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Biomedical subjects

M Mellies

Publications and source records attributed to M Mellies.

At least 19 recordsLinked to original sources

Planned, ongoing and recently completed clinical trials for atherosclerosis prevention and regression: an update.

Recent landmark studies using hydroxy-methyl-glutaryl-Co-enzyme A reductase inhibitors (HMG-CoA reductase inhibitors or statins), specifically, pravastatin and simvastatin, have led to dramatic changes in medical practice. These clinical trials have demonstrated that clinicians can impact coronary morbidity and mortality in primary (pravastatin) and secondary (pravastatin, simvastatin) prevention settings, including post-infarct patients with 'normal' cholesterol levels (pravastatin). The clinical benefit can be seen irrespective of risk factors at baseline and in women, the elderly and diabetics.

Journal Article↗

Lipid and lipoprotein distributions in black adults. The Cincinnati Lipid Research Clinic's Princeton School Study.

To provide population data on levels of plasma cholesterol, triglyceride, and high- and low-density lipoprotein-cholesterol (HDL-C and LDL-C) in black adults, 627 black adults, aged 20 to 59 years, 206 men and 421 women, were studied in the Cincinnati Lipid Research Clinic's Princeton School Study. Comparisons were made with 2,493 white adults, aged 20 to 59 years, 1,111 men and 1,382 women, from the Princeton School Study. Black men had total plasma cholesterol levels that were comparable with those in whites; plasma cholesterol levels were higher in black than white women. Black men had lower levels of plasma triglycerides, higher HDL-C levels, and lower LDL-C levels than white men. Black women not taking exogenous sex steroid hormones had higher total cholesterol and HDL-C levels, and lower triglyceride and LDL-C levels than white women not taking exogenous sex steroid hormones. Black women taking exogenous sex steroid hormones had lower plasma cholesterol and triglyceride levels and slightly higher HDL-C and lower LDL-C levels than white women taking exogenous sex steroid hormones. These differences not only require the use of race-specific lipoprotein distribution tables for characterization of individual subjects, but are consistent with putatively reduced risk for coronary heart disease in blacks when compared with whites.

Adult↗

Parent-child coronary heart disease risk factor associations.

The aim of this study was to assess parent-child interactions of coronary heart disease risk factors (total cholesterol, high and low density lipoprotein cholesterols, systolic and diastolic blood pressures, and relative ponderosity) in parents and their pediatric-aged children in the Princeton School study. The study population included 430 parent-child pairs from 301 families. Forty-seven of these 301 families were "nuclear" (both parents and at least one child) and included 118 parent-child pairs. Univariate analyses of covariance were used to assess parent-child risk factor interactions and interrelationships. Interdependent coronary heart disease risk factor relationships were extensively shared by parents with their children. Knowledge of parental risk factor levels and their relationships and interactions with children's risk factor levels should be useful in identifying children at presumptively increased long-term risk as adults, and should illuminate metabolic relationships between parents and children for coronary heart disease risk factors.

Adolescent↗

Clustering and interrelationships of coronary heart disease risk factors in schoolchildren, ages 6-19.

Clustering and interrelationships of common and easily identifiable risk factors in 951 children (ages 6-19) from the Cincinnati Lipid Research Clinic's Princeton School of District Study were assessed. Several patterns of partial correlation coeffieients appeared after multiple regression analysis with adjustment for age, sex, Quetelet index, and race. Systolic blood pressure (SBP) was positively correlated with plasma cholesterol and triglyceride, and with saturated fat intake. Plasma high density lipoprotein cholesterol (C-HDL) was positively associated with occupation of the head of the household and inversely associated with cigarette smoking and sucrose intake. Using multiple regression equations, from 29-41% of the variance for SBP and diastolic blood pressure (DBP) could be explained by the measured variables, with age, skinfold thickness, Quetelet, occupation, and education of the head of the household recurrently appearing in the regression equatons. Low density lipoprotein cholesterol (C-HDL) was the variable for which the lowest amount of variance could be explained in the four race-sex groups. Discriminant function analysis allowed an assessment of interrelationships of C-LDL-C-HDL aggregate groups to other risk factor mean residuals. The variables which contributed significantly to the discrimination between lipoprotein groups were Quetelet index, skinfold thickness, and DBP. Children in the highest C-LHL-lowest C-HDL quintile group had by far the highest residual Quetelet index and skinfold thickness, along with above average SBP, while those in The lowest C-LDL-highest C-HDL quintile group had the lowest residual Quetelet index, skinfold thickness, and SBP. Common risk and anti-risk factors for coronary heart disease (CHD) in children cluster, allowing identification of groups of children putatively at relatively high and low CHD risk as adults.

