Derleme
BibTex RIS Kaynak Göster

Niasin Dislipidemi Riskini Azaltmada Potansiyel Bir Ajan Mıdır?

Yıl 2022, Sayı: 17, 626 - 635, 29.08.2022
https://doi.org/10.38079/igusabder.1112685

Öz

Tüm dünyada prevalansı ve mortalite oranı en yüksek, bulaşıcı olmayan hastalıkların başında kardiyovasküler hastalıklar gelmektedir. Bu hastalıkların gelişiminde değiştirilebilir ve değiştirilemez olarak sınıflandırılan bazı risk faktörleri önemli bir rol oynamaktadır. Değiştirilebilir risk faktörleri özellikle kardiyovasküler hastalıkların zeminini oluşturan dislipidemi ile yakından ilişkilidir. Dislipidemi; yüksek triaçilgliserol (TAG) ve serbest yağ asitleri, azalmış yüksek yoğunluklu lipoprotein (HDL-High density lipoprotein) düzeyi ve fonksiyonu, artmış düşük yoğunluklu lipoprotein (LDL-Low density lipoprotein) düzeyi ve apolipoprotein B (Apo B) üretimi ile karakterizedir. Dislipidemi ile beslenme ve fiziksel aktivite alışkanlıkları arasında önemli bir ilişki olduğu bilinmektedir. Özellikle Batı tarzı beslenme alışkanlıkları yerine Akdeniz diyeti ve Akdeniz tipi yaşam tarzının benimsenmesi ile birlikte dislipidemi riskinde önemli bir azalma olabileceği düşünülmektedir. Diğer yandan, niasin gibi bazı mikro besin öğelerinin besin desteği olarak kullanımının dislipidemi riskini potansiyel olarak azalttığı görülmüştür. B grubu, suda çözünen bir vitamin olan niasinin potansiyel olarak TAG, serbest yağ asitleri, Apo B, çok düşük yoğunluklu lipoprotein (VLDL-Very low density lipoprotein) ve LDL düzeylerini azaltırken, HDL ve apolipoprotein A (Apo A) düzeylerini arttırabildiği bilinmektedir. Bu potansiyel etkileri dolayısı ile niasin, dislipidemi riskinin azaltılmasında ve tedavisinde farmakolojik bir ajan olarak görev almaktadır. Ancak potansiyel etkilerin görülmesi adına, önerilen üst alım düzeyinin (35 mg/gün) oldukça üzerinde (1-3 g) niasin tedavisi uygulanmakta, bu durum ‘niasin flush’ semptomunu tetikleyebilmektedir. Ek olarak, yüksek miktarda niasin alımının uzun vadede insan sağlığı üzerindeki olumsuz etkilerini inceleyen araştırmalara ihtiyaç olduğu düşünülmektedir. Bu derleme yazıda niasinin dislipidemi üzerindeki potansiyel etkileri literatürde yer alan güncel bilgiler ve araştırma sonuçları doğrultusunda incelenmiştir.

