Iranian Journal of

---

Insulin resistant states are emerging rapidly and lots of efforts have gone into understanding their pathogenesis and major metabolic consequences. Hypertriglyceridemia, a major complication of this metabolic syndrome, seems to be caused by overproduction of lipoproteins (LPs) containing apo B that are rich in triglycerides. Some in vitro and in vivo models have been introduced so as to understand mechanisms governing lipid metabolism in insulin resistance states. Human and animal studies have suggested a key role for overproduction of VLDL in hypertriglyceridemia and dyslipidemic states. Recently, we have employed a diet-induced animal model of insulin resistance (hamster fed with fructose) in our laboratory in order to examine the relationship among development of insulin resistant state, impaired metabolism of LPs and overproduction of LPs containing apo B. These experiments have indicated that insulin resistant states occur along with overproduction of VLDL containing apoB105 from liver and enteral LPs rich in apo B 48. In insulin resistant states, decreased metabolic signaling to liver and intestine seems to play a critical role in overproduction of LPs. We have also been recognized a number of intracellular factors which may regulate VLDL production. This article reviews recent advances in the area the hypothesis indicating that a complex interaction exist between increased free fatty acids flow from peripheral tissues to the liver and intestine (caused by hyperinsulinemia) and prolonged lipogenesis has also been expounded.

---

Background: To evaluate the role of lipid markers including total cholesterol (TC), LDL-C and HDL-C vs. lipid indices (TC/HDL-C, LDL-C/HDL-C and non-HDL-C) as short term predictors of cardiovascular outcomes in adults over 30 years.
Methods: As a nested case and control study, there were 207 CVD events among participants of Tehran Lipid and Glucose Study (TLGS) documented during 3 years of follow-up. Those cases that were free of CVD at baseline (132 subjects) were matched to 264 controls for age and sex. In all subjects, demographic and clinical data including blood pressure and anthropometric measurements as well as serum lipids, fasting and 2-hour glucose were available from the database of the TLGS. We estimated the relative risk (RR) for each lipid parameter in a multiple stepwise regression model after adjustment for family history of premature CHD, smoking, systolic and diastolic blood pressure, fasting and 2-hour plasma glucose and waist-to-hip ratio.
Results: The RRs associated with an increase of ≈1 SD of independent lipid predictors in the multivariate model were as follow: total cholesterol (RR=1.6 [1.2-2.0], SD= 1.3 mmol/L), LDL-C (RR=1.5 [1.1-2.0], SD= 1 mmol/L), non-HDL-C (RR=1.6 [1.2-2.1], SD= 1.2 mmol/L) and cholesterol/HDL-C (RR= 1.5 [1.1-2.0], SD= 1.8). The comparing of these four independent variables with ROC curve analysis showed that there was no significant difference in their predictive power for cardiovascular outcome. There was no association between HDL-C, triglyceride and LDL-C/HDL-C and CVD outcome in multivariate analysis.
Conclusion: This study showed that TC, LDL-C, non-HDL-C and TC/HDL-C have similar predictive values for short term prediction of CVD outcome. It seems TC may be a reasonable choice for short term prediction of CVD outcome, because of lower cost.

