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Search Results (1,506)

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Keywords = low-density lipoprotein (LDL) cholesterol

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12 pages, 535 KiB  
Article
Real-World Effectiveness of Rosuvastatin–Ezetimibe Single Pill (Rovazet®) in Korean Dyslipidemia Patients
by Hack-Lyoung Kim, Hyun Sung Joh, Sang-Hyun Kim and Myung-A Kim
J. Clin. Med. 2025, 14(15), 5480; https://doi.org/10.3390/jcm14155480 - 4 Aug 2025
Viewed by 168
Abstract
Background: Fixed-dose combinations of rosuvastatin and ezetimibe are increasingly used in clinical practice, but real-world data on their effectiveness and safety in large populations remain limited. Methods: This prospective, single-group, open-label, non-interventional observational study was conducted in the Republic of Korea to evaluate [...] Read more.
Background: Fixed-dose combinations of rosuvastatin and ezetimibe are increasingly used in clinical practice, but real-world data on their effectiveness and safety in large populations remain limited. Methods: This prospective, single-group, open-label, non-interventional observational study was conducted in the Republic of Korea to evaluate the effectiveness and safety of Rovazet® (a fixed-dose combination of rosuvastatin and ezetimibe). Patients were prospectively enrolled from 235 institutions (50 general hospitals and 185 private clinics) as part of routine clinical practice over a five-year period. Lipid profiles and medication compliance questionnaire results were collected at baseline, 12 weeks, and 24 weeks of treatment. Results: A total of 5527 patients with dyslipidemia, the majority were men (53.0%), and the mean age was 60.4 years. Rovazet® significantly reduced low-density lipoprotein cholesterol (LDL-C) by 23.5% at 12 weeks (from 117.47 ± 50.65 mg/dL to 81.14 ± 38.20 mg/dL; p < 0.0001) and by 27.4% at 24 weeks (from 117.47 ± 50.65 mg/dL to 74.52 ± 33.36 mg/dL; p < 0.0001). Total cholesterol was significantly reduced by 17.7% at 12 weeks and by 19.8% at 24 weeks. Rovazet® treatment reduced triglycerides by 4.1% at 12 weeks and by 7.2% at 24 weeks. High-density lipoprotein cholesterol increased by 4.5% at 12 weeks and by 7.9% at 24 weeks following Rovazet® treatment. These changes in lipid profiles were consistent, regardless of cardiovascular risk profiles. By 24 weeks of treatment with Rovazet®, 91.8% of patients had reached their target LDL-C goals. Adverse drug reactions were reported in 2.81% of patients, most of which were minor, indicating that Rovazet® was well tolerated. Conclusions: Rovazet® was effective in improving lipid profiles and well tolerated in Korean adults with dyslipidemia. Full article
(This article belongs to the Section Pharmacology)
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22 pages, 5182 KiB  
Article
Effects of High-Phenolic Extra Virgin Olive Oil (EVOO) on the Lipid Profile of Patients with Hyperlipidemia: A Randomized Clinical Trial
by Christos Kourek, Emmanouil Makaris, Prokopios Magiatis, Virginia Zouganeli, Vassiliki Benetou, Alexandros Briasoulis, Andrew Xanthopoulos, Ioannis Paraskevaidis, Eleni Melliou, Georgios Koudounis and Philippos Orfanos
Nutrients 2025, 17(15), 2543; https://doi.org/10.3390/nu17152543 - 2 Aug 2025
Viewed by 622
Abstract
Background/Objectives: Hyperlipidemia is a major risk factor for cardiovascular disease and atherosclerosis. Polyphenols found in polyphenol-rich extra virgin olive oil (EVOO) have been shown to possess strong antioxidant, anti-inflammatory, and cardioprotective properties. The present study aimed to assess the effects of two types [...] Read more.
