EFFECT OF SIMVASTATIN TREATMENT ON BONE MINERAL DENSITY IN HYPERCHOLESTEROLEMIC POSTMENOPAUSAL WOMEN

Statins are able to reduce cardiovascular morbidity and mortality mainly through their hypocholesterolemic effect. Beyond the inhibition of cholesterol synthesis, the identification of pleiotropic mechanisms has motivated many studies to evaluate the effects of statin use on bone mineral density (BMD) modification.The aim of our study was to evaluate whether simvastatin treatment (20 mg/d) could modify BMD in hypercholesterolemic women (n=28) after one-year treatment as compared with a control group treated only with a diet (n=11). The exclusion criteria was current or previous therapy with statins, bisphosphonates and/or estrogens. The following parameters were determined at the beginning and after one year, and those are: total cholesterol, triglycerides, HDL-C and LDL-C (Friedewald equation). The BMD was measured at the lumbar spine by dual energy x-ray absorpiometry (DEXA).In the simvastatin treated group, BMD showed an insignificant 2,812% increase after 12 months, respectively (0,965+0,111 v 0,992+0,110, P>0,05). The group treated only with hypolipidic diet demonstrated a 3,45% decrease in BMD (respectively, 1,042+0,181 v 1.006+0,182; P>0,05) after 12 months. Nevertheless, the comparison of average BMD changes between the two examined groups during one year showed a significant value diference (-0,027+0,037 v 0,036+0,036; P<0,0006).As partly suggested by retrospective or observational data, this longitudinal study indicates that simvastatin treatment achieves a beneficial effect on BMD

HYPOLIPEMIC THERAPY AND LOW SERUM CHOLESTEROL CONCENTRATION

Low concentration of plasma lipoproteins (hypolipoproteinemia) presents decreasing concentrations of all or particular lipids components. Classification of hypolipoproteinemia (hypoLP) divides them into: primary (hereditary) and secondary. Primary hipoLP are rare diseases and their main characteristic is disorder of apolipoproteins synthesis, which leads to low serum cholesterol concentration. Secondary hipoLP are presented in many diseases. They have diagnostic, prognostic significance and present good therapeutic marker. However, modern therapeutic approaches for aggressive lipid lowering pointed out many questions about physiological limits for cholesterol lowering. These approaches, also, open many questions about consequences of low serum concentration of total cholesterol and triglicerides

GENDER-RELATED DIFFERENCES IN INFLAMMATORY AND LIPID PARAMETERS IN PATIENTS WITH DIABETES MELLITUS TYPE 2

Diabetes mellitus type 2 (DM type 2) is one of the most common health problems worldwide. Diabetics have increased risk for development of wide spectrum of atherosclerotic complications, at the basis of which are inflammation and diabetic dyslipidemia. Increasing of relative risk for coronary artery disease development is higher in females with DM type 2.The aim of this study was determination of characteristic inflammatory and lipid disorders in type 2 diabetics and their association with patient gender.The study involved 35 patients with DM type 2 and stable angina pectoris. Besides anamnesis, all patients underwent clinical examinations (measure of blood pressure, body height and weight and calculation of body mass index). Inflammatory markers (sedimentation in I and II hour-SE I and SE II, C reactive protein - CRP, fibrinogen concentration and leukocyte count) as well as lipid parameters (total cholesterol, LDL and HDL cholesterol concentration and triglycerides) were determined in all the patients.Total cholesterol and triglycerides concentrations were higher in females with DM type 2 compared to males (p<0,05). There were not significant gender differences in HDL and LDL cholesterol concentration. All inflammatory markers (SE I and SE II, CRP, fibrinogen concentration and leukocyte count) were higher in females with DM type 2 and CAD compared to men (p<0,05). In males, there was a strong positive correlation between SE I and SE II with total LDL (p<0,05) and HDL cholesterol concentrations (p<0,01). Concentration of CRP was only significantly connected with triglycerides concentration (p<0,05). There was a strong association between leukocyte count and increased triglycerides (p<0,05) and low HDL cholesterol concentration (p<0,01). In females, there was only a strong positive correlation between SE II (p<0,01) and CRP concentration (p<0,05) and triglycerides.Women with DM type 2 and clinically manifest CAD (stable angina pectoris) are at higher risk for development the cardiovascular complications as they have more prominent lipid and inflammatory disorders than men

