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Niacin Technical Reports

There are 72 different studies for which the entire abstract is reproduced below.  If you were to print these it would probably take about 72 pages!   Each of these has a unique bookmark to which you can jump, instantly, and from each of them you can return to the Top Of Document, immediately below.

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HealthGate Document

Record 1 from database: MEDLINE

Title

New developments in the use of niacin for treatment of hyperlipidemia: new considerations in the use of an old drug.

Author

Crouse JR 3rd

Address

Bowman Gray School of Medicine, Winston Salem, North Carolina 27157, USA.

Source

Coron Artery Dis, 1996 Apr, 7:4, 321-6

Abstract

Niacin has been used for many years to treat hyperlipidemia. It has been shown to reduce coronary death and non-fatal myocardial infarction and, in a separate analysis of long-term (15-year) follow-up, all cause mortality. It reduces total cholesterol, low density lipoprotein cholesterol (LDL-C) and triglycerides and increases high density lipoprotein cholesterol (HDL-C). Sustained-release niacin may be associated with more dramatic changes in LDL-C and triglyceride, whereas the short acting preparation causes greater increases in HDL-C. The increase of HDL-C occurs at a lower dose (1500 mg/day) than the reduction of LDL-C (> 1500 mg/day). Niacin also favorably influences other lipid parameters including lipoprotein(a) [Lp(a)], alimentary lipemia, familial defective apolipoprotein B-100 and small dense LDL. Combination of niacin with a bile acid sequestrant or a reductase inhibitor represents a powerful lipid-altering regimen. Whereas the reductase inhibitors and bile acid binding resins primarily affect LDL-C, the combined therapy has a synergistic effect to reduce LDL-C and, in addition, the niacin reduces triglycerides and increases HDL-C. The major drawback in the use of niacin is associated side effects (flushing and palpitations) and toxicity (worsening of diabetes control, exacerbation of peptic ulcer disease, gout, hepatitis). Niacin has a long history of use as a lipid lowering agent and has several attractive features. Unfortunately, the side effect profile of this agent warrants its use only in patients with marked dyslipidemia in whom side effects and potential toxicity are closely monitored.

Language of Publication

English

Unique Identifier

97006291

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MeSH Heading (Major)

Antilipemic Agents|AD/PD/*TU; Hyperlipidemia|*DT; Niacin|AD/AE/PD/*TU

MeSH Heading

Apolipoproteins B|BL; Cholesterol|BL; Follow-Up Studies; Human; Lipoprotein(a)|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Triglycerides|BL

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW LITERATURE

ISSN

0954-6928

Country of Publication

UNITED STATES

Section A

Record 2 from database: MEDLINE

Title

Reversibility of atherosclerosis--evolving perspectives from two arterial imaging clinical trials: the cholesterol lowering atherosclerosis regression study and the monitored atherosclerosis regression study.

Author

Hodis HN

Address

Atherosclerosis Research Unit, Division of Cardiology, University of Southern California School of Medicine, Los Angeles, USA.

Source

J Cardiovasc Pharmacol, 1995, 25 Suppl 4:, S25-31

Abstract

The Cholesterol Lowering Atherosclerosis Study (CLAS) and the Monitored Atherosclerosis Regression Study (MARS) are serial arterial imaging clinical trials that have explored the reversibility of atherosclerosis with lipid-lowering therapy in native coronary, carotid, and femoral arterial beds, as well as in coronary artery bypass grafts. Results demonstrate that progression of atherosclerosis can be reduced in all these vascular beds. Evolving data indicate that coronary lesions > or = 50% diameter stenosis (%S) at baseline respond more readily to lipid-lowering therapy than lesions <50%S. In addition, lipoproteins may have a differential effect on coronary lesion progression according to lesion size, with triglyceride-rich lipoproteins playing an important role in the progression of lesions <50%S. Limited data indicate that progression of atherosclerosis in women may be more responsive to lipid-lowering therapy than in men, and that estrogen replacement may enhance the anti-atherosclerosis effects of lipid lowering. Longitudinal measurements of carotid artery far wall intima-media thickness (IMT) with B-mode ultrasonography in CLAS and MARS indicate that carotid atherosclerosis at a stage before lesions intrude into the vessel lumen can be reduced by lipid-lowering therapy. Together, CLAS and MARS data indicate that the spectrum from very early lesions confined to the arterial wall to established lesions late in the atherosclerotic process can be reversed with lipid-lowering therapy.

Language of Publication

English

Unique Identifier

97063344

MeSH Heading (Major)

Antilipemic Agents|AD/PD/*TU; Atherosclerosis|DH/*DT/SU; Coronary Artery Bypass|*

MeSH Heading

Angiography; Carotid Arteries|DE/IN/US; Colestipol|AD/PD/TU; Coronary Vessels|DE/IN/US; Dose-Response Relationship, Drug; Female; Femoral Artery|DE/IN/US; Human; Image Processing, Computer-Assisted; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Niacin|AD/PD/TU; Sex Factors; Support, U.S. Gov't, P.H.S.; Treatment Outcome

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0160-2446

Country of Publication

UNITED STATES

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Section A

Record 3 from database: MEDLINE

Title

Fluvastatin with and without niacin for hypercholesterolemia.

Author

Jacobson TA; Chin MM; Fromell GJ; Jokubaitis LA; Amorosa LF

Address

Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303.

Source

Am J Cardiol, 1994 Jul, 74:2, 149-54

Abstract

Seventy-four patients with plasma low-density lipoprotein cholesterol levels > or = 160 mg/dl after an American Heart Association phase 1 diet were randomized to double-blind treatment with fluvastatin, 20 mg/day, or placebo for 6 weeks. Immediate-release niacin was then added to both treatment regimens and titrated to a maximum of 3 g/day for a further 9 weeks. After 6 weeks of fluvastatin monotherapy, low-density lipoprotein cholesterol levels decreased by 21% (p < 0.001 vs placebo), and after the addition of niacin, response was potentiated to 40% compared with 25% for the niacin control group at study end point (p < 0.001). Fluvastatin, alone and in combination with niacin, also significantly improved high-density lipoprotein cholesterol (increases of about 30%) and triglyceride profiles (decreases of approximately 28%) from baseline. Lipoprotein(a) decreased by 37% in those receiving fluvastatin-niacin but was unaltered in those receiving fluvastatin alone. No serious adverse events were ascribed to fluvastatin, and no cases of myositis were observed. Small, transient, asymptomatic increases in aspartate aminotransferase were noted with fluvastatin-niacin treatment but were not considered clinically relevant. Although the fluvastatin-niacin combination in this study was without evidence of significant transaminitis, myopathy, or rhabdomyolysis, it would seem prudent to continue to monitor its safety with longer term use. In conclusion, fluvastatin, both as monotherapy and in combination with niacin, proved to be an effective, safe, and well-tolerated therapeutic alternative for hypercholesterolemia.

Language of Publication

English

Unique Identifier

94295511

MeSH Heading (Major)

Anticholesteremic Agents|AD/AE/*TU; Fatty Acids, Monounsaturated|AD/AE/*TU; Hypercholesterolemia|BL/DH/*DT; Indoles|AD/AE/*TU; Niacin|AD/AE/*TU

MeSH Heading

Adult; Aged; Alanine Transaminase|BL; Aspartate Transaminase|BL; Cholesterol|BL; Double-Blind Method; Drug Combinations; Drug Tolerance; Female; Follow-Up Studies; Human; Lipoprotein(a)|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Patient Compliance; Placebos; Triglycerides|BL

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0002-9149

Country of Publication

UNITED STATES

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Section A

Record 4 from database: MEDLINE

Title

Experience with crystalline niacin as the preferred drug for dyslipidemia in a specialty clinic.

Author

Rindone JP; Arriola OG

Address

Department of Pharmacy, Veterans Affairs Medical Center, Prescott, Arizona 86313, USA.

Source

Pharmacotherapy, 1997 Nov, 17:6, 1296-9

Abstract

To determine the tolerability and efficacy of crystalline niacin in reaching target lipid goals, we conducted a retrospective review of medical records of 62 patients treated with the agent over 2 years in a lipid clinic at a nonacademic veterans hospital. Most patients received niacin for hypercholesterolemia. Thirty-one patients (50%) stopped therapy due to adverse events, principally, intolerable cutaneous reactions. Twenty-nine withdrew from therapy during the first 6 weeks of treatment. Of those who tolerated niacin, 23 did not achieve target lipid serum concentrations at the maximum tolerated dosage; 8 did achieve target concentrations. Thus crystalline niacin was largely ineffective in treating patients with dyslipidemia.

Language of Publication

English

Unique Identifier

98060535

MeSH Heading (Major)

Antilipemic Agents|AD/AE/*TU; Hyperlipidemia|BL/*DT; Niacin|AD/AE/*TU

MeSH Heading

Crystallization; Female; Human; Hypercholesterolemia|BL/DT; Hypertriglyceridemia|BL/DT; Male; Middle Age; Retrospective Studies

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0277-0008

Country of Publication

UNITED STATES

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Section A

Record 5 from database: MEDLINE

Title

A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients [see comments]

Author

McKenney JM; Proctor JD; Harris S; Chinchili VM

Address

School of Pharmacy, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.