Background/Objectives: Hyperlipidemia is a major risk factor for cardiovascular disease and atherosclerosis. Polyphenols found in polyphenol-rich extra virgin olive oil (EVOO) have been shown to possess strong antioxidant, anti-inflammatory, and cardioprotective properties. The present study aimed to assess the effects of two types of EVOO with different polyphenol content and dosages on the lipid profile of hyperlipidemic patients. Methods: In this single-blind, randomized clinical trial, 50 hyperlipidemic patients were randomized to receive either a higher-dose, lower-phenolic EVOO (414 mg/kg phenols, 20 g/day) or a lower-dose, higher-phenolic EVOO (1021 mg/kg phenols, 8 g/day), for a period of 4 weeks. These doses were selected to ensure equivalent daily polyphenol intake in both groups (~8.3 mg of total phenols/day), based on chemical analysis performed using NMR spectroscopy. The volumes used (8–20 g/day) reflect typical daily EVOO intake and were well tolerated by participants. A group of 20 healthy individuals, separated into two groups, also received the two types of EVOO, respectively, for the same duration. Primary endpoints included blood levels of total blood cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, lipoprotein-a (Lpa), and apolipoproteins A1 and B. Measurements were performed at baseline and at the end of the 4-week intervention. Linear mixed models were performed for the data analysis. Results: The higher-phenolic, lower-dose EVOO group showed a more favorable change in total blood cholesterol (p = 0.045) compared to the lower-phenolic, higher-dose group. EVOO intake was associated with a significant increase in HDL (p < 0.001) and reduction in Lp(a) (p = 0.040) among hyperlipidemic patients in comparison to healthy individuals. Conclusions: EVOO consumption significantly improved the lipid profile of hyperlipidemic patients. Higher-phenolic EVOO at lower dosages appears to be more effective in improving the lipid profile than lower-phenolic EVOO in higher dosages. Full article
(This article belongs to the Section Clinical Nutrition)
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19 pages, 1376 KiB  
Article
The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial
by Melissa Hui Juan Tay, Qai Ven Yap, Su Lin Lim, Yuki Wei Yi Ong, Victoria Chantel Hui Ting Wee and Chin Meng Khoo
Nutrients 2025, 17(15), 2541; https://doi.org/10.3390/nu17152541 - 1 Aug 2025
Viewed by 331
Abstract
Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net [...] Read more.
Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m2 were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article
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21 pages, 2807 KiB  
Article
Phage Therapy Enhances Survival, Immune Response, and Metabolic Resilience in Pacific White Shrimp (Litopenaeus vannamei) Challenged with Vibrio parahaemolyticus
by Chao Zeng, Long Qi, Chao-Li Guan, Yu-Lin Chang, Yu-Yun He, Hong-Zheng Zhao, Chang Wang, Yi-Ran Zhao, Yi-Chen Dong and Guo-Fang Zhong
Fishes 2025, 10(8), 366; https://doi.org/10.3390/fishes10080366 - 30 Jul 2025
Viewed by 328
Abstract
Acute hepatopancreatic necrosis disease (AHPND), caused by the bacterium Vibrio parahaemolyticus, is a major threat to global shrimp aquaculture. In this study, we evaluated the therapeutic effects of phage therapy in Litopenaeus vannamei challenged with AHPND-causing Vibrio parahaemolyticus. Phage application at [...] Read more.
Acute hepatopancreatic necrosis disease (AHPND), caused by the bacterium Vibrio parahaemolyticus, is a major threat to global shrimp aquaculture. In this study, we evaluated the therapeutic effects of phage therapy in Litopenaeus vannamei challenged with AHPND-causing Vibrio parahaemolyticus. Phage application at various concentrations significantly improved shrimp survival, with the 1 ppm group demonstrating the highest survival rate. Enzymatic assays revealed that phage-treated shrimp exhibited enhanced immune enzyme activities, including acid phosphatase (ACP), alkaline phosphatase (AKP), and lysozyme (LZM). In addition, antioxidant defenses such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX), and total antioxidant capacity (T-AOC) significantly improved, accompanied by reduced malondialdehyde (MDA) levels. Serum biochemical analyses demonstrated marked improvements in lipid metabolism, particularly reductions in triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL), alongside higher levels of beneficial high-density lipoprotein (HDL). Transcriptomic analysis identified 2274 differentially expressed genes (DEGs), notably enriched in pathways involving fatty acid metabolism, peroxisome functions, lysosomes, and Toll-like receptor (TLR) signaling. Specifically, phage treatment upregulated immune and metabolic regulatory genes, including Toll-like receptor 4 (TLR4), myeloid differentiation primary response protein 88 (MYD88), interleukin-1β (IL-1β), nuclear factor erythroid 2-related factor 2 (Nrf2), and peroxisome proliferator-activated receptor (PPAR), indicating activation of innate immunity and antioxidant defense pathways. These findings suggest that phage therapy induces protective immunometabolic adaptations beyond its direct antibacterial effects, thereby providing an ecologically sustainable alternative to antibiotics for managing bacterial diseases in shrimp aquaculture. Full article
(This article belongs to the Special Issue Healthy Aquaculture and Disease Control)
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27 pages, 2593 KiB  
Review
Mobile Health Interventions for Individuals with Type 2 Diabetes and Overweight or Obesity—A Systematic Review and Meta-Analysis
by Carlos Gomez-Garcia, Carol A. Maher, Borja Sañudo and Jose Manuel Jurado-Castro
J. Funct. Morphol. Kinesiol. 2025, 10(3), 292; https://doi.org/10.3390/jfmk10030292 - 29 Jul 2025
Viewed by 436
Abstract
Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent [...] Read more.
Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent a promising strategy to address both conditions simultaneously. Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of mHealth-based interventions for the management of adults with T2D and overweight/obesity. Specifically, it assessed the quantitative impact of these interventions on glycosylated hemoglobin (HbA1c), body weight, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases from inception to 9 July 2025. The inclusion criteria focused on randomized controlled trials (RCTs) using mHealth interventions in adults with T2D and overweight/obesity, reporting HbA1c or weight as primary or secondary outcomes. The risk of bias was assessed using the Cochrane Risk of Bias tool 2. A total of 13 RCTs met the inclusion criteria. Results: Meta-analysis indicated significant improvements after 6–12 months of intervention in HbA1c (MD −0.23; 95% CI −0.36 to −0.10; p < 0.001; I2 = 72%), body weight (MD −2.47 kg; 95% CI −3.69 to −1.24; p < 0.001; I2 = 79%), total cholesterol (MD −0.23; 95% CI −0.39 to −0.07; p = 0.004; I2 = 0%), and LDL (MD −0.27; 95% CI −0.42 to −0.12; p < 0.001; I2 = 0%). Conclusions: mHealth interventions are effective and scalable for managing T2D and obesity, particularly when incorporating wearable technologies to improve adherence. Future research should focus on optimizing personalization, engagement strategies, and long-term implementation. Full article
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14 pages, 839 KiB  
Article
Biochemical Profile Variations Among Type 2 Diabetic Patients Stratified by Hemoglobin A1c Levels in a Saudi Cohort: A Retrospective Study
by Abdulrahman Alshalani, Nada AlAhmari, Hajar A. Amin, Abdullah Aljedai and Hamood AlSudais
J. Clin. Med. 2025, 14(15), 5324; https://doi.org/10.3390/jcm14155324 - 28 Jul 2025
Viewed by 381
Abstract
Background: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories [...] Read more.
Background: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories to support early identification and better management of diabetes-related complications. Methods: A retrospective observational study at King Khalid University Hospital (KKUH), Riyadh, included 621 adult patients diagnosed with T2DM categorized into four HbA1c groups: normal (<5.7%), prediabetes (5.7–6.4%), controlled diabetes (6.5–7.9%), and uncontrolled diabetes (≥8.0%). Biochemical parameters included the liver profile: alkaline phosphatase (ALP) and bilirubin, renal profile: creatinine, blood urea nitrogen (BUN), glucose, sodium, and chloride, and lipid profile: cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. Regression models identified predictors of ALP, cholesterol, and LDL. Results: ALP was higher in uncontrolled diabetes (89.0 U/L, Q1–Q3: 106.3–72.0) than in the prediabetes group (75.0 U/L, Q1–Q3: 96.8–62.3). Sodium and chloride were lower in uncontrolled diabetes (Na: 138.3 mmol/L, Q1–Q3: 140.3–136.4; Cl: 101.1 mmol/L, Q1–Q3: 102.9–99.4) compared to the normal group (Na: 139.5 mmol/L, Q1–Q3: 142.4–136.9; Cl: 103.5 mmol/L, Q1–Q3: 106.1–101.7). LDL was lower in uncontrolled diabetes (2.1 mmol/L, Q1–Q3: 2.8–1.7) than in the normal group (2.8 mmol/L, Q1–Q3: 3.7–2.2), while triglycerides were higher in patients with uncontrolled diabetes compared to the normal group (1.45 mmol/L, Q1–Q3: 2.02–1.11 vs. 1.26 mmol/L, Q1–Q3: 1.44–0.94). Regression models showed low explanatory power (R2 = 2.1–7.3%), with weight, age, and sex as significant predictors of select biochemical markers. Conclusions: The study observed biochemical variations across HbA1c categories in T2DM patients, likely reflecting insulin resistance. Monitoring these markers in conjunction with HbA1c can enhance early detection and improve the management of complications. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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25 pages, 1329 KiB  
Review
Research Progress and Prospects of Flavonoids in the Treatment of Hyperlipidemia: A Narrative Review
by Xingtong Chen, Jinbiao Yang, Yunyue Zhou, Qiao Wang, Shuang Xue, Yukun Zhang and Wenying Niu
Molecules 2025, 30(15), 3103; https://doi.org/10.3390/molecules30153103 - 24 Jul 2025
Viewed by 540
Abstract
Hyperlipidemia (HLP) is a disorder of human lipid metabolism or transport, primarily characterized by abnormally elevated levels of total cholesterol (TC), triglycerides (TGs), and low-density lipoprotein cholesterol (LDL-C) in the blood. It is a key factor contributing to the development of non-alcoholic fatty [...] Read more.
