الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
Lipids consist of the diverse groups of molecules, which are nearly insoluble in water, but soluble in organic solvents. The most important lipids in the human body are cholesterol and cholesterol esters, fatty acids, triglycerides, glycerophospholipids, sphingolipids, bile acids, steroid hormones, and fat-soluble vitamins. Dyslipidemia is defined as an abnormality in one or more type of lipids in the blood. Dyslipidemia is a strong predictor and pathogenic factor for cardiovascular diseases (CVD) and contributes to the development of coronary graft atherosclerosis occlusion. Treatment of dyslipidemia should always involve lifestyle changes and statins to reduce LDL cholesterol. To decrease the risk of pancreatitis, fibrates can be used to decrease TGs when levels are > 500 mg/dL (> 5.65 mmol/L). Statins, which are inhibitors of 3-hydroxy-3-methylglutaryl-CoA (HMG CoA) reductase, are considered as one of the most important drugs and the drug of choice for reducing an abnormal cholesterol level. Statins are normally used to decrease the risk of congestive heart death and non-fatal MI, revascularization procedures, strokes and other cardiovascular mortality. This is because it can reduce the level of LDL and triglycerides, as well as increase the level of HDL. The present work was designed to study the effect of ordinary meal on the lipid profile of patients Receiving Treatment with 3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Inhibitors. This study was conducted on one hundred patients with dyslipidemia receiving statin therapy whose doses had not changed
for two or more months ( group Ι ) and one hundred patients with dyslipidemia not receiving statin therapy ( group ΙΙ). In addition to investigations needed to fulfill the selection criteria, all the studied patients in both groups were subjected to full history taking including (personal history, history of risk factors and other diseases and family history), also were conducted to clinical examination including (general examination, vital signs and local cardiac examination) and laboratory investigations which include: (serum total cholesterol (CHOL), serum triglycerides (TG), serum high density lipoprotein (HDL) and serum low density lipoprotein (LDL)) for all groups in fasting and post prandial status. In the present work, the mean level of serum CHOL was statistically significant higher in fasting status (242.02 mg/dL) compared to the postprandial status (237.92 mg/dL) (P= 0.0001). The mean level of serum LDL was statistically significant higher in fasting status (161.19mg/dL) compared to the postprandial status (159.25 mg/dL) (P= 0.0001). The mean level of serum HDL was statistically not significant in fasting status (45.96 mg/dL) compared to the postprandial status (45.84 mg/dL) (P= 0.186).The mean level of serum T.G was statistically significant lower in fasting status (176.21 mg/dL) compared to the post prandial status (213.49 mg/dL) (P= 0.0001).in ( group Ι ) Also, the mean level of serum CHOL was statistically significant higher in fasting status (272.88 mg/dL) compared to the postprandial status (269.02 mg/dL) (P= 0.01). The mean level of serum LDL was statistically significant higher in fasting status (185.18mg/dL) compared to the postprandial status (181.32 mg/dL) (P= 0.0001). The mean level of serum HDL was statistically not
significant in fasting status (41.73 mg/dL) compared to the postprandial status (41.92 mg/dL) (P= 0.107).The mean level of serum T.G was statistically significant lower in fasting status (231.06 mg/dL) compared to the postprandial status (284.60 mg/dL) (P= 0.0001). In (group ΙΙ) In our study, the increases in triglycerides are likely attributable directly to fat intake, the parallel reduction in HDL cholesterol likely is due to bidirectional lipid exchange between triglyceride-rich lipoproteins and HDL particles: Lipid transfer proteins mediate transfer of triglycerides from triglyceride-rich lipoproteins to HDL, with back-transfer of cholesteryl ester from HDL to triglyceride-rich lipoproteins. The only modest increase in triglyceride levels during normal food intake, together with the recent demonstration of high predictive ability of non fasting triglycerides for risk of cardiovascular events and risk of myocardial infarction, ischemic heart disease, and death, suggests the possibility that non fasting rather than fasting triglyceride levels could be used for cardiovascular risk prediction. Finally, from this study there is no significant clinical difference between fasting and non-fasting levels of Total cholesterol, HDL and LDL.