JUNE 01, 2008

Premature Birth, High Cholesterol Link Found

Women who give birth early appear to increase their risk of having cholesterol problems later in life, according to findings presented recently at the Society for Gynecologic Investigation.

The current study compared 47 women who had a preterm birth, defined as giving birth before 37 weeks of gestation, with 104 women who gave birth to full-term infants. A majority of women in the preterm group gave birth prior to 34 weeks of gestation. Cholesterol was measured from blood samples taken an average of 7.4 years after delivery.

The researchers found that women who had given birth before 34 weeks of gestation had the highest levels of total cholesterol at 202.6 mg/dL. Women who had given birth between 34 and 37 weeks had levels of 190.1 mg/dL, and women who had full-term babies had levels of 180.1 mg/dL. After taking into account race, smoking history, and body mass index, the researchers determined that women who had a premature birth had a 2.3 times higher risk of developing cholesterol levels above 240 mg/dL. Furthermore, these women were 3.3 times more likely to have elevated low-density lipoprotein, compared with women who gave birth to full-term babies.

ALS Survival: High Lipid Levels

French researchers have found that hyperlipidemia seems to considerably affect survival in patients with amyotrophic lateral sclerosis (ALS; often referred to as Lou Gehrig?s disease), according to a study reported recently in Neurology.

The study involved blood samples from 369 patients with ALS and 286 healthy participants. The researchers discovered that elevated lipid levels, as seen by increased blood levels of total cholesterol or low-density lipoprotein (LDL; the "bad" cholesterol), were twice as common in patients with ALS, compared with the control group. The results also indicated that patients with ALS with a low ratio of LDL to high-density lipoprotein (the "good" cholesterol) faced a 35% increased risk of death. The median survival in those with the highest ratio was 49 months, compared with 36 months in those with the lowest ratio.

"These results," said study author Vincent Meininger, MD, PhD, "raise the question of using a fat diet for ALS patients, and to avoid using cholesterol-lowering drugs?mainly statins."

Study Tests Aggressive Cholesterol, BP Therapy

Researchers did not get a definitive answer on whether aggressively lowering cholesterol levels and blood pressure in individuals at greater risk for heart disease is worth the effort, according to a study reported in the April 9, 2008, issue of the Journal of the American Medical Association. The study of 499 American Indians with diabetes found that the approach led to some improvements without resulting in dangerous side effects.

"This is the first trial that really tested targeting," said lead author Barbara V. Howard, PhD. "Until now, clinical trials have meant taking a drug and escalating the dose and comparing the reduction in heart disease. Our goal was to target people at high risk and test lower targets for both risk factors hypertension and LDL [low-density lipoprotein] cholesterol. What we showed is that you can reach those lower targets safely."

Researchers found a reduction in the thickening of the walls of the carotid artery. No difference in the rate of adverse events was indicated between the participants who had the most aggressive treatment and the participants who had the standard treatment, however. "But there have been no trials where the carotid measurements did not correlate eventually with what happened in the end points," she noted.

Dr. Howard concluded that "we see improvement with lower targets, but we need longer studies."

High Cholesterol in Midlife Ups Dementia Odds

Middle-age individuals with elevated cholesterol levels may up their risk of developing Alzheimer?s disease decades later. The findings, presented recently at the American Academy of Neurology, reinforce the importance of health factors in individuals in their 40s on the risk of dementia.

The study showed that those with high cholesterol between the ages of 40 and 45 were about 50% more prone to later develop the brain ailment, compared with individuals with low cholesterol. "Cholesterol is just one piece of the puzzle. There are other risk factors like hypertension and obesity. The more risk factors you have, the higher the risk gets," said researcher Alina Solomon, MD.

She noted that earlier research had evaluated the issue of high cholesterol levels in middle age as a risk factor for later development of dementia but did not focus exclusively on Alzheimer?s disease.