Hyperlipidemia (HLP) is a disorder of human lipid metabolism or transport, primarily characterized by abnormally elevated levels of total cholesterol (TC), triglycerides (TGs), and low-density lipoprotein cholesterol (LDL-C) in the blood. It is a key factor contributing to the development of non-alcoholic fatty liver disease, obesity, diabetes, atherosclerosis, and cardiovascular and cerebrovascular diseases. Statistics show that the prevalence of dyslipidemia among Chinese adults is as high as 35.6%, and it has shown a trend of younger onset in recent years, posing a serious threat to public health. Therefore, the prevention and treatment of dyslipidemia carry significant social significance. The pathogenesis of hyperlipidemia is complex and diverse, and currently used medications are often accompanied by side effects during treatment, making the research and development of new therapeutic approaches a current focus. Numerous studies have shown that flavonoids, which are abundant in most medicinal plants, fruits, and vegetables, exert effects on regulating lipid homeostasis and treating hyperlipidemia through a multi-target mechanism. These compounds have demonstrated significant effects in inhibiting lipid synthesis, blocking lipid absorption, promoting cholesterol uptake, enhancing reverse cholesterol transport, and suppressing oxidative stress, inflammation, and intestinal microbiota disorders. This article reviews the latest progress in the mechanisms of flavonoids in the treatment of hyperlipidemia, providing a theoretical basis for future research on drugs for hyperlipidemia. Full article
(This article belongs to the Section Natural Products Chemistry)
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17 pages, 1774 KiB  
Article
A Randomized Double-Blind Trial of the Effect of Liupao Tea on Metabolic Parameters, Body Composition, and Gut Microbiota in Adults with Metabolic Syndrome
by Yuyang Wang, Qiang Hu, Qiliu Jiang, Jiamin Jiang, Biandi Li and Defu Ma
Nutrients 2025, 17(14), 2371; https://doi.org/10.3390/nu17142371 - 19 Jul 2025
Viewed by 639
Abstract
Background: Metabolic syndrome (MetS) represents a significant global health challenge. Liupao tea (LPT), a post-fermented dark tea, has shown potential metabolic benefits, but clinical evidence remains limited. Objectives: This study aimed to investigate the effects of LPT with varying aging durations [...] Read more.