Adolescent↗

Familial hyper-alpha-lipoproteinemia in 26 kindreds.

The inheritance of familial hyper-alpha-lipoproteinemia was investigated in 161 individuals in 11 black kindreds and 15 white kindreds. After age and sex adjustment, the distribution of high density lipoprotein-cholesterol (C-HDL) in the relatives of probands was examined for evidence of bimodality. In whites, bimodality appeared to be present, with one mode at about 46 mg/dl and the other at about 69 mg/dl. In blacks, there was little convincing evidence of bimodality. In the white kindreds, it appeared that one factor with a relatively large effect is causing the familial aggregation of high C-HDL levels; this factor could be a major gene.

Adolescent↗

Cigarette smoking, alcohol intake, and oral contraceptives: relationships to lipids and lipoproteins in adolescent school-children.

The effects of cigarette smoking, alcohol intake, and oral contraceptives on plasma cholesterol, triglyceride, high density lipoprotein cholesterol (C-HDL), and low density lipoprotein cholesterol (C-LDL) were assessed in 965 12--19-year-old school-children in the Cincinnati Lipid Research Clinic's Princeton school survey. After pair matching for age, sex, race, and total plasma cholesterol, adolescent children who smoked had mean C-HDL 6.1 mg/dl lower, and mean C-LDL 4.1 mg/dl higher, than nonsmokers (p less than 0.01). These findings for C-HDL were replicated by covariance analysis, adjusting for age, race, sex, alcohol intake, and triglyceride levels. Adolescents who drank alcohol had higher C-HDL and triglyceride levels and lower C-LDL than nondrinkers, but the differences were not significant. Adolescent females taking oral contraceptives had higher triglyceride, C-HDL, and C-LDL levels than matched controls, but the differences were not significant. If a portion of smoking's contribution to coronary heart disease risk is mediated through its inverse association with C-HDL, and if smoking habits initiated in adolescence continue into adulthood, this report provides additional physiologic data relevant to programs designed to prevent, reduce, or stop cigarette smoking in the adolescent years.

Adolescent↗

Effects of chlorinated hydrocarbon on plasma alpha-lipoprotein cholesterol in rats.

Ten chlorinated hydrocarbons (tetradifon, Chlorobenzilate, Kepone, lindane, Kelthane, toxaphene, dieldrin, hexachlorobenzene, dienochlor, and Aroclor 1254; see below) were evaluated in rats to assess agents which might selectively elevate high-density lipoprotein cholesterol (C-HDL). Single, nontoxic doses of Aroclor, dieldrin, and Kepone elevated C-HDL at day 7 (31%, 26%, and 24%, respectively, p less than 0.05). The C-HDL elevations were maintained at days 21 and 60 (28% and 31%, p less than 0.01) in the Aroclor group, while C-HDL returned to baseline in the dieldrin and Kepone groups. Liver function tests were unchanged from control, suggesting that the changes in C-HDL were not the consequence of hepatotoxicity. The hepatic microsomal cytochrome P-450 content of animals receiving Aroclor, dieldrin, and Kepone was 67%, 56%, and 44% higher than control values (p less than 0.02), indicating probable hepatic enzyme induction. If HDL (an antiatherogenic lipoprotein) is also selectively elevated by chlorinated hydrocarbons in man, then analogues might potentially be developed as antiatherogenic pharmacologic agents. Alternatively, the implications of man's exposure to halogenated hydrocarbons may be better understood.

Cholesterol↗

Black-white similarities in cord blood lipids and lipoproteins.

Cord blood lipoproteins were quantitated in 117 neonates (58 white, 50 black) to assess for potential early expression of racial lipid distinctions. In comparison of black and white neonates there were no differences in total cholesterol (TC), high-density lipoprotein cholesterol (C-HDL), low-density lipoprotein cholesterol (C-LDL), C-HDL/C-LDL, or C-HDL/TC. Cord blood triglycerides were slightly higher in black neonates (p = 0.02). Unlike certain adult black-white comparisons and within the limits of "genicity" as expressed by cord blood lipoproteins, there were no racial differences in C-HDL, C-LDL, and total cholesterol.

Black People↗

Therapy of familial hypercholesterolemia in childhood: diet and cholestyramine resin for 24 to 36 months.