Source

JAMA, 1994 Mar, 271:9, 672-7

Abstract

OBJECTIVE--To compare escalating doses of immediate-release (IR) and sustained-release (SR) niacin for effectiveness in reducing levels of low-density lipoprotein cholesterol and triglycerides and increasing levels of high-density lipoprotein cholesterol, and for the occurrence of adverse reactions, especially hepatotoxicity. DESIGN--Randomized, double-blind, parallel comparison of IR and SR niacin administered sequentially at 500, 1000, 1500, 2000, and 3000 mg/d, each for 6 weeks. SETTING--Cholesterol research center. PATIENTS--Forty-six adults, 23 in each group, with low-density lipoprotein cholesterol levels greater than 4.14 mmol/L (160 mg/dL) after 1 month of a step 1 National Cholesterol Education Program diet. OUTCOME MEASURES--Fourteen-hour fasting lipid and lipoprotein cholesterol levels, results of clinical laboratory tests, a symptom questionnaire, and withdrawal rates. RESULTS--The SR niacin lowered low-density lipoprotein cholesterol levels significantly more than IR niacin did at the dosage of 1500 mg/d and above, while IR niacin increased high-density lipoprotein cholesterol levels significantly more than SR niacin did at all dosage levels. The reduction in triglyceride levels was similar with IR and SR niacin. Nine (39%) of the 23 patients assigned to the IR dosage form withdrew before completing the 3000-mg daily dose; the most common reasons for withdrawal were vasodilatory symptoms, fatigue, and acanthosis nigricans. Eighteen (78%) of the 23 patients assigned to the SR dosage form withdrew before completing the 3000-mg daily dose; the most common reasons for withdrawal were gastrointestinal tract symptoms, fatigue, and increases in levels of liver aminotransferases, often with symptoms of hepatic dysfunction. None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did. CONCLUSION--The SR form of niacin is hepatotoxic and should be restricted from use. The IR niacin is preferred for the management of hypercholesterolemia but can also cause significant adverse effects and should be given only to patients who can be carefully monitored by experienced health professionals.

Language of Publication

English

Unique Identifier

94142085

MeSH Heading (Major)

Hypercholesterolemia|BL/*DT; Niacin|*AD/AE/TU

MeSH Heading

Adult; Capsules; Comparative Study; Delayed-Action Preparations; Double-Blind Method; Drug Administration Schedule; Female; Human; Lipids|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Liver|DE; Male; Middle Age; Statistics; Triglycerides|BL

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0098-7484

Country of Publication

UNITED STATES

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Section A

Record 6 from database: MEDLINE

Title

Combination of low-dose niacin and pravastatin improves the lipid profile in diabetic patients without compromising glycemic control.

Author

Gardner SF; Marx MA; White LM; Granberry MC; Skelton DR; Fonseca VA

Address

Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock 72205, USA. gardner@cop.uams.edu

Source

Ann Pharmacother, 1997 Jun, 31:6, 677-82

Abstract

OBJECTIVE: To determine the efficacy and tolerability of the addition of low-dose niacin (1.5 g/d) in a diabetic hypercholesterolemic population who were unable to attain desired lipid control with low-dose (20 mg) pravastatin monotherapy. RESEARCH DESIGN AND METHODS: This was a prospective, open-label study conducted over a 14-week period. Twenty-three diabetic patients with low-density lipoprotein (LDL) cholesterol concentrations of at least 150 mg/dL after dietary therapy were recruited from the outpatient diabetes clinic of a university teaching hospital. After 4 weeks of dietary stabilization and baseline determination of the lipid profile and glycemic control, patients received pravastatin 20 mg once daily for 4 weeks. Laboratory parameters were reassessed and niacin was added to the regimen in qualifying patients. Over 2 weeks, patients' regimens were titrated to a maximal dosage of 500 mg tid. Patients continued to receive the combination regimen for 4 weeks and were reassessed. MEASUREMENTS AND MAIN RESULTS: Sixteen patients (14 non-insulin-dependent diabetes mellitus, 2 insulin-dependent diabetes mellitus) completed the study. Mean fasting blood sugar and fructosamine concentrations were unchanged throughout the study. Five patients required minor alterations (3 increased, 2 decreased) in their hypoglycemic regimens during the study. The addition of low-dose niacin to pravastatin therapy resulted in a significant lowering of LDL cholesterol compared with pravastatin monotherapy. CONCLUSIONS: Low-dose niacin is a promising addition to hydroxymethylglutaryl-coenzyme A reductase inhibitor therapy in the treatment of hypercholesterolemia in patients with diabetes mellitus.

Language of Publication

English

Unique Identifier

97328158

MeSH Heading (Major)

Anticholesteremic Agents|AD/AE/*TU; Diabetes Mellitus, Insulin-Dependent|BL/CO/*DT; Diabetes Mellitus, Non-Insulin-Dependent|BL/CO/*DT; Enzyme Inhibitors|AD/AE/*TU; Niacin|AD/AE/*TU; Pravastatin|AD/AE/*TU

MeSH Heading

Adult; Aged; Blood Glucose|ME; Comparative Study; Drug Therapy, Combination; Female; Fructosamine|BL; Human; Hypercholesterolemia|DT/ET; Lipoprotein(a)|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Prospective Studies; Support, Non-U.S. Gov't

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

1060-0280

Country of Publication

UNITED STATES

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Section A

Record 7 from database: MEDLINE

Title

Niacin for lipid disorders. Indications, effectiveness, and safety.

Author

Brown WV

Address

Division of Arteriosclerosis and Lipid Metabolism, Emory University School of Medicine, Atlanta, USA.

Source

Postgrad Med, 1995 Aug, 98:2, 185-9, 192-3

Abstract

Niacin can be very effective and safe in lowering low-density lipoprotein cholesterol and triglyceride levels and also in increasing high-density lipoprotein cholesterol levels. In combination with other lipid-lowering drugs (eg, bile acid sequestrants), it has reduced the incidence of cardiovascular events and stopped the progression of coronary artery lesions. It may be the most cost-effective lipid-lowering agent currently available. At lower doses, sustained-release forms of niacin may also improve patient compliance.

Language of Publication

English

Unique Identifier

95357279

MeSH Heading (Major)

Antilipemic Agents|*TU; Hyperlipidemia|*DT; Niacin|AE/CT/*TU

MeSH Heading

Drug Eruptions|ET; Female; Human; Liver|DE; Male

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0032-5481

Country of Publication

UNITED STATES

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Section A

Record 8 from database: MEDLINE

Title

Combination therapy with low-dose lovastatin and niacin is as effective as higher-dose lovastatin.

Author

Gardner SF; Schneider EF; Granberry MC; Carter IR

Address

Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, USA.

Source

Pharmacotherapy, 1996 May, 16:3, 419-23

Abstract

STUDY OBJECTIVES. To determine if low-dose lovastatin in combination with niacin causes a greater percentage reduction in low-density lipoprotein (LDL) cholesterol than lovastatin alone, and to determine if the combination increases the risk of serious adverse effects. design. Prospective, randomized, open-label, clinical trial. setting. Family medicine clinic of a university-affiliated hospital. Patients. Patients with fasting LDL cholesterol concentrations of at least 150 mg/dl after 4 weeks of dietary stabilization and washout of any cholesterol-lowering drugs. INTERVENTIONS. Twenty-eight patients received lovastatin 20 mg/day for 4 weeks after dietary stabilization and washout. If LDL cholesterol remained above 130 mg/dl (100 mg/dl in patients with coronary artery disease), they were randomized to receive either lovastatin 40 mg/day or a combination of lovastatin 20 mg/day and niacin 500 mg 3 times/day. MEASUREMENTS AND MAIN RESULTS. There was no difference in actual or percentage reductions of LDL cholesterol, total cholesterol, and triglycerides between the groups. A greater increase in high-density lipoprotein (HDL) cholesterol occurred with combination therapy (p = 0.024). There was no difference in liver function tests, glucose, or uric acid between the therapies. Based on drug-acquisition cost, combination therapy is approximately 40% less expensive than monotherapy. CONCLUSION. Low-dose niacin plus low-dose lovastatin was as effective as higher-dose lovastatin in lowering total cholesterol, LDL cholesterol, and triglyceride levels. The combination may offer benefit in raising HDL cholesterol levels.

Language of Publication

English

Unique Identifier

96336745

MeSH Heading (Major)

Antilipemic Agents|*AD/AE/BL; Hyperlipidemia|*DT; Lovastatin|*AD/AE/BL; Niacin|*AD/AE/BL

MeSH Heading

Adolescence; Adult; Aged; Comparative Study; Drug Therapy, Combination; Female; Human; Male; Middle Age; Prospective Studies; Support, Non-U.S. Gov't

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0277-0008

Country of Publication

UNITED STATES

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Section A

Record 9 from database: MEDLINE

Title

A randomized trial to assess effectiveness and cost in clinical practice: rationale and design of the Cholesterol Reduction Intervention Study (CRIS).