Background: Metabolic syndrome (MetS) represents a significant global health challenge. Liupao tea (LPT), a post-fermented dark tea, has shown potential metabolic benefits, but clinical evidence remains limited. Objectives: This study aimed to investigate the effects of LPT with varying aging durations on clinical parameters, body composition and gut microbiota in individuals with MetS. Methods: In a randomized, double-blind trial, patients with MetS were randomly assigned to intervention groups, receiving 6 g/day of LPT aged for 1, 4, 7, or 10 years, respectively, over a 90-day intervention period. Blood pressure, lipid and glucose levels, body weight, body composition, and gut microbiota were assessed at baseline and post-intervention. Results: A total of 71 participants, with a mean age of 53.5 years, were included. At the final assessment, significant reductions in both systolic and diastolic blood pressure were observed in the 10-year-aged groups (p < 0.05). In terms of lipid profiles, the 1-year-aged group showed a significant decrease in total cholesterol (TC), while low-density lipoprotein cholesterol (LDL-C) levels significantly decreased in the 1-, 4-, 7-, and 10-year-aged groups (p < 0.05). All intervention groups showed significant reductions in body weight, body fat mass (BFM), along with an increase in muscle mass (MM) (p < 0.05). A decrease in the Firmicutes/Bacteroides (F/B) ratio was observed in the 10-year-aged group. No significant differences in clinical parameters or body composition regulation were observed between groups with varying aging durations (p > 0.05). Conclusions: LPT intervention effectively improves metabolic health and modulates gut microbiota in MetS patients, irrespective of aging duration. These findings support LPT as a functional beverage for the management of MetS. Full article
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23 pages, 1809 KiB  
Review
Pediatric Familial Hypercholesterolemia: Targeting Intestinal Absorption and Other Therapeutic Strategies
by Konstantinos Arvanitakis, Elena Chatzikalil, Christina Antza, Christos Topalidis, Georgios Kalopitas, Elena Solomou, Vasilios Kotsis, Georgios Germanidis, Theocharis Koufakis and Michael Doumas
Nutrients 2025, 17(14), 2357; https://doi.org/10.3390/nu17142357 - 18 Jul 2025
Viewed by 1312
Abstract
Familial hypercholesterolemia (FH) is a genetic disorder marked by significantly elevated levels of low-density lipoprotein cholesterol (LDL-C) since childhood, substantially increasing the risk of premature atherosclerosis and cardiovascular disease. While dysfunction of hepatic LDL-C receptors is the main underlying cause, the gastrointestinal tract [...] Read more.
Familial hypercholesterolemia (FH) is a genetic disorder marked by significantly elevated levels of low-density lipoprotein cholesterol (LDL-C) since childhood, substantially increasing the risk of premature atherosclerosis and cardiovascular disease. While dysfunction of hepatic LDL-C receptors is the main underlying cause, the gastrointestinal tract plays a key role in cholesterol homeostasis and represents an important therapeutic target. Inhibition of intestinal cholesterol absorption has emerged as an effective strategy in the management of pediatric FH, particularly in patients for whom statins may not be the ideal first-line treatment. Ezetimibe, an inhibitor of the Niemann-Pick C1-like 1 (NPC1L1) protein, has been shown to reduce LDL-C levels in children with FH, with a greater efficacy observed when used in combination with statins. Bile acid sequestrants also enhance cholesterol excretion but are often limited by gastrointestinal side effects, while dietary interventions, such as phytosterol supplementation and fiber-enriched diets, provide additional benefits in lowering LDL-C and are generally well tolerated. Emerging therapies, including microbiota-targeted strategies and novel cholesterol absorption inhibitors, show promise for expanding future treatment options. This review explores the mechanisms of intestinal cholesterol absorption and their relevance to pediatric FH. We examine key pathways, including dietary cholesterol uptake through NPC1L1, bile acid reabsorption, and cholesterol efflux mediated by ATP-binding cassette transporters, while also discussing clinical and experimental evidence on pharmacological and dietary interventions that modulate these pathways. A deeper understanding of cholesterol metabolism, the emerging role of the gut microbiota, and innovative therapeutic agents can support the development of more effective and personalized approaches to the treatment of children with FH. Full article
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10 pages, 551 KiB  
Article
Cross-Sectional Retrospective Observational Study on Lipid-Lowering Therapy for Secondary Prevention in Patients with Peripheral Arterial Disease: LEONIDA Registry
by Ilaria Radano, Fabrizio Delnevo, Tiziana Claudia Aranzulla, Salvatore Piazza, Catia De Rosa, Silvia Muccioli, Maria Chiara Ferrua Trucco, Andrea Ricotti, Simone Quaglino, Michelangelo Ferri, Giuseppe Patti, Andrea Gaggiano and Giuseppe Musumeci
J. Vasc. Dis. 2025, 4(3), 27; https://doi.org/10.3390/jvd4030027 - 17 Jul 2025
Viewed by 233
Abstract
Background and aim: Low-density lipoprotein cholesterol (LDL-C) is an important and well-established modifiable risk factor for cardiovascular disease, including peripheral artery disease (PAD). We aimed at evaluating the lipid profile at admission in PAD patients with an indication for invasive treatment. Methods: Among [...] Read more.
