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A Randomized Controlled Clinical Study of Lipids Regulating Effects of Extended-release Niacin Tablet in the Old Patients with Lipids Abnormity

Author: DiWenHui
Tutor: SiQuanJin
School: PLA Postgraduate Medical School
Course: Geriatrics
Keywords: Extended-release niacin Fenofibrate Elderly Abnormal lipid metabolism Arteriosclerosis Lipoprotein Clinical Research Security
CLC: R589.2
Type: Master's thesis
Year: 2007
Downloads: 54
Quote: 0
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Abstract


Background: Dyslipidemia is an independent predictor of coronary heart disease in elderly patients progress and recurrent coronary events, the absolute risk of coronary heart disease in the elderly caused higher than the general adult. The the dyslipidemia elderly hyperinsulinemia, impaired glucose tolerance, elevated low-density lipoprotein cholesterol (LDL-C), elevated triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) decreased and small, dense LDL increased. Most commonly used in clinical statins reduce LDL-C is better, but at a reduced TG and increased HDL-C is not ideal, although fibrates can lower triglyceride levels, but increase HDL-C is not the best ideal, combined with statins and fibrates can achieve a more comprehensive lipid effects, but significantly increased muscle dissolution adverse reactions, especially for highly cardiovascular hazard lipoprotein This is a water-soluble vitamin, niacin, taking over as the use of vitamin supplements dose, can significantly improve the lipid metabolism. The study shows that the rational application of niacin can significantly lower blood TG, Lp (a), increased HDL-C, with the exact anti-atherosclerosis. Emergence of niacin extended-release technology, the incidence and severity of the original niacin side effects were significantly improved. Currently no release niacin for treatment studies of elderly lipid metabolism abnormality. Objective: To compare niacin sustained-release tablets of the elderly abnormal lipid metabolism in patients with clinical efficacy and safety, at the same time through a comparative study to observe the extended-release niacin compared with other lipid-lowering drugs in the elderly lipid lowering therapy applications superiority and feasibility . METHODS: 61 cases of patients with dyslipidemia mainly triglycerides from November 2005 to January 2007, 301 hospital outpatient patients and Beijing forces retired cadres retired personnel, were randomly divided into study group and control group, the study group 31 cases, including 23 males and 8 females, aged 76.9 ± 7.5 years, 30 patients, including 21 males and 9 females, age 75.7 ± 7.0 years. After a two-week drug washout period, study group, 1-4 weeks to niacin extended-release tablets 0.5,1 / night 5-12 weeks to niacin sustained-release tablets 1.0,1 / night, fenofibrate group during the study period Liping, 0.2, 1, I / day, the study period was 12 weeks. Lipids, liver and kidney function, blood count, fibrinogen, carotid intima-determination, a questionnaire survey of all patients before and after treatment, respectively. Statistical Methods SPSS11.5 statistical software, normality and homogeneity of variance test, respectively, according to the nature of information, before and after treatment with the paired t test comparison between groups using group designed t-test, p <0.05 think difference statistically significant. Results: Before treatment, the two sets of indicators there was no significant statistical difference. Extended-release niacin and fenofibrate groups, respectively, lower total cholesterol (TC) after treatment compared with before treatment, 10% and 14%, TG 28% and 53%, LDL-C by 6% and 7% of Lp ( a) 26% and 6%, TC/HDL21% and 15%, 11% and 10% of plasma fibrinogen, increased HDL-C 15% and 6%. Lower than TC, TG, Lp (a), TC / HDL-release niacin group before treatment and increased HDL-C were statistically significant, but not statistically significant compared to lower LDL-C treatment. Lower than in the fenofibrate group before treatment TC, TG, TC / HDL statistically significant, and reduce Lp (a), LDL-C, elevated HDL were no statistically significant. Compared to the two-phase, reducing TG, Lp (a), amplitude increased HDL-C significantly statistical difference, lower TC, LDL, TC / HDL amplitude no statistically significant differences. Media thickness of the carotid artery - change is not statistically significant. After treatment, blood glucose and treatment, there was no significant difference, but statistical differences in the two groups after treatment. The two groups of the study period, no serious adverse reactions occurred. Conclusion: The extended-release niacin can significantly improve the elderly dyslipidemia lipid profile in reducing TG, fenofibrate significantly better than the extended-release niacin group, elevated HDL-C, reduce Lp (a) aspects, sustained-release Niacin significantly better than fenofibrate. Extended-release niacin can significantly reduce the fibrinogen in the blood, has a positive effect on the prevention of thrombosis. Sustained-release formulation of niacin can significantly reduce traditional niacin treatment of abnormal lipid metabolism process often appear in the incidence of the adverse reactions such as facial flushing, liver dysfunction in the elderly is safe, but in the course of treatment. should pay attention to changes in blood sugar monitoring. Extended-release niacin on atherosclerotic plaque has yet to be studied further.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Metabolic diseases > Lipodystrophy
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