Author

Oster G; Borok GM; Menzin J; Heys JF; Epstein RS; Quinn V; Benson VV; Dudl RJ; Epstein A

Address

Policy Analysis Inc. (PAI), Brookline, Massachusetts 02146, USA.

Source

Control Clin Trials, 1995 Feb, 16:1, 3-16

Abstract

To compare the effectiveness and costs of two alternative approaches to the treatment of hypercholesterolemia, a prospective randomized trial is being undertaken at Southern California Kaiser Permanente, a large health maintenance organization. Six hundred and twelve patients with postdiet LDL cholesterol (LDL-C) levels in the range of 190-230 mg/dl (or 160-230 mg/dl for those with coronary heart disease or two or more coronary risk factors) were randomized to a stepped-care regimen (initial treatment with niacin followed by other agents if needed) or to initial use of lovastatin, an HMG-CoA reductase inhibitor. All patients are being followed for 1 year. The study seeks to approximate conditions of typical clinical practice: provider compliance with these plans of treatment is encouraged but not enforced and patients pay for medication as they customarily would. Principal outcomes of interest include the proportion of participants who achieve goal LDL-C at one year, the mean change in total cholesterol and LDL-C levels between baseline and the end of follow-up, and the costs of cholesterol-lowering therapy.

Language of Publication

English

Unique Identifier

95262410

MeSH Heading (Major)

Hypercholesterolemia|BL/*DT; Lovastatin|AD/AE/*TU; Niacin|AD/AE/*TU

MeSH Heading

Adult; Aged; Comparative Study; Coronary Disease|BL; Cost-Benefit Analysis; Costs and Cost Analysis; Follow-Up Studies; Gemfibrozil|AD/AE/TU; Human; Intervention Studies; Lipoproteins, LDL Cholesterol|BL; Middle Age; Patient Selection; Prospective Studies; Risk Factors; Support, Non-U.S. Gov't; Treatment Outcome

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0197-2456

Country of Publication

UNITED STATES

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Section A

Record 10 from database: MEDLINE

Title

Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors.

Author

Thomas VL; Gropper SS

Address

TADC-DPH-SP, US Army Personnel Command, Alexandria, VA, USA.

Source

Biol Trace Elem Res, 1996 Dec, 55:3, 297-305

Abstract

The effects of daily supplemental chromium (200 micrograms) complexed with 1.8 mg nicotinic acid on plasma glucose and lipids, including total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides, were assessed in 14 healthy adults and 5 adults with noninsulin-dependent diabetes mellitus (NIDDM) using a double-blind crossover study with 8-wk experimental periods. Eight of the 14 healthy subjects and all 5 subjects with NIDDM also underwent an oral glucose tolerance test with assessment of 90 min postprandial plasma glucose and insulin concentrations. No statistically significant effects of chromium nicotinic acid supplementation were found on plasma insulin, glucose, or lipid concentrations, although chromium nicotinic acid supplementation slightly lowered fasting plasma total and LDL cholesterol, triglycerides, and glucose concentrations, and 90-min postprandial glucose concentrations in individuals with NIDDM.

Language of Publication

English

Unique Identifier

97251174

MeSH Heading (Major)

Blood Glucose|AN/*DE; Cardiovascular Diseases|EP/*PC; Chromium|AD/*PD/TU; Diabetes Mellitus, Non-Insulin-Dependent|*BL/CO/DT; Lipids|*BL; Niacin|AD/*PD/TU

MeSH Heading

Administration, Oral; Adult; Aged; Cross-Over Studies; Double-Blind Method; Female; Glucose Tolerance Test; Human; Insulin|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Risk Factors; Support, Non-U.S. Gov't; Triglycerides|BL

Publication Type

CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0163-4984

Country of Publication

UNITED STATES

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Section A

Record 11 from database: MEDLINE

Title

ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. American Society of Health-System Pharmacists [see comments]

Address

 

Source

Am J Health Syst Pharm, 1997 Dec, 54:24, 2815-9

Abstract

ASHP supports the use of niacin as an effective therapy for the management of dyslipidemias in adults. Successful and safe therapy requires ongoing supervision and instruction by qualified health care providers to monitor the efficacy of therapy and minimize niacin's potential for adverse effects. Because many niacin products are available without a prescription, pharmacists are in a unique position to help ensure that patients make the best use of this medication.

Language of Publication

English

Unique Identifier

98090635

MeSH Heading (Major)

Hyperlipidemia|*DT; Niacin|AD/*AE/*TU

MeSH Heading

Drug Monitoring; Gastrointestinal Diseases|CI; Human; Liver Diseases|CI; Pharmaceutical Services; Pharmacists; Skin Diseases|CI

Publication Type

GUIDELINE; JOURNAL ARTICLE; PRACTICE GUIDELINE

ISSN

1079-2082

Country of Publication

UNITED STATES

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Section A

Record 12 from database: MEDLINE

Title

Membrane fatty acids, niacin flushing and clinical parameters.

Author

Glen AI; Cooper SJ; Rybakowski J; Vaddadi K; Brayshaw N; Horrobin DF

Address

Highland Psychiatric Research Group, Craig Dunain Hospital, Inverness, UK.

Source

Prostaglandins Leukot Essent Fatty Acids, 1996 Aug, 55:1-2, 9-15

Abstract

Clinical definitions of schizophrenia are unreliable and difficult to use. The niacin flush test, which involves prostaglandin-induced vasodilatation, offers a method of exploring essential fatty acid metabolism in schizophrenic patients and may serve to define a subgroup of patients. In a multicentre study of schizophrenic patients with negative symptoms, we have examined the clinical accompaniments of the niacin response. Patients failing to flush with niacin showed significantly reduced levels of arachidonic and docosahexaenoic acids. Conversion from non-flushing to flushing during the 6 month supplementation period was predicted by an increase in arachidonic acid levels in red blood cell membranes irrespective of nature of supplementation. In this study, patients were selected for their negative symptoms and, therefore, it was not surprising that further measures of negative or positive symptoms did not predict flushing. However, an increased score for affective symptoms was significantly associated with a positive flush response. The stability of the niacin test needs to be examined in relation to the periodicity of symptoms in schizophrenia and manic depressive illness. New information on the anandamide system suggests that it may be associated with periodic phenomena and should be investigated in relation to the niacin test.

Language of Publication

English

Unique Identifier

97042919

MeSH Heading (Major)

Dietary Fats, Unsaturated|AD/*TU; Fatty Acids, Essential|AD/*BL/*TU; Flushing|*CI; Niacin|AE/*DU; Schizophrenia|*BL/DT

MeSH Heading

Adult; Antipsychotic Agents|PD; Arachidonic Acids|BL; Capsules; Cell Membrane|CH; Clozapine|PD; Comparative Study; Docosahexaenoic Acids|BL; Double-Blind Method; Erythrocytes|CY/UL; Female; Human; Male; Middle Age; Psychiatric Status Rating Scales

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0952-3278

Country of Publication

SCOTLAND

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Section A

Record 13 from database: MEDLINE

Title

Cholesterol-reduction intervention study (CRIS): a randomized trial to assess effectiveness and costs in clinical practice [see comments]

Author

Oster G; Borok GM; Menzin J; Heyse JF; Epstein RS; Quinn V; Benson V; Dudl RJ; Epstein AM

Address

Policy Analysis Inc, Brookline, Mass, USA.

Source

Arch Intern Med, 1996 Apr, 156:7, 731-9

Abstract

BACKGROUND: The 1988 US National Cholesterol Education Program Expert Panel Report recommended initial treatment with niacin or bile acid sequestrants, followed by other agents if needed, to lower low-density lipoprotein cholesterol (LDL-C) levels in hypercholesterolemic patients who require drug therapy. It is unknown how the effectiveness and costs of such an approach ("stepped care") compare in typical clinical practice to those of initial therapy with lovastatin. PATIENTS AND METHODS: We randomly assigned 612 patients, aged 20 to 70 years, who met 1988 National Cholesterol Education Program guidelines for drug treatment of elevated LDL-C level and had not previously used cholesterol-lowering medication, to either a stepped-care regimen or initial therapy with lovastatin (both n=306). The study, conducted at Southern California Kaiser Permanente, was designed to approximate typical practice: provider compliance with treatment plans was encouraged but not enforced, and patients paid for medication as they customarily would. RESULTS: At 1 year, the decline in mean LDL-C level was significantly greater among patients assigned to initial treatment with lovastatin (22% vs 15% for stepped care; P<.001), as was the number who attained goal LDL-C level (

Language of Publication

English

Unique Identifier

96194210

MeSH Heading (Major)

Anticholesteremic Agents|EC/*TU; Hypercholesterolemia|*DT/EC; Lovastatin|EC/*TU; Niacin|EC/*TU

MeSH Heading

Adult; Aged; Comparative Study; Cost-Benefit Analysis; Drug Therapy, Combination; Female; Human; Male; Middle Age; Support, Non-U.S. Gov't; Treatment Outcome

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0003-9926

Country of Publication

UNITED STATES

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Section A

Record 14 from database: MEDLINE

Title

Evaluation of effects of unmodified niacin on fasting and postprandial plasma lipids in normolipidemic men with hypoalphalipoproteinemia [see comments]

Author

King JM; Crouse JR; Terry JG; Morgan TM; Spray BJ; Miller NE

Address

Departments of Medicine, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1047.