Background and aim: Low-density lipoprotein cholesterol (LDL-C) is an important and well-established modifiable risk factor for cardiovascular disease, including peripheral artery disease (PAD). We aimed at evaluating the lipid profile at admission in PAD patients with an indication for invasive treatment. Methods: Among patients with PAD diagnosis admitted to the vascular surgery department, those receiving statins and those with LDL-C values in the recommended target (<55 mg/dL) were identified. The correlation of LDL-C values with different clinical variables was investigated. Results: Of the 399 patients, 259 (65%) were on statin therapy. According to multivariate linear regression analysis, diabetes (p = 0.004), previous CAD history (p < 0.001), and statin therapy (p < 0.001) were independently associated with LDL-C levels. Patients with LDL-C < 55 mg/dL at admission were 89 (22% of the overall cohort). Among these patients, diabetes (48.3% versus 35.8%, p = 0.036), CAD history (52.8% versus 30%, p < 0.001), and statin use (91% versus 57.4%, p < 0.001) were more frequent as compared with patients not at target. Conclusion: Despite the very high cardiovascular risk of our group, the rate of statin prescription was very low and far from ideal. Only a small percentage of patients achieved target LDL-C values. Patients with coexistent diabetes and CAD had lower LDL-C values, suggesting management by specialists with greater attention to lipid profile and pointing out an urgent need for information on cardiovascular disease management. Full article
(This article belongs to the Section Peripheral Vascular Diseases)
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21 pages, 749 KiB  
Review
HDL Function Versus Small Dense LDL: Cardiovascular Benefits and Implications
by Claudiu Stoicescu, Cristina Vacarescu and Dragos Cozma
J. Clin. Med. 2025, 14(14), 4945; https://doi.org/10.3390/jcm14144945 - 12 Jul 2025
Viewed by 651
Abstract
High-density lipoprotein (HDL) and small dense low-density lipoprotein (sdLDL) represent two critical yet contrasting components in lipid metabolism and cardiovascular risk modulation. While HDL has traditionally been viewed as cardioprotective due to its role in reverse cholesterol transport and anti-inflammatory effects, emerging evidence [...] Read more.
High-density lipoprotein (HDL) and small dense low-density lipoprotein (sdLDL) represent two critical yet contrasting components in lipid metabolism and cardiovascular risk modulation. While HDL has traditionally been viewed as cardioprotective due to its role in reverse cholesterol transport and anti-inflammatory effects, emerging evidence emphasizes that HDL functionality—rather than concentration alone—is pivotal in atheroprotection. Conversely, sdLDL particles are increasingly recognized as highly atherogenic due to their enhanced arterial penetration, oxidative susceptibility, and prolonged plasma residence time. This review critically examined the physiological roles, pathological implications, and therapeutic interventions targeting HDL function and sdLDL burden. Lifestyle modifications, pharmacologic agents including statins, fibrates, PCSK9 inhibitors, and novel therapies such as icosapent ethyl were discussed in the context of their effects on HDL quality and sdLDL reduction. Additionally, current clinical guidelines were analyzed, highlighting a paradigm shift away from targeting HDL-C levels toward apoB-driven risk reduction. Although HDL-targeted therapies remain under investigation, the consensus supports focusing on lowering apoB-containing lipoproteins while leveraging lifestyle strategies to improve HDL functionality. In the setting of heart failure, particularly with preserved ejection fraction (HFpEF), alterations in HDL composition and elevated sdLDL levels have been linked to endothelial dysfunction and systemic inflammation, further underscoring their relevance beyond atherosclerosis. A comprehensive understanding of HDL and sdLDL dynamics is essential for optimizing cardiovascular prevention strategies. Full article
(This article belongs to the Special Issue Clinical Management of Patients with Heart Failure—2nd Edition)
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14 pages, 1751 KiB  
Article
Associations Between Low-Density Lipoprotein Cholesterol Levels and Cardiovascular Outcomes in Patients Undergoing Dialysis: A Nationwide Cohort Study
by Byung Sik Kim, Jiyeong Kim, Nayeon Choi, Hyun-Jin Kim and Jeong-Hun Shin
J. Clin. Med. 2025, 14(14), 4845; https://doi.org/10.3390/jcm14144845 - 8 Jul 2025
Viewed by 523
Abstract
Background/Objectives: Low-density lipoprotein cholesterol (LDL-C) is a causal factor in the development of atherosclerosis and a predictor of cardiovascular disease. However, the association between LDL-C levels and cardiovascular outcomes in patients undergoing dialysis remains controversial, with current guidelines advising against initiating statin therapy [...] Read more.