THE EFFECTS OF PHYSICAL TRAINING ON CARDIOVASCULAR PARAMETERS AND REDUCTION OF VISCERAL FATTY TISSUE

Regular physical activity and good physical condition are widely accepted as factors that reduce all-cause mortality and improve a number of health outcomes.The aim of this study was to investigate the effects of aerobic exercise training on cardiovascular parameters and reduction of visceral obesity in patients with stable coronary artery disease participating in a cardiovascular rehabilitation exercise program. Fifty-two patients with stable coronary heart disease who had been accepted into the outpatient Phase II cardiovascular rehabilitation program at the Institute for Treatment and Rehabilitation of Cardiovascular Diseases Niska Banja, Nis, Serbia,were recruited for this study. All patients were divided into two groups: group with stable coronary heart disease who had regular aerobic physical training during 6weeks and control without physical training. There were not significant differences in body weight, body mass index, waist circumference and waist /hip ratio in start and at the end of physical training program. Physical training did not reduce the above mentioned parameters after 6 weeks. There were not significant differences in systolic and diastolic blood pressure at the beginning and at the end of the observed period.In group with physical training, a significant reduction of systolic and diastolic blood pressure after cardiovascular rehabilitation were reported (p<0.05). In patients with moderate aerobic physical training, a significant decrease in the heart rate was registered after the 6-week follow-up (p<0.05), while heart rate was significantly lower in this group compared to group with sedentary lifestyle (p<0.05). The effects of the 6-week cardiovascular rehabilitation on lipid parameters is visible only in slight reduction of triglyceride values in group with physical training (p<0.05). The concentration of triglycerides were significantly lower in this group compared to sedentary patients after the 6-week follow-up (p<0.05).Dynamic training can improve blood pressure in patients with moderate to severe hypertension and reduce the need for medication. Exercise programs induced favorable adaptations on total cholesterol, triglycerides, and body composition

THE EFFECT OF PHYSICAL ACTIVITY ON INFLAMMATORY MARKERS.THE RISK OF NEW CORONARY EVENT IN CORONARY HEART DISEASE PATIENTS

Inflammation is an important factor in the pathogenesis of atherosclerosis, and several markers of inflammation have been associated with an increased risk of cardiovascular events. Physical activity may lower the risk of coronary heart disease(CHD) by mitigating inflammation. The aim of the study was to investigate the effects of aerobic exercise training on systemic inflammatory response in patients with stabile coronary artery disease participating in a cardiovascular rehabilitation exercise program. Male (n=29) and female (n=23) patients with stable coronary heart disease were recruited for this study. All patients were divided into two groups: group with regular aerobic physical training during cardiovascular rehabilitation program phase II along 3 weeks in rehabilitation center and 3 weeks after that in home of patients and sedentary lifestyle group. There were no significant differences in gender distribution among analyzed groups. Student’s t test showed no significant difference in mean age, waist circumference (OS) and waist/hip ratio (WHR). Degree of obesity was measured by BMI, and there was a significant improvement in BMI in patients who underwent the six-week physical training compared to control group (p<0.05).Physical training during 6 weeks did not show any effects on leukocyte count and ICAM-1 levels compared to control group. The exercise training induced reduction in plasma CRP levels by 23.72%, p<0.001, and reduction in plasma VCAM-1 levels by Moderate aerobic exercise training resulted in a significant reduction of inflammatory state by decreasing CRP and VCAM-1 levels without significant body mass and visceral obesity reduction. The obtained results indicate that regular physical activity is clinically attractive in primary and secondary prevention of coronary heart diseases