Source

Am J Med, 1994 Oct, 97:4, 323-31

Abstract

PURPOSE: The aim of this study was to define the effects of unmodified niacin on basal lipids and lipoproteins and on the plasma triglyceride response to a fatty meal--postprandial or alimentary lipemia--in individuals with low levels of high-density lipoprotein cholesterol (HDL-C) and normal fasting cholesterol and triglyceride concentrations (normolipidemic hypoalphalipoproteinemia, isolated low HDL-C). PATIENTS AND METHODS: Twenty-eight normolipidemic men (total plasma cholesterol concentration [TC] < 230 mg/dL [< 6 mmol/L], plasma triglyceride [Tg] < 250 mg/dL [2.75 mmol/L]) with low plasma concentrations of HDL-C were randomly assigned to increasing doses of crystalline niacin (up to 3,000 mg/d) or no drug for 12 weeks, then crossed over to the alternate regimen. Outcome measures included changes in plasma lipoproteins and alimentary lipemia. RESULTS: Fifteen participants completed the study. Mean baseline HDL-C +/- SD was 31.7 +/- 6.2 mg/dL (0.82 +/- 0.16 mmol/L). Mean baseline TC, plasma concentration of low-density lipoprotein cholesterol (LDL-C), and Tg were 192 +/- 29.4 mg/dL (4.97 +/- 0.76 mmol/L), 123 +/- 27 mg/dL (3.17 +/- 0.69 mmol/L), and 197 +/- 75 mg/dL (2.17 +/- 0.83 mmol/L), respectively. Unmodified niacin treatment resulted in significant (P < 0.001) reductions of 14% in TC (to 165 mg/dL, 4.26 mmol/L), 40% in Tg (to 119 mg/dL, 1.31 mmol/L), and 18% in LDL-C (to 101 mg/dL, 2.60 mmol/L) and significant increases of 30% in HDL-C (to 42 mg/dL, 1.07 mmol/L), 100% in HDL2 cholesterol (from 5 mg/dL to 9 mg/dL, 0.12 mmol/L to 0.24 mmol/L), and 21% in HDL3 cholesterol (from 27 mg/dL to 33 mg/dL, 0.70 mmol/L to 0.85 mmol/L). Unmodified niacin treatment reduced alimentary lipemia by 45% (P < 0.02). CONCLUSIONS: Crystalline niacin effectively raises HDL-C, lowers LDL-C, and reduces alimentary lipemia in patients with isolated low HDL-C. However, many patients have difficulty tolerating the drug, and supervision may be required to sustain patient compliance and avoid toxicity.

Language of Publication

English

Unique Identifier

95029461

MeSH Heading (Major)

Hypolipoproteinemia|*DT; Lipids|*BL; Lipoproteins, HDL|*BL/DE; Niacin|*PD/TU

MeSH Heading

Dietary Fats|AD; Fasting; Gemfibrozil|PD; Human; Male; Middle Age; Time Factors; Treatment Outcome; Triglycerides|BL

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0002-9343

Country of Publication

UNITED STATES

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. HealthGate Document

Section B

Record 1 from database: MEDLINE

Title

A randomized trial to assess effectiveness and cost in clinical practice: rationale and design of the Cholesterol Reduction Intervention Study (CRIS).

Author

Oster G; Borok GM; Menzin J; Heys JF; Epstein RS; Quinn V; Benson VV; Dudl RJ; Epstein A

Address

Policy Analysis Inc. (PAI), Brookline, Massachusetts 02146, USA.

Source

Control Clin Trials, 1995 Feb, 16:1, 3-16

Abstract

To compare the effectiveness and costs of two alternative approaches to the treatment of hypercholesterolemia, a prospective randomized trial is being undertaken at Southern California Kaiser Permanente, a large health maintenance organization. Six hundred and twelve patients with postdiet LDL cholesterol (LDL-C) levels in the range of 190-230 mg/dl (or 160-230 mg/dl for those with coronary heart disease or two or more coronary risk factors) were randomized to a stepped-care regimen (initial treatment with niacin followed by other agents if needed) or to initial use of lovastatin, an HMG-CoA reductase inhibitor. All patients are being followed for 1 year. The study seeks to approximate conditions of typical clinical practice: provider compliance with these plans of treatment is encouraged but not enforced and patients pay for medication as they customarily would. Principal outcomes of interest include the proportion of participants who achieve goal LDL-C at one year, the mean change in total cholesterol and LDL-C levels between baseline and the end of follow-up, and the costs of cholesterol-lowering therapy.

Language of Publication

English

Unique Identifier

95262410

MeSH Heading (Major)

Hypercholesterolemia|BL/*DT; Lovastatin|AD/AE/*TU; Niacin|AD/AE/*TU

MeSH Heading

Adult; Aged; Comparative Study; Coronary Disease|BL; Cost-Benefit Analysis; Costs and Cost Analysis; Follow-Up Studies; Gemfibrozil|AD/AE/TU; Human; Intervention Studies; Lipoproteins, LDL Cholesterol|BL; Middle Age; Patient Selection; Prospective Studies; Risk Factors; Support, Non-U.S. Gov't; Treatment Outcome

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0197-2456

Country of Publication

UNITED STATES

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Section B

Record 2 from database: MEDLINE

Title

A randomized trial of the effects of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. Collaborative Atorvastatin Study Group.

Author

McKenney JM; McCormick LS; Weiss S; Koren M; Kafonek S; Black DM

Address

Virginia Commonwealth University, Richmond, USA.

Source

Am J Med, 1998 Feb, 104:2, 137-43

Abstract

BACKGROUND: To assess the lipid-lowering effects and safety of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. METHODS: We performed a randomized, open-label, parallel-design, active-controlled, study in eight centers in the United States. We enrolled 108 patients with total cholesterol (TC) of > or =200 mg/dL, serum triglycerides (TG) > or =200 and < or =800 mg/dL, and apolipoprotein B (apo B) > or =110 mg/dL. Patients were randomly assigned to receive atorvastatin 10 mg once daily (n=55) or immediate-release niacin 1 g three times daily for 12 weeks (n=53). Patients were stratified based on low-density lipoprotein cholesterol (LDL-C): Patients with LDL-C > or =135 mg/dL were considered to have combined hyperlipidemia and patients with LDL-C <135 mg/dL were considered to have isolated hypertriglyceridemia. The primary outcome measure was percent change from baseline in LDL-C. Other lipid levels were evaluated as secondary parameters. RESULTS: Atorvastatin reduced LDL-C 30% and TC 26% from baseline, and increased high-density lipoprotein cholesterol (HDL-C) 4%. Total TG were reduced 17%. Niacin reduced LDL-C 2%, TC 7%, increased HDL-C 25%, and reduced total TG 29% from baseline. There was a significant difference in LDL-C reduction, the primary efficacy parameter, between the two treatment groups (P <0.05, favoring atorvastatin), as well as a significant difference in the improvement in HDL-C (P <0.05, favoring niacin). The effect of atorvastatin was relatively consistent between patients with combined hyperlipidemia and isolated hypertriglyceridemia, whereas there was more variability between these strata in the niacin treatment group. Atorvastatin was better tolerated than niacin. CONCLUSION: Atorvastatin may allow patients with combined hyperlipidemia to be treated with monotherapy and offers an efficacious and well-tolerated alternative to niacin for the treatment of patients with isolated hypertriglyceridemia.

Language of Publication

English

Unique Identifier

98187580

MeSH Heading (Major)

Anticholesteremic Agents|*TU; Heptanoic Acids|*TU; Hydroxymethylglutaryl-CoA Reductase Inhibitors|*TU; Hyperlipidemia|BL/*DT; Hypertriglyceridemia|BL/*DT; Niacin|*TU; Pyrroles|*TU

MeSH Heading

Adult; Aged; Cholesterol|BL; Female; Human; Male; Middle Age; Treatment Outcome; Triglycerides|BL; United States

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0002-9343

Country of Publication

UNITED STATES

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Section B

Record 3 from database: MEDLINE

Title

Evaluating the role of niacin in human carcinogenesis.

Author

Jacobson EL; Dame AJ; Pyrek JS; Jacobson MK

Address

Department of Clinical Sciences, University of Kentucky, Lexington 40536-0093, USA.

