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Biomedical subjects

S Rössner

Publications and source records attributed to S Rössner.

353 records · Page 20Linked to original sources
PubMedDate not supplied

Dose-response effect of single and combined clofibrate (Atromidin) and niceritrol (Perycit) treatment on serum lipids and lipoproteins in type II hyperlipoproteinaemia.

The dose-response effects of clofibrate and niceritrol on serum cholesterol and triglycerides (TG) were studied in 29 patients with Type IIa and IIb hyperlipoproteinaemia. In 17 patients, clofibrate and niceritrol were then given as combined treatment, and the effects of this combination on serum lipoproteins were studied. Clofibrate was given in three doses: 1.5,2 and 2.5 g/day. The optimum effect on serum TG and cholesterol in patients with Type IIa was observed with the 1.5 g dose and higher doses did not lower the serum lipids further. In patients with Type IIb the optimal clofibrate dose was 1.5-2 g/day. Niceritrol was then given in three doses: 3,45 and 6 g/day. In patients with Type IIa the serum TG concentration was not significantly affected by any dose used, whereas the reduction of the serum cholesterol concentration was dose dependent. In patients with Type IIb the reduction of both serum TG and cholesterol was dose dependent. Combined treatment with 2 g clofibrate and 3 g niceritrol resulted in a normal lipoprotein pattern i 15 out of 17 patients. The reduction of the serum lipids was approximately the same as during treatment with 6 g niceritrol/day. No additional side-effects were observed during combined treatment.

Adult↗
PubMedDate not supplied

Fenofibrate therapy of hyperlipoproteinaemia. A dose-response study and a comparison with clofibrate.

Fenofibrate is an efficient serum lipid-lowering drug with few clinical side effects. The drug was further evaluated in a study comprising 56 patients, which combined a dose-response trial with a subsequent comparison between the optimal fenofibrate dose and a clofibrate dose of 2 g/day. When the fenofibrate dose was gradually increased (200-300-400 mg/day), a reduction of the elevated lipoproteins within each type of hyperlipoproteinaemia was found. During the dose-response part of the therapy a transient serum creatinine rise was observed, which disappeared at the 400 mg/day level. The highest dose, 400 mg/day, proved to have the best lipid-lower effects. On this therapy the elevated LDL-cholesterol fell by 28% in type IIA + B patients, and the elevated VLDL-TG by 65% in type IIB + IV patients. The HDL/VLDL + LDL-cholesterol ratio increased significantly in all groups, in particular in type IV patients (from 0.19 to 0.28, P less than 0.001). Fenofibrate and clofibrate were each given for 2 months in random order, and the effects on lipoproteins compared. Significant differences were: higher HDL-cholesterol in type IIA on clofibrate, lower LDL-cholesterol in type IIB on fenofibrate, lower TG and cholesterol in both VLDL an LDL in type IV on fenofibrate, combined with higher HDL-cholesterol on this drug. Thus, fenofibrate seems to be an efficient lipid lowering drug with 400 mg/day as an optimal dosage under our conditions.

Cholesterol↗
PubMedDate not supplied

Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance.

BACKGROUND: Sibutramine is a tertiary amine that has been shown to induce dose-dependent weight loss and to enhance the effects of a low-calorie diet for up to a year. We did a randomised, double-blind trial to assess the usefulness of sibutramine in maintaining substantial weight loss over 2 years. METHODS: Eight European centres recruited 605 obese patients (body-mass index 30-45 kg/m2) for a 6-month period of weight loss with sibutramine (10 mg/day) and an individualised 600 kcal/day deficit programme based on measured resting metabolic rates. 467 (77%) patients with more than 5% weight loss were then randomly assigned 10 mg/day sibutramine (n=352) or placebo (n=115) for a further 18 months. Sibutramine was increased up to 20 mg/day if weight regain occurred. The primary outcome measure was the number of patients at year 2 maintaining at least 80% of the weight lost between baseline and month 6. Secondary outcomes included changes in uric acid concentrations and glycaemic and lipid variables. Analysis was by intention to treat. FINDINGS: 148 (42%) individuals in the sibutramine group and 58 (50%) in the placebo group dropped out. Of the 204 sibutramine-treated individuals who completed the trial, 89 (43%) maintained 80% or more of their original weight loss, compared with nine (16%) of the 57 individuals in the placebo group (odds ratio 4.64, p<0.001). Patients had substantial decreases over the first 6 months with respect to triglycerides, VLDL cholesterol, insulin, C peptide, and uric acid; these changes were sustained in the sibutramine group but not the placebo group. HDL cholesterol concentrations rose substantially in the second year: overall increases were 20.7% (sibutramine) and 11.7% (placebo, p<0.001). 20 (3%) patients were withdrawn because of increases in blood pressure; in the sibutramine group, systolic blood pressure rose from baseline to 2 years by 0.1 mm Hg (SD 12.9), diastolic blood pressure by 2.3 mm Hg (9.4), and pulse rate by 4.1 beats/min (11.9). INTERPRETATION: This individualised management programme achieved weight loss in 77% of obese patients and sustained weight loss in most patients continuing therapy for 2 years. Changes in concentrations of HDL cholesterol, VLDL cholesterol, and triglyceride, but not LDL cholesterol, exceed those expected either from weight loss alone or when induced by other selective therapies for low concentrations of HDL cholesterol relating to coronary heart disease.

