferase) and polyunsaturated fatty acid synthesis (e.g. Delta5 and Delta6-desaturases). PUFA affect membrane fluidity and the synthesis of eicosanoids: prostaglandins and leukotrienes. Protein deficiency affects severely the PUFA amounts, particularly arachidonic and EPA acids which are precursors of prostaglandins, thromboxanes and leukotrienes, and the possible consequences of their diminution may be an underlying cause of some of the common clinical symptoms in protein malnutrition, such as hair loss, dry scaly dermatitis and increased water permeability. Protein deficiency may thus increase the EFA requirement and precipitate marginal EFA deficiency. The dietary protein level may also influence the efficiency of antioxidant system and/or the release of reactive oxygen species. Tissue lipid peroxidation could be markedly enhanced by feeding low-protein diets, probably due to a depressed efficiency of antioxidative enzyme activities

EFFETS DES PROTEINES ET DU CHOLESTEROL ALIMENTAIRES SUR LE METABOLISME DU CHOLESTEROL ET DES LIPOPROTEINES, LA BIOSYNTHESE DES ACIDES GRAS POLYINSATURES ET LA PEROXYDATION LIPIDIQUE CHEZ LE RAT

DIJON-BU Sciences Economie (212312102) / SudocSudocFranceF

Relationship between rat liver microsomal Δ6 and Δ5 desaturase activities and fatty acid composition: comparative effects of coconut and salmon oils during protein restriction

International audienceThe aim of this work was to compare the effects of coconut and salmon oils on rat liver microsomal Δ6 and Δ5 desaturations, during protein restriction. A higher Δ6 desaturase activity was noted in rats fed the low-protein coconut oil diet, in comparison with that occurring in rats fed either a low-protein or normal-protein salmon oil diet. No variation was observed in Δ5 desaturase activity or in 20:4n-6/ 18:2n-6 ratio. The fatty acid composition of liver microsomal phospholipids provided evidence of higher levels of 20:5n-3 and 22:6n-3 in the normal-protein salmon oil group, when compared with the low-protein salmon oil group. No influence of experimental diets on the total n-3 and total n-6 fatty acids could be demonstrated. Aside from investigating the effects of protein restriction on the liver microsomal desaturases, this work shows that there is no correlation between microsomal desaturation rates and microsomal phospholipid profiles even when diets are rich in polyunsaturated fatty acids (salmon oil)

Maximal voluntary eccentric, isometric and concentric torque recovery following a concentric isokinetic exercise

Cutaneous hyperpigmentation is a well-known side effect of tetracyclines, but doxycycline-induced cutaneous hyperpigmentation has only been described in one patient with a therapeutic dosage of doxycycline, and in one patient using suprapharmacological doses. We describe four patients with cutaneous hyperpigmentation in previously unaffected skin, and speculate that this was due to treatment with doxycycline in therapeutic doses. After cessation of therapy, the hyperpigmentation diminished in all four patients, illustrating the need for recognition and timely cessation of therapy

Clinical usefulness of the visibility of the transcerebral veins at 3T on T2*-weighted sequence in acute stroke patients.

International audienceOBJECTIVES: The objective of this work was to investigate the clinical usefulness of the visibility of the transcerebral veins (VTV) in acute ischemic stroke patients at 3T. METHODS: Sixty consecutive carotid artery territory stroke patients were included retrospectively. Two readers categorized the VTV on T2*-weighted sequence at 3T for each hemisphere, and asymmetry of this sign was assessed between each hemisphere by an asymmetry index (AI) using a three-item scale. The VTV and AI were correlated with clinical and radiological covariates. Particular interest was focused on patients for whom initial diffusion-weighted imaging alone was inconclusive. RESULTS: VTV were detected in the stroke hemisphere in 58.3% (n = 35) and in the contralateral side in 10% (n = 6, p<0.0001). Asymmetry of the VTV between ischemic and contralateral hemispheres was present in 53.3% (n = 32). Intracranial artery occlusion, final infarct volume and symptomatic hemorrhagic transformation were correlated with a higher AI at baseline (ρ = 0.563, ρ = 0.291, and ρ = 0.285, p<0.05, respectively). Three hyperacute stroke patients with subtle DWI high signal intensity at admission demonstrated VTV. CONCLUSIONS: The pathological value of the VTV seems to reside in its asymmetry between hemispheres, as it was correlated with important clinical parameters. This study also suggests that the VTV could be a supportive finding in stroke diagnosis, especially when DWI is unreliable