Source

Biochimie, 1995, 77:5, 394-8

Abstract

Our understanding of the role of ADP-ribose polymer metabolism in limiting carcinogenic events and the dependence of this metabolism on cellular NAD levels predicts that niacin deficiency leading to reduced NAD levels may enhance carcinogenesis. This prediction has led us to initiate studies to evaluate the potential of niacin as a preventive factor in human cancer. The first approach involves development of a method to assess biochemically niacin status in humans using intracellular NAD derived from whole blood, primarily erythrocytes, as the relevant marker of niacin status. We have shown that erythrocyte NAD content varies by as much as 12-fold within a population and can be modulated readily by supplementation. A second approach to testing this hypothesis involves understanding the relationship of dietary niacin, circulating levels of NAD precursors (nicotinamide and nicotinic acid) and NAD in target tissues for human cancer. Current analytical methods for quantification of plasma levels of nicotinic acid and nicotinamide following intake in the dietary range are not sufficient. Thus, we have developed a GC-MS method for the rapid, sensitive, and selective determination of both nicotinamide and nicotinic acid in plasma. These methods will now allow assessment of niacin metabolism in humans that could lead to a new understanding of niacin in prevention of cancer.

Language of Publication

English

Unique Identifier

96051183

MeSH Heading (Major)

Anticarcinogenic Agents|ME/*TU; Niacin|*ME/*TU; NAD|*ME; Poly Adenosine Diphosphate Ribose|*ME

MeSH Heading

Diet; Erythrocytes|ME; Human; Niacinamide|ME; Support, U.S. Gov't, P.H.S.; Tryptophan|ME

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0300-9084

Country of Publication

FRANCE

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Section B

Record 4 from database: MEDLINE

Title

Effect of nicotinic acid on exogenous myocardial glucose utilization.

Author

Stone CK; Holden JE; Stanley W; Perlman SB

Address

Department of Medicine, University of Wisconsin-Madison Medical School, USA.

Source

J Nucl Med, 1995 Jun, 36:6, 996-1002

Abstract

Clinical assessment of myocardial glucose uptake with 18F-fluorodeoxyglucose (18F-FDG) and PET requires the control of circulating substrates to achieve acceptable image quality. METHODS: To determine the efficacy of the hypolipemic effect of oral niacin upon myocardial 18F-FDG uptake, five volunteers were studied with 18F-FDG and PET in the fasting state, with and without treatment with niacin. Levels of glucose, fatty acids, insulin and catecholamines were measured at baseline and before and after 18F-FDG administration by programmed infusion. RESULTS: No significant changes in glucose or insulin levels occurred with niacin. A significant decrease in fatty acid levels with niacin treatment was associated with a two- to three-fold increase in myocardial glucose utilization rates relative to the fasting state. Furthermore, regional variation in tracer distribution with greater uptake in the lateral wall than the septum or anterior wall in the fasting studies was not present after niacin treatment. CONCLUSION: As determined by programmed infusion of 18F-FDG and PET imaging, niacin treatment in normal volunteers was associated with an increase in exogenous glucose utilization by the heart and a decrease in the cardiac regional variation of 18F-FDG. Further studies are needed to compare the relative value of niacin therapy and oral glucose loading for determination of myocardial exogenous glucose utilization rates.

Language of Publication

English

Unique Identifier

95287225

MeSH Heading (Major)

Deoxyglucose|*AA/DU; Fluorine|*DU; Glucose|*ME; Myocardium|*ME; Niacin|*PD; Tomography, Emission-Computed|*

MeSH Heading

Adult; Blood Glucose|AN; Fatty Acids, Nonesterified|BL; Female; Heart|RI; Human; Insulin|BL; Male; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE

ISSN

0161-5505

Country of Publication

UNITED STATES

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Section B

Record 5 from database: MEDLINE

Title

Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors.

Author

Thomas VL; Gropper SS

Address

TADC-DPH-SP, US Army Personnel Command, Alexandria, VA, USA.

Source

Biol Trace Elem Res, 1996 Dec, 55:3, 297-305

Abstract

The effects of daily supplemental chromium (200 micrograms) complexed with 1.8 mg nicotinic acid on plasma glucose and lipids, including total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides, were assessed in 14 healthy adults and 5 adults with noninsulin-dependent diabetes mellitus (NIDDM) using a double-blind crossover study with 8-wk experimental periods. Eight of the 14 healthy subjects and all 5 subjects with NIDDM also underwent an oral glucose tolerance test with assessment of 90 min postprandial plasma glucose and insulin concentrations. No statistically significant effects of chromium nicotinic acid supplementation were found on plasma insulin, glucose, or lipid concentrations, although chromium nicotinic acid supplementation slightly lowered fasting plasma total and LDL cholesterol, triglycerides, and glucose concentrations, and 90-min postprandial glucose concentrations in individuals with NIDDM.

Language of Publication

English

Unique Identifier

97251174

MeSH Heading (Major)

Blood Glucose|AN/*DE; Cardiovascular Diseases|EP/*PC; Chromium|AD/*PD/TU; Diabetes Mellitus, Non-Insulin-Dependent|*BL/CO/DT; Lipids|*BL; Niacin|AD/*PD/TU

MeSH Heading

Administration, Oral; Adult; Aged; Cross-Over Studies; Double-Blind Method; Female; Glucose Tolerance Test; Human; Insulin|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Risk Factors; Support, Non-U.S. Gov't; Triglycerides|BL

Publication Type

CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0163-4984

Country of Publication

UNITED STATES

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Section B

Record 6 from database: MEDLINE

Title

Relative effectiveness of niacin and lovastatin for treatment of dyslipidemias in a health maintenance organization [see comments]

Author

OConnor PJ; Rush WA; Trence DL

Address

HealthPartners Group Health Foundation, Minneapolis, MN 55440-1309, USA.

Source

J Fam Pract, 1997 May, 44:5, 462-7

Abstract

BACKGROUND: We conducted an historical cohort study to evaluate the relative effectiveness of niacin and lovastatin in the treatment of dyslipidemias in patients enrolled in a health maintenance organization (HMO). METHODS: To be eligible for this study, adults aged 18 years and older who were initially treated with either niacin or lovastatin between January 1, 1992, and December 31, 1993, were identified from pharmacy databases. Each potentially eligible member with a fasting lipid panel prior to initiation of drug therapy and with a second fasting lipid panel between 9 and 15 months after initiation of drug therapy was included in the study. A total of 244 patients treated with niacin and 160 patients treated with lovastatin had complete data and are subjects of this report. RESULTS: Patients initially treated with lovastatin had higher baseline mean cholesterol and low-density lipoprotein (LDL) levels as well as higher rates of diabetes mellitus and heart disease than did patients initially treated with niacin. Lovastatin use was associated with a mean 25.8% decrease in LDL cholesterol, while niacin use was associated with a mean 17.5% drop in LDL cholesterol (t = 3.19, P < .002). Niacin use was associated with a 16.3% improvement in high-density lipoprotein (HDL) cholesterol, while HDL-cholesterol levels in the lovastatin group improved 1.5% (t = 4.74, P < .001). Niacin use was associated with an 18.4% improvement in triglycerides, while lovastatin use was associated with an 8% improvement in triglyceride levels (t = 2.81, P = .005). Differences in LDL/HDL ratio from before treatment to follow-up were no different in the two groups of patients (t = -1.21, P = .22). A total of 46% of patients initially treated with either drug reached their treatment goals in accordance with those set by the National Cholesterol Education Program. Drug discontinuation rates were 73% for niacin and 52% for lovastatin at follow-up, which averaged 10.7 months in each group. CONCLUSIONS: These results suggest that both niacin and lovastatin are effective in treating dyslipidemic patients in this care system, and that physicians appropriately use lovastatin more often for patients with higher baseline LDL levels and more comorbidity. The data also strongly suggest that establishing an organized, population-based approach to systematically identify, treat, and monitor patients with dyslipidemias may be the single most important intervention HMOs should consider for improving control of dyslipidemias on a population basis.

Language of Publication

English

Unique Identifier

97296794

MeSH Heading (Major)

Antilipemic Agents|*TU; Health Maintenance Organizations|*; Hyperlipidemia|BL/*DT; Lovastatin|*TU; Niacin|*TU

MeSH Heading

Cohort Studies; Comparative Study; Female; Follow-Up Studies; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Midwestern United States; Patient Compliance; Support, Non-U.S. Gov't; Triglycerides|BL

Publication Type

JOURNAL ARTICLE

ISSN

0094-3509

Country of Publication

UNITED STATES

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Section B

Record 7 from database: MEDLINE

Title

Niacin deficiency and cancer in women.

Author

Jacobson EL

Address

Dept. of Clinical Sciences, Markey Cancer Center, University of Kentucky, Lexington 40536-0080.