Adolescent↗
PubMedDate not supplied

Pronounced dyslipoproteinemia in intensive care patients.

Concentrations of triglycerides (TG) and cholesterol in serum and in lipoproteins were determined in two groups of intensive care patients. Group I included 17 moderately ill, postelective surgery patients, and group II, 23 critically ill patients. All were studied in an intensive care situation. The lipoprotein lipid concentrations were compared with those from a group of healthy men and women. In group I, both TG and cholesterol concentrations in serum were decreased, whereas in group II, only cholesterol concentration was lowered and the TG concentration was close to control values. In the lipoproteins, marked abnormalities were found. The most striking was an increase in low density lipoprotein (LDL)-TG and a decrease in high density lipoprotein (HDL)-cholesterol concentrations. In group II, 5/18 males had a LDL-TG concentration above any control value and 21/23 had a HDL-cholesterol concentration below any value in the control group. In addition, the alpha-lipoprotein (HDL) band on electrophoresis was often grossly abnormal with a broad or double-peaked band. There was a highly significant negative correlation between LDL-TG and HDL-cholesterol concentrations. Patients who received conventional treatment with insulin or heparin had similar lipid concentrations as those not given these drugs. The time effect on lipoprotein changes was analyzed in 11 patients, from whom samples were drawn repeatedly during the intensive care period. A tendency was found for LDL-TG to increase and HDL-cholesterol to decrease with time. The mechanisms causing the lipoprotein changes are not presently known; however, possible explanations include liver function impairment, gastrointestinal tract paralysis, physical inactivity, the catabolic state as such, and combinations.

Adult↗
PubMedDate not supplied

Serum lipid and lipoprotein levels in female type I diabetics: relationships to aerobic capacity and glycaemic control.

The aims of this study were to examine the relationships between serum lipoprotein levels, glycaemic control and physical fitness in female Type I diabetic patients. Twenty-one patients were investigated. Those with the best glycemic control, as assessed by measurements of haemoglobin A1 levels, were found to have lower total triglyceride and VLDL triglyceride concentrations. They also had higher HDL and HDL2 cholesterol level than patients with less good control. Patients with high maximal oxygen uptake had higher HDL2 and lower LDL cholesterol levels as well as lower total triglyceride levels. It is concluded that both high aerobic capacity and good glycaemic control may be favourable for lipid status in Type I diabetic patients.

Adult↗
PubMedDate not supplied

Increase of intra-abdominal fat in patients treated with continuous ambulatory peritoneal dialysis.

OBJECTIVE: To evaluate changes in amount and distribution of body fat in patients treated with continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Prospective study. Computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) were used for determination of body composition at commencement of CAPD, and after a mean of 7.2 months of dialysis treatment. SETTING: CAPD unit at an academic teaching hospital. PATIENTS: The study included 19 consecutive patients who started CAPD during a 15-month time frame. Of these 19 patients, 12 (8 males) with a mean initial age of 60 years completed the study. MAIN OUTCOME MEASURES: Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the abdomen and of the right thigh. Fat and muscle areas were expressed as square centimeters. The proportion of total fat mass was determined by body composition analysis using DEXA (DPX-L densitometer) (Lunar, Madison, WI, U.S.A.) and expressed as percentage of total body weight (FA%). RESULTS: Body weight changed from 67.1 to 68.4 kg (p = 0.20), and the intra-abdominal fat area increased 22.8% (p = 0.02). This increase was predominantly seen in male patients (p = 0.007). The FAT% changed from 27.8% to 30.9% (p = 0.25), without difference between sexes. CONCLUSION: The increase of intra-abdominal fat found in this study may suggest a mechanism by which the established risk for CAPD patients to develop cardiovascular morbidity and mortality may be at least partially explained.

Abdomen↗