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新型调血脂、抗血小板化合物 d-003 对健康志愿者血脂谱和脂质过氧化的影响。

Effects of d-003, a new hypocholesterolaemic and antiplatelet compound, on lipid profile and lipid peroxidation in healthy volunteers.

机构信息

Medical Surgical Research Center, Havana City, Cuba.

出版信息

Clin Drug Investig. 2003;23(3):193-203. doi: 10.2165/00044011-200323030-00005.

Abstract

BACKGROUND

D-003 is a mixture of long-chain aliphatic primary acids purified from sugarcane wax with hypocholesterolaemic effects proven in rabbits and healthy volunteers; it lowers serum total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) and increases high-density lipoprotein-cholesterol (HDL-C). D-003 also prevents lipoprotein lipid peroxidation in experimental models.

OBJECTIVE

To investigate the effects of D-003 on lipid profile and lipid peroxidation in healthy human volunteers.

PARTICIPANTS

Forty-six healthy volunteers (24 women, 22 men).

METHODS

This double-blind, randomised, placebo-controlled study investigated the effects of D-003 at 5 and 10 mg/day on the susceptibility of LDL to lipid peroxidation induced by copper ions in healthy volunteers. Forty-six individuals were randomised (1 : 2) to placebo or D-003 at 5 or 10 mg/day, the tablets being taken once a day with the evening meal for 8 weeks. Laboratory determinations and physical examination were performed at baseline and after 4 and 8 weeks of therapy, and compliance and adverse experience assessments were performed at weeks 4 and 8.

RESULTS

All groups were well matched at baseline. At study completion, D-003 at 5 and 10 mg/day significantly (p < 0.001) lowered LDL-C, the primary response variable, by 20.8% and 28.8%, respectively. In addition, D-003 at 5 and 10 mg/day reduced (p < 0.001) TC (12.7% and 17.5%, respectively), LDL-C/ HDL-C (25.9% and 36.3%, respectively) and TC/HDL-C (18.6% and 26.3%, respectively), while significantly (p < 0.01) increasing HDL-C (7.7% and 12.4%, respectively). Triglycerides were significantly (p < 0.05) reduced (8.8% and 13.1%, respectively) with respect to baseline, but not versus placebo. Responses assessed at 4 weeks showed significant reductions of LDL-C, TC and atherogenic ratios with both doses of D-003, whereas HDL-C was significantly increased. Triglycerides, however, remained unchanged. No significant changes in any lipid profile variable occurred in the placebo group. D-003 at 5 and 10 mg/day significantly (p < 0.05) increased lag time (18.3% and 32.0%, respectively) and decreased maximum rate of diene propagation (V(max)) [12.7% and 19.1%, respectively] of copper-induced LDL peroxidation. D-003 5 and 10 mg/day attenuated the reduction of the reactivity against 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) by 19.9% and 32.0%, respectively. The treatment was well tolerated. Three subjects (one from each group) discontinued the study. Only one, treated with D-003 5 mg/day, discontinued because of an adverse event (gastritis).

CONCLUSIONS

D-003 at 5 and 10 mg/day demonstrated dose-dependent cholesterol-lowering effects in healthy volunteers characterised by reductions in LDL-C, TC and atherogenic ratios, and increases in HDL-C. Effects on triglycerides were modest and uncertain. As expected from experimental studies, D-003 inhibited the susceptibility of LDL to lipid peroxidation assessed by three indicators lag time V(max) and reactivity versus TNBS. Further studies investigating the effect of larger doses and treatment duration must be conducted to confirm the reproducibility of the present results in different study populations.

摘要

背景

D-003 是一种从甘蔗蜡中提取的长链脂肪族初级酸混合物,在兔子和健康志愿者中已证明具有降胆固醇作用;它降低血清总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C),并增加高密度脂蛋白胆固醇(HDL-C)。D-003 还可以防止实验模型中的脂蛋白脂质过氧化。

目的

研究 D-003 对健康志愿者血脂谱和脂质过氧化的影响。

参与者

46 名健康志愿者(24 名女性,22 名男性)。

方法

这项双盲、随机、安慰剂对照研究调查了 D-003 在 5 和 10mg/天时对铜离子诱导 LDL 脂质过氧化易感性的影响。46 名个体随机(1:2)分为安慰剂或 D-003 5 或 10mg/天,每天一次随晚餐服用,共 8 周。在基线和治疗 4 周和 8 周时进行实验室测定和体格检查,并在第 4 周和第 8 周时进行依从性和不良事件评估。

结果

所有组在基线时均匹配良好。研究结束时,D-003 5 和 10mg/天分别显著(p<0.001)降低 LDL-C,主要反应变量,分别为 20.8%和 28.8%。此外,D-003 5 和 10mg/天还降低了(p<0.001)TC(分别为 12.7%和 17.5%)、LDL-C/HDL-C(分别为 25.9%和 36.3%)和 TC/HDL-C(分别为 18.6%和 26.3%),同时显著(p<0.01)增加了 HDL-C(分别为 7.7%和 12.4%)。甘油三酯也显著(p<0.05)降低(分别为 8.8%和 13.1%),但与安慰剂相比没有降低。4 周时的反应显示,D-003 的两种剂量均显著降低 LDL-C、TC 和致动脉粥样硬化比值,而 HDL-C 则显著升高。然而,甘油三酯没有变化。安慰剂组任何血脂谱变量均无显著变化。D-003 5 和 10mg/天分别显著(p<0.05)增加了滞后时间(分别为 18.3%和 32.0%)和降低了最大二烯增殖速率(Vmax)[分别为 12.7%和 19.1%]铜诱导的 LDL 过氧化。D-003 5 和 10mg/天分别减轻了对 2,4,6-三硝基苯磺酸(TNBS)的反应性降低 19.9%和 32.0%。治疗耐受性良好。三名受试者(每组一名)退出了研究。只有一名接受 D-003 5mg/天治疗的受试者因不良事件(胃炎)而退出。

结论

D-003 5 和 10mg/天在健康志愿者中表现出剂量依赖性的降胆固醇作用,其特征是 LDL-C、TC 和致动脉粥样硬化比值降低,HDL-C 增加。对甘油三酯的影响较小且不确定。正如实验研究所预期的,D-003 通过三种指标滞后时间 Vmax 和与 TNBS 的反应性抑制 LDL 对脂质过氧化的易感性。必须进行更大剂量和治疗持续时间的进一步研究,以确认本研究结果在不同研究人群中的重现性。

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