Postprandial Hyperlipidemia: Its Pathophysiology, Diagnosis, Atherogenesis, and Treatments

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(18), P. 13942 - 13942

Published: Sept. 11, 2023

Postprandial hyperlipidemia showing postprandial increases in serum triglyceride (TG) is associated with the development of atherosclerotic cardiovascular disease (ASCVD). To diagnose hyperlipidemia, oral fat loading test (OFLT) should be performed; however, this very time-consuming and difficult to perform. Elevated TG levels reflect an increase TG-rich lipoproteins (TRLs), such as chylomicrons (CM), low-density (VLDL), their remnants (CM [CMRs] VLDL [VLDLRs]). Understanding elevation CMR and/or VLDLR can lead us understand existence hyperlipidemia. The measurement apo B48, which a constituent CM CMR; non-fasting TG, includes content all including non-high-density lipoprotein cholesterol (non-HDL-C), TRLs lipoprotein; remnant are useful reveal observed patients familial type III hyperlipoproteinemia, combined chronic kidney disease, metabolic syndrome 2 diabetes. closely related hyperglycemia, insulin resistance may inducing enhancing factor for both hyperglycemia. Remnant disorders have various atherogenic properties induction inflammation endothelial dysfunction. A healthy diet, calorie restriction, weight loss, exercise positively impact Anti-hyperlipidemic drugs pemafibrate, fenofibrate, bezafibrate, ezetimibe, eicosapentaenoic acid been shown improve Anti-diabetic metformin, alpha-glucosidase inhibitors, pioglitazone, dipeptidyl-peptidase-4 inhibitors glucagon-like peptide 1 analogues ameliorate Although sodium glucose cotransporter-2 not proven reduce they reduced fasting B48 cholesterol. In conclusion, it important appropriately connect optimal treatments. However, there some problems diagnosis cannot specifically defined by measures h after meal. study interventions outcome preventing onset ASCVD, necessary define using reference values IGT.

Language: Английский

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Meta-analysis of the effect of metformin on the regression of different types of prediabetes mellitus

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: May 16, 2025

OBJECTIVE To investigate the differences in efficacy of metformin interventions for progression to type 2 diabetes people with different subtypes prediabetes (impaired fasting glucose, impaired glucose tolerance, mixed). MATERIALS AND METHODS Following PRISMA guidelines, ten Chinese and English databases including PubMed Cochrane were systematically searched (up May 2025), 18 randomized controlled trials included a meta-analysis using randomized/fixed-effects models assess effect versus lifestyle/placebo on incidence diabetes, calculate risk ratios (RR) their 95% confidence intervals (CI), subgroup analyses performed based subtype length intervention. All statistical Review Manager 5.4 software. RESULTS Eighteen RCTs found 35% lower T2DM onset group compared control group, lifestyle change/placebo (RR = 0.65, CI [0.55, 0.77], P < 0.00001), but there was moderate heterogeneity. Subgroup analysis participants showed 62% reduction 0.38, [0.38, 0.61], 0.0001) IFG best effect, 42% 0.58, [0.43, 0.79], 0.0004) IGT subtype; Mixed 23% 0.77, [0.70, 0.86], 0.00001). In addition, intervention duration ≤ 24 months had more significant 0.22, 0.0001); higher proportion glycemic inverse returned normoglycemia than 1.80, [1.39, 2.34], 0.0001). CONCLUSION Metformin can effectively delay significantly better that mixed types, which may be related mechanism drug targeting hepatic gluconeogenesis. It is recommended combined treatment prioritized population.

Language: Английский

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Interventions for Type 2 Diabetes reduction among older people living with HIV in Harare

South African Family Practice, Journal Year: 2024, Volume and Issue: 66(1)

Published: March 26, 2024

Background: Interventions for Type 2 Diabetes reduction among older people aged more than 50 years living with HIV (PLWH) are pertinent as they face excess risks amid a growing population of ageing PLWH. Aim: To describe interventions in Harare Urban District Setting: The study was conducted low socio-economic setting from five primary health care clinics urban District. Methods: A qualitative multi-method approach applied using an exploratory descriptive design and integrative review literature. collected data two purposively selected samples; (1) PLWH (2) nurses. Whittemore Knafl's framework used the literature articles 2013 to 2023 selected. Data source triangulation Braun Clark's content analysis framework. Ethical approval obtained (14056739_CREC_CHS_2022). Results: 23 mean age, 62 years, 9 nurses average 6 years' experience 12 comprised three sources. Key themes that emerged were that, screening should include; assessment younger age; ART-specific risks; diagnostic testing diabetes tests at ART initiation routinely. Health education provide information on adequate physical activity parameters increased consumption fruits vegetables. Metformin may be considered pharmacological intervention where lifestyle fail. Conclusion: proposed suggest measures reduce mitigate faced by Contribution: Improved screening, settings enable reduction.

Language: Английский

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Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: a systematic review and meta-analysis with meta-regression of observational studies

BMC Endocrine Disorders, Journal Year: 2024, Volume and Issue: 24(1)

Published: Sept. 30, 2024

Language: Английский

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