---

Background: Lipoprotein abnormalities have been identified among the several risk factors that could account for increases the risk of CVD in diabetes. Abnormal status of B-group and antioxidant vitamins in diabetes may illustrate the benefits of these vitamins supplementation on modification of lipid profiles.
Methods: As a randomized double blind placebo controlled clinical trial, 110 type 2 diabetic patients were randomly assigned to one of the five treatment groups and received one of the following supplements per day for a period of 2 months: 1) B-group vitamins including B2 (10 mg), B6 (10mg), B12 (200µg) and Folate (1000µg) 2) B-group vitamins and vitamin E (100mg) 3) B-group vitamins and vitamin C (200mg) 4) B-group vitamins, vitamins E (100mg) and C (200mg) and 5) placebo. Fasting blood samples at the beginning and at the end of 2 months trial were collected and analyzed for cholesterol, triglyceride, apolipoproteins A1 and B (apo A1 & B), vitamin E, folate, vitamin B12 in serum and vitamin C in whole blood. Differences in baselines models. Covariates and changes in variables during study were adjusted by analysis of covariance using general linear.
Results: No significant changes were found in mean serum apolipoproteins levels after 2 months of supplementation. Vitamin E variation showed significant positive correlation with variation in apo A1 (P=0.003) and apo B (P<0.001). In multiple regression analysis, serum vitamin E levels were an independent and important predictor of serum apoA1 and B levels (P=0.002 and P<0.001, respectively). Serum vitamin B12 variation was important predictor of serum apo B levels (P<0.05).
Conclusion: Serum vitamin E level is a good predictor of serum apo A1 and B levels. Further increases in dose of vitamin supplements and intervention period are recommended for obtaining the desirable modifications.

---

Background: The liver plays a main role in the production and metabolism of lipoproteins, and then impaired lipid metabolism is often seen in patients with liver cirrhosis and chronic hepatitis (CH). As a result, plasma lipid levels could be as useful indicators of liver function and patient's prognosis especially in liver cirrhosis.
Methods: We measured the lipoprotein levels in 77 consecutive patients with liver cirrhosis and CH. 47 men (61%) and 30 women (39%) with mean age 43years (SD=16.4) and mean BMI 26(SD=4.2) have been recruited as patients group. Child score and MELD scale was determined in patients group. The control group was age and sex matched with patients group.
Results: In case group, the levels of HDL LDL, TG, and total cholesterol were significantly lower than control group (p <0.0001). In patients with cirrhosis, the levels of LDL, HDL and total cholesterol were progressively lower when comparing patients in Child class A with patients in class C (p<0.0001).This difference was more significant in LDL and total cholesterol and between upper Child scores ,similarly decreasing in LDL, HDL ,and total cholesterol level was observed when MELD score increased (P<0.0001).
Conclusion: There is a correlation between plasma lipid levels and liver function, so it may be mentioned as an accessible and reliable indicator of liver function in cirrhotic and CH patients.

---

Background: In many studies, Serum lipoprotein(a) [Lp(a)] levels considered as an independent risk factor for atherosclerosis. The aim of this study was to assess the association between Lp(a) and cervical carotid artery stenosis in one sample the Iranian population.
Methods: As a cross sectional study, between June 2004 and January 2005, at Tehran Heart Center, 1189 candidates for any kind of open heart surgery, were recruited into this study. Carotid Dopplers ultrasonography was performed for all participants. Serum levels of Lp(a), total cholesterol, triglyceride and blood sugar and quantitative CRP were measured in fasting state and their correlations with carotid atherosclerosis were assessed.
Results: Among 1189 participants, 837 (70.5%) were male and 352 (29.4%) were female. Their mean age was 60±9.3 years (range between 35 to 88). There was not significant relation between Lp(a) serum levels and carotid artery stenosis (P=0.46). The relationship between Lp(a) levels and carotid artery stenosis in both ≤55 years and >55 years patients was not significant too (P=0.25). Also gender has no relationship in this regard (P=0.15). Significant relationship was found between Lp(a) level & hypoecho plaques (vulnerable lesions) (P=0.001).
Conclusion: In our study, we found no significant correlation between serum Lp(a) and carotid stenosis. Lp(a) was found to have positive relationship with hypoecho plaques (vulnerable lesions) which predispose patients for CVA. Further investigations suggest for better evaluations.