Source

J Am Coll Nutr, 1993 Aug, 12:4, 412-6

Abstract

A new interest in the relationship between niacin and cancer has evolved from the discovery that the principal form of this vitamin, NAD, is consumed as a substrate in ADP-ribose transfer reactions. Poly(ADP-ribose) polymerase, an enzyme activated by DNA strand breaks, is the ADP-ribosyltransferase of greatest interest with regard to effects on the niacin status of cells since its Km for NAD is high, and its activity can deplete NAD. Studies of the consequences of DNA damage in cultured mouse and human cells as a function of niacin status have supported the hypothesis that niacin may be a protective factor that limits carcinogenic events. To test this hypothesis in humans, we used a biochemical method based on the observation that as niacin nutriture decreases, NAD readily declines and NADP remains relatively constant. This has been demonstrated in both fibroblasts and in whole blood from humans. Thus, we use "niacin number," (NAD/NAD+NADP) x 100% from whole blood, as a measure of niacin status. Healthy control subjects showed a mean niacin number of 62.8 +/- 3.0 compared to 64.0 for individuals on a niacin-controlled diet. Analyses of women in the Malmö Diet and Cancer Study showed a mean niacin number of 60.4 with a range of 44 to 75. The distribution of niacin status in this population was nongaussian, with an unpredictably large number of individuals having low values.

Language of Publication

English

Unique Identifier

94014001

MeSH Heading (Major)

Diet|*; Neoplasms|*ET; Niacin|*DF; Women's Health|*

MeSH Heading

Female; Follow-Up Studies; Human; Male; Middle Age; Nutritional Status; NAD|BL; NADP|BL; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE

ISSN

0731-5724

Country of Publication

UNITED STATES

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CAS Registry/EC Number

53-59-8 (NADP); 53-84-9 (NAD); 59-67-6 (Niacin)

HealthGate Documents

Section C

Record 1 from database: MEDLINE

Title

Adenocarcinomas of the esophagus and gastric cardia: the role of diet.

Author

Zhang ZF; Kurtz RC; Yu GP; Sun M; Gargon N; Karpeh M Jr; Fein JS; Harlap S

Address

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. zhang@biosta.mskcc.org

Source

Nutr Cancer, 1997, 27:3, 298-309

Abstract

The incidence of adenocarcinomas of the esophagus and gastric cardia (ACEGC) has been increasing for the past 10-15 years in the United States. The reason for this increase is unknown. This hospital-based case-control study was conducted to assess the effects of dietary and nutritional factors on the risk of ACECG. A total of 95 incident cases with pathological diagnosis and 132 cancer-free controls were included in the study. Patients were recruited at Memorial Sloan-Kettering Cancer Center from 1 November 1992 to 1 November 1994. Epidemiologic data were collected by a modified National Cancer Institute Health Habits History Questionnaire. Nutritional and dietary factors were analyzed using a logistic regression model. Increased risk of ACEGC was significantly related to higher intake of dietary calories and fat after controlling for several potential confounding factors. Decreased risk of ACEGC was significantly associated with high ingestion of dietary fiber, lutein, niacin, vitamin B6, iron, and zinc. Higher intakes of vitamin A, beta-carotene, vitamin E, folate, phosphorus, and potassium were associated with a decreased risk of the disease, but these were not statistically significant. The study suggests that ACEGC can be preventable through dietary interventions.

Language of Publication

English

Unique Identifier

97256230

MeSH Heading (Major)

Adenocarcinoma|*ET/PA/PC; Diet|*; Esophageal Neoplasms|*ET/PA/PC; Stomach Neoplasms|*ET/PA/PC

MeSH Heading

Case-Control Studies; Dietary Fats|AD; Dietary Fiber|AD; Energy Intake; Human; Iron|AD; Logistic Models; Minerals|AD; Niacin|AD; Nutrition; Pyridoxine|AD; Risk Factors; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Vitamins|AD; Xanthophyll|AD; Zinc|AD

Publication Type

JOURNAL ARTICLE

ISSN

0163-5581

Country of Publication

UNITED STATES

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Section C

Record 2 from database: MEDLINE

Title

Effects of soaking, cooking and fermentation on composition, in-vitro starch digestibility and nutritive value of common beans.

Author

Barampama Z; Simard RE

Address

DÆepartement de Science et Technologie des Aliments, UniversitÆe Laval, Ste-Foy, Qc Canada.

Source

Plant Foods Hum Nutr, 1995 Dec, 48:4, 349-65

Abstract

A common bean variety, grown in Burundi, was either fermented, soaked and/or cooked, and then assessed for nutrient composition, in-vitro starch digestibility and protein nutritive value. A decrease in ash, most minerals, vitamins, and some essential amino acids was noted for soaked, cooked and soaked-cooked beans. Compared to untreated beans, soaking decreased soluble sugar (9.8 percent) but increased starch (7.3 percent) and soluble fiber (16.9 percent). In cooked beans, an increase in soluble sugar (1.5 percent), and a decrease in thiamine (81.7 percent), starch (24.6 percent) and soluble fiber (16.6 percent) and nitrogen (2.9 percent) contents were observed. Crude fiber (6.9 percent) and starch (10.0 percent) increased while fat (17.6 percent), fatty acids (linoleic: 10.7 percent; linolenic: 14.3 percent) and soluble sugars (25.4 percent) and nitrogen (14.4 percent) decreased in soaked-cooked beans. Fermentation increased potassium (11.6 percent), soluble fiber (18.9 percent), and some amino acids but decreased fatty acids (linoleic: 13.5 percent; linolenic: 19.9 percent), soluble sugar (75.2 percent) and vitamin (riboflavin: 41.0 percent; niacin: 24.5 percent) contents in common beans. However, the in-vitro starch digestibility was greatly improved (12.3 percent) by cooking while it decreased in soaked beans (29.2 percent). Soaking-cooking and fermentation did not have any significant effect on the digestibility of common bean starch. Finally, among the five treatments applied to common beans, only fermentation showed a significant improvement (8.3 percent) on the protein nutritive value of this legume.

Language of Publication

English

Unique Identifier

97036726

MeSH Heading (Major)

Digestion|*PH; Food Handling|*MT; Legumes|*CH/ST; Starch|*AN/*ME

MeSH Heading

Amino Acids|AN; Burundi; Carbohydrates|AN; Dietary Fats|AN; Dietary Fiber|AN; Dietary Proteins|AN; Fatty Acids|AN; Fermentation; Human; Hydrogen-Ion Concentration; Minerals|AN; Niacin|AN; Nitrogen|AN; Nutritive Value; Potassium|AN; Riboflavin|AN; Support, Non-U.S. Gov't; Thiamine|AN

Publication Type

JOURNAL ARTICLE

ISSN

0921-9668

Country of Publication

NETHERLANDS

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Section C

Record 3 from database: MEDLINE

Title

High-performance liquid chromatographic and capillary electrophoretic determination of free nicotinic acid in human plasma and separation of its metabolites by capillary electrophoresis.

Author

Zarzycki PK; Kowalski P; Nowakowska J; Lamparczyk H

Address

Medical Academy, Faculty of Pharmacy, GdaÆnsk, Poland.

Source

J Chromatogr A, 1995 Aug, 709:1, 203-8

Abstract

Two methods are described based on high-performance liquid chromatography and capillary electrophoresis that provide the selective and sensitive determination of nicotinic acid in human plasma. Moreover, the capillary electrophoresis system was used for the separation of nicotinic acid, nicotinamide, nicotinamide N-oxide, N'-methylnicotinamide, 6-hydroxynicontinic acid, nicotinuric acid and barbital (internal standard). The extraction procedure is simple; no gradient elution or derivatization is required. Both methods can be useful for clinical and biomedical investigations.

Language of Publication

English

Unique Identifier

96073441

MeSH Heading (Major)

Chromatography, High Pressure Liquid|*MT; Electrophoresis|*MT; Niacin|*BL/ME

MeSH Heading

Human; Reference Standards; Reference Values; Reproducibility of Results; Spectrophotometry, Ultraviolet

Publication Type

JOURNAL ARTICLE

Country of Publication

NETHERLANDS

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Section C

Record 4 from database: MEDLINE

Title

Effects of crystalline nicotinic acid-induced hepatic dysfunction on serum low-density lipoprotein cholesterol and lecithin cholesteryl acyl transferase.

Author

Tatò F; Vega GL; Grundy SM

Address

Department of Clinical Nutrition of the University of Texas Southwestern Medical Center and The Veterans Affairs Medical Center at Dallas, 75235-9052, USA.

Source

Am J Cardiol, 1998 Mar, 81:6, 805-7

Abstract

Marked lowering of plasma total and low-density lipoprotein cholesterol levels that occur during treatment of dyslipidemia with pharmacologic doses of nicotinic acid result from hepatotoxicity. Therefore, a marked reduction in low-density lipoprotein may suggest generalized liver toxicity and drug treatment should be discontinued.

Language of Publication

English

Unique Identifier

98186331

MeSH Heading (Major)

Acyltransferases|*ME; Lipoproteins, LDL Cholesterol|*BL; Liver|*PP; Liver Diseases|*BL/*CI/PP; Niacin|*AE; Phosphatidylcholines|*ME

MeSH Heading

Case Report; Human; Liver Function Tests; Male; Middle Age; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE

ISSN

0002-9149

Country of Publication

UNITED STATES

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Section C

Record 5 from database: MEDLINE

Title

Vitamins as therapy in the 1990s.

Author

Swain R; Kaplan B

Address

Department of Family Medicine and Sports Medicine, West Virginia University, Charleston 25301, USA.