Background/Objectives: Low-density lipoprotein cholesterol (LDL-C) is a causal factor in the development of atherosclerosis and a predictor of cardiovascular disease. However, the association between LDL-C levels and cardiovascular outcomes in patients undergoing dialysis remains controversial, with current guidelines advising against initiating statin therapy in this population. This study investigated the relationship between LDL-C levels and cardiovascular outcomes in Korean adults undergoing dialysis, using nationwide data. Methods: A total of 21,692 patients with end-stage kidney disease undergoing dialysis between 2009 and 2017 were identified from the Korean National Health Insurance Service database. Statin non-users (primary cohort) and users (secondary cohort) comprised 15,414 and 6278 patients, respectively. LDL-C levels were categorized, and cardiovascular outcomes including composites of cardiovascular death, myocardial infarction, and ischemic stroke were analyzed. Results: Among statin non-users, LDL-C levels > 100 mg/dL were significantly associated with an increased risk of the composite outcome, in a dose-dependent manner, compared with LDL-C levels < 70 mg/dL. Specifically, participants with LDL-C levels ≥ 160 mg/dL demonstrated a 43% increased risk of the composite outcome and a 2.25-fold higher risk of myocardial infarction compared to those with LDL-C levels < 70 mg/dL. Among statin users, LDL-C levels > 130 mg/dL were associated with an increased risk of the composite outcome. Conclusions: This study highlights the significant association between elevated LDL-C levels and adverse cardiovascular outcomes in patients undergoing dialysis. These findings underscore the importance of close monitoring and proactive management of LDL-C levels in this high-risk population. Future research should focus on developing tailored lipid-lowering strategies to improve cardiovascular outcomes in these patients. Full article
(This article belongs to the Section Cardiovascular Medicine)
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15 pages, 584 KiB  
Review
The Role of Non-HDL Cholesterol and Apolipoprotein B in Cardiovascular Disease: A Comprehensive Review
by Vasiliki Katsi, Nikolaos Argyriou, Christos Fragoulis and Konstantinos Tsioufis
J. Cardiovasc. Dev. Dis. 2025, 12(7), 256; https://doi.org/10.3390/jcdd12070256 - 4 Jul 2025
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Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains the leading global cause of morbidity and mortality, even in the era of aggressive low-density lipoprotein cholesterol (LDL-C) lowering. This persistent residual risk has prompted a reevaluation of atherogenic lipid markers, with non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein [...] Read more.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading global cause of morbidity and mortality, even in the era of aggressive low-density lipoprotein cholesterol (LDL-C) lowering. This persistent residual risk has prompted a reevaluation of atherogenic lipid markers, with non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (Apo B) emerging as superior indicators of the total atherogenic particle burden. Unlike LDL-C, non-HDL-C includes cholesterol from all atherogenic lipoproteins, while Apo B reflects the total number of atherogenic particles regardless of cholesterol content. Their clinical relevance is underscored in populations with diabetes, obesity, and hypertriglyceridemia, where LDL-C may not adequately reflect cardiovascular risk. This review explores the biological, clinical, and genetic foundations of non-HDL-C and Apo B as critical tools for risk stratification and therapeutic targeting. It highlights discordance analysis, inflammatory mechanisms in atherogenesis, the influence of metabolic syndromes, and their utility in specific populations, including those with chronic kidney disease and children with familial hypercholesterolemia. Additionally, the role of lipoprotein (a), glycation in diabetes, and hypertriglyceridemia are examined as contributors to residual risk. Clinical trials and genetic studies support Apo B and non-HDL-C as more robust predictors of cardiovascular events than LDL-C. Current guidelines increasingly endorse these markers as secondary or even preferred targets in complex lipid disorders. The incorporation of Apo B and non-HDL-C into routine clinical practice, especially for patients with residual risk, represents a paradigm shift toward personalized cardiovascular prevention. The review concludes with recommendations for guideline integration, emerging therapies, and future directions in biomarker-driven cardiovascular risk management. Full article
(This article belongs to the Special Issue Effect of Lipids and Lipoproteins on Atherosclerosis)
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18 pages, 456 KiB  
Article
Group Aerobic Exercise Improves Body Composition and Lipid Profile in Young Women with Elevated BMI: A Randomized Controlled Trial
by Omer Špirtović, Ilma Čaprić, Borko Katanić, Karuppasamy Govindasamy, Vlad Adrian Geantă, Viorel Petru Ardelean, Zerina Salihagić, Aldina Ajdinović and Mima Stanković
Appl. Sci. 2025, 15(13), 7489; https://doi.org/10.3390/app15137489 - 3 Jul 2025
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Abstract
Sedentary behavior among young women is increasingly associated with adverse metabolic and cardiovascular outcomes. The aim of this randomized controlled trial was to evaluate and compare the effects of three structured group fitness programs on anthropometric parameters, body composition, and lipid profile in [...] Read more.