---

Background: A high dietary lipid intake is an important mediator of cholesterolemia and cardiovascular disease. Oils such as Sesame oil are not thought to contribute to such complications although information on the subject seems to be spare and contradictory. Since the ground seed of Sesame or “Ardeh” is commonly used in certain parts of this country (Iran), so its effects on the serum lipid profile of the rats have been investigated.
Methods: The study was performed on six groups of male Wistar albino rats (10 in each group) weighing 300-350 gr. Ardeh was prepared by grinding the seeds after they had been roasted at 60ºC. To prepare a high cholesterol diet, 1% cholesterol and 0.5% cholic acid was added. Group 1 consumed the ordinary diet 2 the ordinary diet plus Ardeh (24%), 3 the ordinary diet plus sunflower oil (10%), group 4 the high cholesterol diet, 5 the high cholesterol diet plus Ardeh, and group 6 the high cholestrol diet plus sunflower oil, all for 30 days. Blood samples were obtained and sera were used to determine the lipid profile
Results: The results of the study revealed that addition of Ardeh to the ordinary diet decreased serum cholesterol level significantly (P<0.01) in group 2 (38.2±2.3 mg/dl) as compared to the group 1 (49.9±5.9). Ardeh and sunflower oil had a similar effect on the groups, which consumed the high cholesterol diet. Ardeh also reduced the triglyceride level significantly (P<0.01) in group 2 (65.1±7.6 mg/dl) as compared to group 1 (106.3±15.1). Presence of both Ardeh and sunflower in the diets failed to affect HDL, but VLDL levels in group 2 (13.0±1.5 mg/dl) were significantly (P<0.01) lowered as compared to group 1 (21.2±3).
Conclusion: From the results of this study it appears that Ardeh can have a beneficial effect on lipid profiles and its addition to the diet is recommended.

---

Background: Aloe vera is a herbal plant being used as an anti-inflammatory agent, burning recovery as well as immune system boosting agent. The aim of this study was to evaluate the effects of Aloe vera on blood glucose , lipids and lipoproteins in streptozotocin-induced diabetic male rats.
Methods: This study was carried out on 56 male rats, weighing 150-200 gr. Animals are divided into 7 groups (one control and six test groups). Diabetes were induced in test groups via streptozocin (65mg/ kg-IP). After a week, blood samples analyses for FBS. All diabetic groups, except the control one, were taken 100,200,300,400 mg/kg Aloe vera extract and 5mg/kg glibenclamid by gavages for a period of 4 weeks, respectively. After this period fasting blood samples were collected from all groups.
Results:The results showed that the FBS decreased in groups that received 400mg/kg and glibenclamid (respectively,162/62±23.12and193.37±26.51). In addition, 3-6 groups showed decrease TG and Cholesterol level in comparison with those of control groups. In all groups which received Aloe vera and glibenclamid, LDL level were significantly decreased in comparison with control groups but HDL level had no change.
Conclusion: The results of this research indicate that Aloe vera aqueous extract lead to decreased Blood glucose, Cholesterol, LDL and TG levels. Further studies is suggested for exact mechanism of Aloe vera in diabetic rats.

---

Abstract
Background: This study aimed to compare the effects of high-intensity interval games and high intensity interval training on body composition indicators, aerobic capacity and lipid profiles of obese and overweight girls aged 10 to 12 years.
Methods: In this semi-experimental research, 30 girls (average height 149.26 ± 5.32 m, weight 67.41 ± 7.65 kg, and body mass index 30.14 ± 2.3 kg/m2) with overweight and obesity participated and were randomly divided into the groups of high intensity interval training (10), high intensity interval game (10) and the control (10). Training programs for eight weeks(3d/w), (90-85% of maximum heart rate) and 3-minute recovery (65-75% of maximum heart rate) with 4 times Repetition was done, which was done in the form of running in high intensity interval training and in the form of playing in high intensity interval game. Blood samples were taken to measure the serum levels of lipid profiles (48 hours before and after the intervention period).
Results: The two training groups compared to the control group, increased aerobic capacity and HDL and body fat percentage, TG, TC and LDL (P < 0.010) showed a significant decrease and between the two training groups in TG, LDL and HDL (P<0.01) was a significant difference, with a greater increase in HDL and a greater decrease in TG and LDL was accompanied in the high intensity game group.
Conclusion: High intensity interval games can be suggested as a more suitable solution to improve the lipid profile of obese and overweight girls.