Source

J Am Board Fam Pract, 1995 May, 8:3, 206-16

Abstract

BACKGROUND: At one time vitamins were considered as essential nutrients needed only in very small amounts to prevent deficiency syndromes. Many vitamins and their derivatives, however, are currently being used in the mainstream of medicine as therapeutic modalities. METHODS: A MEDLINE literature search for clinical reviews and original studies on the use of vitamins in medicine was conducted along with a search of the obtained papers' bibliographies. The primary years of search were 1990-1994. Research reports written before 1990 were used after cross-referencing from more recent articles. RESULTS AND CONCLUSIONS: Based on the literature review, several recommendations for the use of vitamins for treatment and prevention are presented. They include topical vitamin A derivatives (tretinoin) for the treatment of acne and age-related skin damage, oral vitamin A derivatives for severe cystic acne (isotretinoin) and psoriasis (etretinate), vitamin D3 for the treatment and prevention of osteoporosis in postmenopausal females, topical vitamin D in psoriasis patients, and niacin for serum cholesterol reduction. Folate appears to decrease the incidence of neural tube defects if given in the preconception phase of pregnancy. Finally, recent preliminary evidence suggests the possible benefit of antioxidants (vitamins C, E, and beta-carotene) in the prevention of atherosclerosis and cancer.

Language of Publication

English

Unique Identifier

95343789

MeSH Heading (Major)

Vitamins|*TU

MeSH Heading

Female; Human; Hypercholesterolemia|DT; Niacin|TU; Osteoporosis, Postmenopausal|DT; Preventive Medicine; Skin Diseases|DT; Vitamin D|TU

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0893-8652

Country of Publication

UNITED STATES

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Section C

Record 6 from database: MEDLINE

Title

Comparison of lovastatin (20 mg) and nicotinic acid (1.2 g) with either drug alone for type II hyperlipoproteinemia.

Author

Vacek JL; Dittmeier G; Chiarelli T; White J; Bell HH

Address

Mid-America Heart Institute, Kansas City, Missouri, USA.

Source

Am J Cardiol, 1995 Jul, 76:3, 182-4

Abstract

Our study indicates that the combination of nicotinic acid (1.2 g/day) and lovastatin (20 mg/day) is more effective than either drug alone in reducing total and LDL cholesterol. Although HDL cholesterol was not significantly improved by these doses of agents over the duration of this study, LDL/HDL and HDL/total cholesterol ratios were improved due to the beneficial actions on total and LDL cholesterol. No serious side effects or changes in serum chemistries were observed, and the combination was well tolerated.

Language of Publication

English

Unique Identifier

95335538

MeSH Heading (Major)

Hypercholesterolemia, Familial|BL/DH/*DT; Lovastatin|*AD/AE; Niacin|*AD/AE

MeSH Heading

Aged; Comparative Study; Drug Therapy, Combination; Female; Human; Lipids|BL; Lipoproteins|BL/DE; Male; Middle Age; Prospective Studies; Support, Non-U.S. Gov't; Treatment Outcome

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

ISSN

0002-9149

Country of Publication

UNITED STATES

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Section C

Record 7 from database: MEDLINE

Title

Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state.

Author

Shakir KM; Kroll S; Aprill BS; Drake AJ 3rd; Eisold JF

Address

Division of Endocrinology and Metabolism, National Naval Medical Center, Bethesda, Maryland 20889-5600, USA.

Source

Mayo Clin Proc, 1995 Jun, 70:6, 556-8

Abstract

OBJECTIVE: To evaluate the effects of nicotinic acid on serum thyroid hormone levels in the absence of systemic illness or hepatic dysfunction. DESIGN: We determined the effect of treatment with nicotinic acid on serum thyroid hormone levels in one female and four male patients (mean age, 44.4 years) with hyperlipidemia. MATERIAL AND METHODS: In the five study patients, we measured serum lipids in conjunction with serum thyroxine (T4), triiodothyronine (T3) resin uptake, T3, free T4, thyroid-stimulating hormone (TSH), and thyroxine-binding globulin before, during, and after treatment with nicotinic acid. RESULTS: Serum lipid levels responded appropriately to nicotinic acid treatment. Thyroid function studies done a mean of 1.3 years (range, 0.5 to 3.5) after initiation of nicotinic acid therapy (mean daily dose, 2.6 +/- 0.7 g) revealed significant decreases in serum levels of total T4 (21%), free T4 index (16%), T3 (13%), and thyroxine-binding globulin (23%) (P < 0.02), whereas no significant changes were noted in free T4, T3 resin uptake, and TSH levels. During the course of treatment, the patients, who were carefully questioned, had no symptoms of hypothyroidism. Hypothyroidism was further excluded in three patients who had a normal serum TSH response to administration of thyrotropin-releasing hormone. In two patients, measurements of thyroid function returned to pretreatment levels after discontinuation of nicotinic acid therapy. No patient had significant abnormalities in liver-associated enzymes or evidence of systemic illness during the course of treatment. CONCLUSION: These results suggest that nicotinic acid decreases serum thyroid hormone concentrations while maintaining a euthyroid state. This effect may be mediated through reduction in thyroxine-binding globulin, but other mechanisms may also be involved.

Language of Publication

English

Unique Identifier

95295367

MeSH Heading (Major)

Hyperlipidemia|*BL/DT; Niacin|*PD/TU; Thyrotropin|BL/*DE; Thyroxine|BL/*DE; Thyroxine-Binding Proteins|*DE

MeSH Heading

Adult; Female; Human; Liver|DE/PH; Liver Function Tests; Male; Middle Age; Thyroid Function Tests; Thyroid Gland|DE/PH; Triiodothyronine|BL/DE

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE

ISSN

0025-6196

Country of Publication

UNITED STATES

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Section C

Record 8 from database: MEDLINE

Title

Number-needed-to-treat analysis of the prevention of myocardial infarction and death by antidyslipidemic therapy [see comments]

Author

Rembold CM

Address

Cardiovascular Division, University of Virginia Health Sciences Center, Charlottesville 22908, USA. crembold@virginia.edu

Source

J Fam Pract, 1996 Jun, 42:6, 577-86

Abstract

BACKGROUND. Atherosclerosis of the coronary arteries is the most common cause of death in the United States for persons over the age of 45. Dyslipidemia is one of the risk factors for the development of coronary atherosclerosis. Recent studies suggest that treating dyslipidemia in persons with coronary atherosclerosis may decrease morbidity and mortality. METHODS. A meta-analysis of 33 studies on the clinical and angiographic benefits of treating dyslipidemia in the prevention of morbidity and mortality from cardiovascular disease was performed. These benefits are quantitated in the form of "number needed to treat" (NNT) as an estimate of the public health benefit. The NNT is defined as the number of people that need to be treated to prevent one event. RESULTS. Treatment of dyslipidemia in persons with multiple atherosclerosis risk factors alone, ie, primary prevention, was effective in preventing myocardial infarction and all-cause death. In six trials of primary prevention, excluding the British cooperative trial using clofibrate, the NNT was 53 to prevent a nonfatal MI and 190 to prevent all-cause death (4.8 years treatment with total cholesterol reduction of 15%). Treatment of dyslipidemia in people with known atherosclerosis, ie, secondary and tertiary prevention, was also effective in preventing myocardial infarctions and death from all causes. For 23 trials of secondary and tertiary prevention, the NNT was 37 to prevent death from any cause (4.9 years treatment with total cholesterol reduction of 18%). In the trials with quantitative angiography, the NNT was 7 to prevent progression of coronary atherosclerosis and 10 to induce regression of coronary atherosclerosis (2.5 years treatment with a low-density lipoprotein cholesterol reduction of 28%). Similar benefits were observed in those trials employing HMG CoA reductase inhibitors. Benefits may be similar with niacin or dietary therapy, but these therapies did not reach significance in all categories of benefits, potentially due to beta error. These treatment benefits are comparable to other secondary prevention measures such as aspirin or beta blockers. The benefits appeared to extend to persons over 65, with less clearly defined benefits for women. CONCLUSIONS. These results support the overall clinical benefit of treating dyslipidemia, both in persons with and without known atherosclerosis.

Language of Publication

English

Unique Identifier

96251910

MeSH Heading (Major)

Antilipemic Agents|*TU; Coronary Arteriosclerosis|*CO/*DT; Hyperlipidemia|*CO/*DT

MeSH Heading

Coronary Angiography; Disease Progression; Female; Human; Hydroxymethylglutaryl CoA Reductases|AI; Male; Myocardial Infarction|ET/PC; Niacin|TU; Risk Factors; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Treatment Outcome

Publication Type

JOURNAL ARTICLE; META-ANALYSIS

ISSN

0094-3509

Country of Publication

UNITED STATES

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Section C

Record 9 from database: MEDLINE

Title

Effects of micronutrient intake on survival in human immunodeficiency virus type 1 infection.

Author

Tang AM; Graham NM; Saah AJ

Address

Department of Epidemiology, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD, USA.