In 16 children heterozygous for familial hypercholesterolemia, two- to three-year therapy with diet and cholestyramine resin (16 gm/day) was assessed in terms of effectiveness, practicality, and safety. All 16 children had previously taken a low-cholesterol (less than 300 mg/day), polyunsaturate-rich (P/S ratio, 1.5:1) diet and choeltyramine resin (12 gm/day) for 12 months. In this study, the cholestyramine resin dose was increased to 16 gm/day, and follow-up was maintained through months 13 through 18, 19 through 24, 25 through 30, and 31 through 36. Eleven children had good drug adherence (four packs of cholestyramine per day) and five children had fair adherence (two to three packs per day). Plasma total cholesterol and low-density lipoprotein (LDL) cholesterol levels were not significantly lowered on the drug-plus-diet regimen as compared to diet alone in five children with fair drug adherence. For children with good drug adherence, mean plasma cholesterol level was lowered below levels achieved on diet alone by 13% (months 13 through 18), 12% (months 19 through 24), 12% (months 25 through 30), and 11% (months 31 through 36) (P less than .05). Reduction in plasma cholesterol level was no greater with 16 than with 12 gm of cholestyramine per day. There were no group changes in mean plasma triglyceride levels. Cholestyramine resin, when added to diet and maintained for two to three years effects a significant reduction in total and LDL cholesterol levels in about 60% of children heterozygous for familial hypercholesterolemia. Continued reinforcement of both diet and drug adherence is necessary in the face of gradual increments in plasma cholesterol level with time.

Adolescent↗

Pediatric familial type II hyperlipoproteinemia: therapy with diet and colestipol resin.

Effects of a low-cholesterol, polyunsaturate-rich diet and a synthetic organic bile sequestrant polymer (U26,597A, colestipol) were studied in 21 children, heterozygous for familial hypercholesterolemia. Total cholesterol, beta-lipoprotein cholesterol, and triglyceride were measured twice on habitual diet, monthly for six months on a low-cholesterol diet, and monthly for six months on low-cholesterol diet plus 10 gm of colestipol per day. Total cholesterol (mean +/- 1 SD) was 295 +/- 37 on habitual diet, 278 +/- 29 on low-cholesterol diet, and fell significantly to 242 +/- 29 mg/100 ml on diet plus colestipol. Low-density lipoprotein (LDL) cholesterol was 234 +/- 37 on habitual diet, 220 +/- 28 on low-cholesterol diet, and fell significantly to 179 +/- 26 mg/100 ml on diet plus drug. Plasma triglyceride levels on habitual diet were 79 +/- 31, remained unchanged on low-cholesterol diet, 86 +/- 22, and were unaffected by low-cholesterol diet plus drug, 85 +/- 17 mg/100 ml. On diet alone, plasma LDL was not normalized (less than 170 mg/100 ml) in any of the 21 children, and cholesterol fell to within normal limits (less than 230 mg/100 ml) in only one child. The combination of diet plus colestipol resin normalized total and LDL cholesterol in 52% of the children. Cholesterol was lowered to a "moderately elevated" range of 230 to 250 mg/100 ml in an additional 14% of the children and LDL was lowered to a range of 170 to 190 mg/100 ml in an additional 29%. In 33% of the children, cholesterol remained greater than 250 mg/100 ml despite diet plus colestipol, while LDL was greater than 190 mg/100 ml in 19%. Colestipol is an effective and well-tolerated cholesterol lowering compound which, in conjunction with diet, may prove to be very useful in the treatment of children heterozygous for familial hypercholesterolemia.

Adolescent↗

Plasma and dietary phytosterols in children.

Plasma phytosterol (plant sterol) levels were studied in 26 infants on various commercial formulas, in 36 infants on breast or cow's milk formulas, in 101 normal and 22 hypercholesterolemic children on a free diet, and in 32 hypercholesterolemic children on a low-cholesterol diet. Commercial formulas, poor in animal fats and enriched with vegetable oils, and low-cholesterol, phytosterol-rich diets generally elevated total plasma phytosterol levels in infants and hypercholesterolemic children from normal mean levels of 2 mg/100 ml to about 9 mg/100 ml. The implications of long-term three- to five-fold elevations of the plasma phytosterols (campesterol, stigmasterol, beta-sitosterol) in infancy and childhood are unknown. Watchful prospective analysis of plasma phytosterol levels may be useful, particularly in regards to otherwise unanticipated long-term effects of cholesterol-poor, phytosterol rich diets.

Adolescent↗