Sedentary behavior among young women is increasingly associated with adverse metabolic and cardiovascular outcomes. The aim of this randomized controlled trial was to evaluate and compare the effects of three structured group fitness programs on anthropometric parameters, body composition, and lipid profile in overweight young women (N = 111, age 18–25, BMI ≥ 25). Participants were assigned to mix aerobics (E1, n = 27), kickbox aerobics (E2, n = 28), step aerobics (E3, n = 27), or a control group (C, n = 29). Each intervention lasted 12 weeks, with sessions conducted three times per week, each lasting 60 min. The results were analyzed using repeated measures ANOVA. Significant reductions were observed in body weight (−4.8 kg in E1, p < 0.01), waist circumference (−5.3 cm in E1, p < 0.001), and body fat percentage (−3.6% in E1, p < 0.01). High-density lipoprotein (HDL) increased by 7.4 mg/dL (p < 0.01), while low-density lipoprotein (LDL), total cholesterol, and triglycerides decreased by 12.1 mg/dL, 18.6 mg/dL, and 19.4 mg/dL, respectively (all p < 0.01). The most pronounced overall improvements were found in the mix aerobics group. In contrast, the control group showed significant deterioration in most variables, including a 2.1 kg weight gain and a 6.3 mg/dL increase in total cholesterol (p < 0.05). These findings confirm the superior effectiveness of mix aerobics as a non-pharmacological intervention to improve body composition (notably through reductions in body weight, fat percentage, and waist circumference) and cardiovascular biomarkers (such as increased HDL and decreased LDL, total cholesterol, and triglycerides) in young overweight women. Compared to kickboxing and step aerobics, mix aerobics consistently achieved the greatest improvements across all measured parameters, making it the most comprehensive and effective option among the three programs tested. Full article
(This article belongs to the Special Issue Exercise, Fitness, Human Performance and Health: 2nd Edition)
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12 pages, 233 KiB  
Article
Effects of Personalized Nutrition Education on Lipid Profiles in Chinese Adults: A Medical Student-Implemented Community Intervention Study
by Hongli Wang, Tianyi Shen, Jingming Zhu, Jing Gao, Shaoxian Liang, Wanshui Yang and Zhuang Zhang
Nutrients 2025, 17(13), 2161; https://doi.org/10.3390/nu17132161 - 28 Jun 2025
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Abstract
Background: Dyslipidemia affects over 30% of Chinese adults, with awareness rates below 20%. Promoting nutrition education programs in the general population is important, but few studies have investigated the specific strategies and their efficacy. Methods: This longitudinal study was conducted in a representative [...] Read more.
Background: Dyslipidemia affects over 30% of Chinese adults, with awareness rates below 20%. Promoting nutrition education programs in the general population is important, but few studies have investigated the specific strategies and their efficacy. Methods: This longitudinal study was conducted in a representative sample of community-dwelling adults in Lu’an City, central-eastern China. After recruitment and propensity score matching, the personalized and conventional nutrition education groups included 306 and 612 participants, respectively. We provided standardized nutrition education based on the Dietary Guidelines for Chinese Residents (2022) for the conventional group, and personalized nutrition advice based on individual food intake and the guidelines for the personalized group. Serum total cholesterol (TC), high-density lipo-protein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured at baseline and again after follow-up. Results: Three years after the intervention, the average levels of TC, LDL-C, and TG in both groups all increased. After adjusting for covariates, an increase in HDL-C was greater in the personalized group than in the convention group, while the increment in TG was less pronounced. LDL-C changes were similar between the groups. The beneficial effect of personalized nutrition education on HDL-C levels was more pronounced in women (pinteraction < 0.05). Similar results were observed among participants with dyslipidemias and after excluding all lipid-lowering medication users. Conclusions: We conducted personalized nutrition education through medical students’ community practice projects among Chinese community residents, revealing that personalized nutrition education based on dietary surveys could significantly improve blood lipid profiles in general residents and individuals with dyslipidemias compared to conventional nutrition education. Full article
(This article belongs to the Special Issue Food Habits, Nutritional Knowledge, and Nutrition Education)
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