Source

Am J Epidemiol, 1996 Jun, 143:12, 1244-56

Abstract

The authors examined the relation between dietary and supplemental micronutrient intake and subsequent mortality among 281 human immunodeficiency type 1 (HIV-1)-infected participants at the Baltimore, Maryland/Washington, DC, site of the Multicenter Acquired Immunodeficiency Syndrome Cohort Study. Subjects completed a semiquantitative food frequency questionnaire at their baseline visit in 1984. Levels of daily micronutrient intake were examined in relation to subsequent mortality over the 8-year follow-up period by using multivariate Cox models, adjusting for age, symptoms, CD4+ count, energy intake, and treatment. The highest quartile of intake for each B-group vitamin was independently associated with improved survival: B1 (relative hazard (RH) = 0.60, 95% confidence interval (CI) 0.38-0.95), B2 (RH = 0.59, 95% CI 0.38-0.93), B6 (RH = 0.45, 95% CI 0.28-0.73), and niacin (RH = 0.57, 95% CI 0.36-0.91). In a final model, the third quartile of beta-carotene intake (RH = 0.60, 95% CI 0.37-0.98) was associated with improved survival, while increasing intakes of zinc were associated with poorer survival. Intakes of B6 supplements at more than twice the recommended dietary allowance were associated with improved survival (RH = 0.60, 95% CI 0.39-0.93), while intakes of B1 and B2 supplements at levels greater than five times the recommended dietary allowance were associated with improved survival (B1: RH = 0.61, 95% CI 0.38-0.98; B2:RH = 0.60, 95% CI 0.37-0.97). Any intake of zinc supplements, however, was associated with poorer survival (RH = 1.49, 95% CI 1.02-2.18). These data support the performance of clinical trials to assess the effects of B-group vitamin supplements on HIV-1-related survival. Further studies are needed to determine the optimal level of zinc intake in HIV-1-infected individuals.

Language of Publication

English

Unique Identifier

96245096

MeSH Heading (Major)

Diet|*; HIV Infections|*MO; HIV-1|*; Micronutrients|*

MeSH Heading

Adult; Cohort Studies; Human; Male; Niacin|AD; Proportional Hazards Models; Questionnaires; Support, U.S. Gov't, P.H.S.; Survival Analysis; Vitamin A|AD; Vitamin B Complex|AD; Zinc|AD

Publication Type

JOURNAL ARTICLE; MULTICENTER STUDY

ISSN

0002-9262

Country of Publication

UNITED STATES

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Section C

Record 10 from database: MEDLINE

Title

A randomized trial of the effects of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. Collaborative Atorvastatin Study Group.

Author

McKenney JM; McCormick LS; Weiss S; Koren M; Kafonek S; Black DM

Address

Virginia Commonwealth University, Richmond, USA.

Source

Am J Med, 1998 Feb, 104:2, 137-43

Abstract

BACKGROUND: To assess the lipid-lowering effects and safety of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. METHODS: We performed a randomized, open-label, parallel-design, active-controlled, study in eight centers in the United States. We enrolled 108 patients with total cholesterol (TC) of > or =200 mg/dL, serum triglycerides (TG) > or =200 and < or =800 mg/dL, and apolipoprotein B (apo B) > or =110 mg/dL. Patients were randomly assigned to receive atorvastatin 10 mg once daily (n=55) or immediate-release niacin 1 g three times daily for 12 weeks (n=53). Patients were stratified based on low-density lipoprotein cholesterol (LDL-C): Patients with LDL-C > or =135 mg/dL were considered to have combined hyperlipidemia and patients with LDL-C <135 mg/dL were considered to have isolated hypertriglyceridemia. The primary outcome measure was percent change from baseline in LDL-C. Other lipid levels were evaluated as secondary parameters. RESULTS: Atorvastatin reduced LDL-C 30% and TC 26% from baseline, and increased high-density lipoprotein cholesterol (HDL-C) 4%. Total TG were reduced 17%. Niacin reduced LDL-C 2%, TC 7%, increased HDL-C 25%, and reduced total TG 29% from baseline. There was a significant difference in LDL-C reduction, the primary efficacy parameter, between the two treatment groups (P <0.05, favoring atorvastatin), as well as a significant difference in the improvement in HDL-C (P <0.05, favoring niacin). The effect of atorvastatin was relatively consistent between patients with combined hyperlipidemia and isolated hypertriglyceridemia, whereas there was more variability between these strata in the niacin treatment group. Atorvastatin was better tolerated than niacin. CONCLUSION: Atorvastatin may allow patients with combined hyperlipidemia to be treated with monotherapy and offers an efficacious and well-tolerated alternative to niacin for the treatment of patients with isolated hypertriglyceridemia.

Language of Publication

English

Unique Identifier

98187580

MeSH Heading (Major)

Anticholesteremic Agents|*TU; Heptanoic Acids|*TU; Hydroxymethylglutaryl-CoA Reductase Inhibitors|*TU; Hyperlipidemia|BL/*DT; Hypertriglyceridemia|BL/*DT; Niacin|*TU; Pyrroles|*TU

MeSH Heading

Adult; Aged; Cholesterol|BL; Female; Human; Male; Middle Age; Treatment Outcome; Triglycerides|BL; United States

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0002-9343

Country of Publication

UNITED STATES

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. HealthGate Document

Section D

Record 1 from database: MEDLINE

Title

The effects of niacin on DNA repair after N-methyl-N'-nitro-N-nitrosoguanidine treatment in normal human lymphocytes.

Author

Ogata S; Okumura K; Taguchi H

Address

Laboratory of Biological Chemistry, Faculty of Bioresources, Mie University, Japan.

Source

Biosci Biotechnol Biochem, 1997 Dec, 61:12, 2116-8

Abstract

We have investigated the effects of niacin on NAD levels and on DNA repair in human lymphocytes. When lymphocytes were incubated in culture medium with various concentrations of niacin, incubation of lymphocytes with nicotinic acid at 5 microM or nicotinamide at 10 mM caused a 2-3 fold increase in NAD content. Under these conditions lymphocytes were treated with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Interestingly, the rejoining of DNA strand breaks was promoted by nicotinic acid but nicotinamide inhibited the rejoining.

Language of Publication

English

Unique Identifier

98101979

MeSH Heading (Major)

Carcinogens|*TO; DNA Repair|*; Methylnitronitrosoguanidine|*TO; Niacin|*PD; Niacinamide|*PD; T-Lymphocytes|*DE/ME

MeSH Heading

Dose-Response Relationship, Drug; DNA|DE; Human; NAD|AN; NAD+ ADP-Ribosyltransferase|GE/ME; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE

ISSN

0916-8451

Country of Publication

JAPAN

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Section D

Record 2 from database: MEDLINE

Title

Effects of vitamin/mineral supplementation on the prevalence of histological dysplasia and early cancer of the esophagus and stomach: results from the Dysplasia Trial in Linxian, China.

Author

Dawsey SM; Wang GQ; Taylor PR; Li JY; Blot WJ; Li B; Lewin KJ; Liu FS; Weinstein WM; Wiggett S; et al

Address

National Cancer Institute, Bethesda, Maryland 20892.

Source

Cancer Epidemiol Biomarkers Prev, 1994 Mar, 3:2, 167-72

Abstract

Linxian, China has some of the highest rates of esophageal/gastric cardia cancer in the world, and epidemiological evidence suggests that chronically low intake of micronutrients may contribute to these high cancer rates. To examine whether supplementation with multiple vitamins and minerals can affect the occurrence of esophageal/gastric cardia cancer in this population, a two-arm randomized nutrition intervention trial was conducted among 3318 Linxian residents with cytological evidence of esophageal dysplasia. During the 6-year intervention, esophageal/gastric cardia cancer mortality was 8% lower among those receiving the active supplements. After 30 and 72 months of intervention, endoscopic surveys were carried out to see if the nutritional supplements had affected the prevalence of clinically silent precancerous lesions and early invasive cancers of the esophagus and stomach. In the first survey, in 1987, 833 subjects were endoscoped; in the second survey, in 1991, 396 subjects were examined. The histological diagnoses from each survey were compared by treatment group. Cancer or dysplasia was diagnosed in 28% of the subjects endoscoped in 1987 and 24% of those examined in 1991. The odds ratio for subjects in the treatment group (versus those in the placebo group) having esophageal or gastric dysplasia or cancer was 0.84 (95% confidence interval, 0.61-1.15) in 1987 and 0.86 (0.54-1.38) in 1991. Although modest protective effects on worst overall diagnosis were seen in the supplemented group in both surveys, none of the results was statistically significant, and the findings must be considered inconclusive.(ABSTRACT TRUNCATED AT 250 WORDS)

Language of Publication

English

Unique Identifier

94325820

MeSH Heading (Major)

Adenocarcinoma|MO/PA/*PC; Cross-Cultural Comparison|*; Esophageal Neoplasms|MO/PA/*PC; Minerals|*AD; Precancerous Conditions|MO/PA/*PC; Stomach Neoplasms|MO/PA/*PC; Vitamins|*AD

MeSH Heading