Kaynakça

  • World Health Organization. Cardiovascular diseases (CVDs). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)#:~:text=Cardiovascular%20diseases%20(CVDs)%20are%20the,%2D%20and%20middle%2Dincome%20countries. Published June 2021. Accessed April 2022.
  • Klop B, Elte JWF, Cabezas MC. Dyslipidemia in obesity: Mechanisms and potential targets. Nutrients. 2013;5(4):1218-1240.
  • Nouh F, Omar M, Younis M. Risk factors and management of hyperlipidemia (Review). Asian Journal of Cardiology Research. 2019;2(1):1-10.
  • Kizilaslan N. The Impact of The nutrition situations and physical activities of academicians on anthropometric measurements and blood parameters. Progress in Nutrition. 2022;24(1):1-16.
  • Guo Q, Ma Z, Zhu C, Zeng Q. Association of dietary pattern and physical activity with lipid-related indices among Chinese population: A cross-sectional study. Lipids in Health and Disease. 2020;19:1-13.
  • O’Connor EA, Evans CV, Rushkin MC, Redmond N, Lin JS. Behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors. Updated evidence report and systematic review for the US preventive services task force. Journal of American Medical Association. 2020;324(20):2076-2094.
  • Antoniazzi L, Arroyyo-Olivares R, Bittencourt MS, et al. Adherence to a mediterranean diet, dyslipidemia and inflammation in familial hypercholesterolemia. Nutrition, Metabolism & Cardiovascular Disease. 2021;31(7):2014-2022.
  • Shah AK, Dhalla NS. Effectiveness of some vitamins in the prevention of cardiovascular disease. A narrative review. Frontiers in Physiology. 2021;12:1-11.
  • Halawani AFM, Alahmari ZS, Asiri DA, et al. Diagnosis and management of dyslipidemia. Archives of Pharmacy Practice. 2019;10(4):67-70.
  • Yuan Y, Chen W, Luo L, Xu C. Dyslipidemia: Causes, symptoms and treatment. International Journal of Trend in Scientific Research and Development. 2021;5(2):1013-1016.
  • Fogacci F, Borghi C, Cicero AFG. Diets, foods and food components’ effect on dyslipidemia. Nutrients. 2021;13(3):1-3.
  • Rosa COB, dos Santos CA, Leite JIA, Caldas APS, Bressan J. Impact of nutrients and food components on dyslipidemias: What is the evidence? Advances in Nutrition. 2015;6(6):703-711.
  • Rader DJ. New therapeutic approaches to the treatment of dyslipidemia. Cell Metabolism. 2016;23(3):405-412.
  • Houston M. The role of nutrition and nutritional supplements in the treatment of dyslipidemia. Clinical Lipidology. 2014;9(3):333-354.
  • Wang Y, Xu D. Effects of aerobic exercise on lipids and lipoproteins. Lipids in Health and Disease. 2017;16(1):1-8.
  • Wu M, Lyons T. Treatment approaches for diabetes and dyslipidemia. Hormone Research in Pediatrics. 2011;76(1):76-80.
  • Çatak J. Determination of niacin profiles in some animal and plant-based foods by high performance liquid chromatography: association with healthy nutrition. Journal of Animal Science and Technology. 2019;61(3):138-146.
  • Türkiye Ulusal Gıda Kompozisyon Veri Tabanı (TürKomp). Niasin içeren besinler. TürKomp. http://www.turkomp.gov.tr/component_result-37. Erişim tarihi Nisan 2022.
  • TC Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu. Türkiye Beslenme Rehberi 2015 (TÜBER). Yayın no: 1031. Türkiye Cumhuriyeti, Ankara: Kayhan Ajans; 2016. https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/rehberler/2015-beslenme-rehberi.pdf. Yayınlanma tarihi 2016.
  • Meyer-Ficca M, Kirkland JB. Niacin. Advances in Nutrition. 2016;7(3):556-558.
  • Prousky J, Millman CG, Kirkland JB. Pharmacologic use of niacin. Journal of Evidence-Based Complementary & Alternative Medicine. 2011;16(2):91-101.
  • Sood A, Arora R. Mechanisms of flushing due to niacin and abolition of these effects. The Journal of Clinical Hypertension. 2009;11(11):685-689.
  • Kamanna VS, Ganji SH, Kashyap ML. The mechanism and mitigation of niacin-induced flushing. The International Journal of Clinical Practice. 2009;63(9):1369-1377.
  • Stone N, Robinson J, Lichtenstein A, et al. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Journal of American College of Cardiology. 2014;65(25-Part B):2889–2934.
  • Boden WE, Sidhu MS, Toth PP. The therapeutic role of niacin in dyslipidemia management. Journal of Cardiovascular Pharmacology and Therapeutics. 2014;19(2):141-158.
  • Zeman M, Vecka M, Perlík F, Hromάdka R, Stañkovά B, Tvrzickά E, et al. Niacin in treatment of hyperlipidemias in light of new clinical trials: Has niacin lost its place? Medical Sciences Monitor. 2015;21:2156-2162.
  • Naranjo MC, Millάn-Linares MC, Montserrat-de la Paz S. Niacin and Hyperlipidemia. In: Elsevier, ed. Molecular Nutrition: Vitamins. 1st ed. Spain: Academic Press; 2020.
  • Romani M, Hofer DC, Katsyuba E, Auwerx J. Niacin: An old lipid drug in a new NAD+ dress. Journal of Lipid Research. 2019;60(4):741-746.
  • Yu B, Zhao S. Anti-inflammatory effect is an important property of niacin on atherosclerosis beyond its lipid-altering effects. Medical Hypothesis. 2007;69(1):90-94.
  • Zeman M, Vecka M, Perlík F, Hromάdka R, Stañkovά B, Tvrzickά E, et al. Pleiotropic effects of niacin: Current possibilities for its clinical use. Acta Pharmaceutica. 2016;66(4)449-469.
  • Adiels M, Chapman JM, Robillard P, Krempf M, Laville M, Borén J. Niacin action in the atherogenic mixed dyslipidemia of metabolic syndrome: Insights from metabolic biomarker profiling and network analysis. Journal of Clinical Lipidology. 2018;12(3):810-821.
  • Song S, Lee CJ, Oh J, Park S, Kang SM, Lee SH. Effect of niacin on carotid atherosclerosis in patients at low-density lipoprotein-cholesterol goal but high lipoprotein (a) level: A 2-year follow-up study. Journal of Lipid and Atherosclerosis. 2019;8(1):58-66.
  • Xiang S, Zhang Q, Wang YT. Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Medicine. 2020;99(29):1-10.
  • Karacaglar E, Atar I, Altin C, Yetis B, Cakmak A, Bayraktar N, et al. The effects of niacin on inflammation in patients with non-ST elevated acute coronary syndrome. Acta Cardiologica Sinica. 2015;31(2):120-126.
  • Kang HJ, Kim DK, Lee SM, Kim KH, Han SH, Kim KH, et al. Effects of low-dose niacin on dyslipidemia and serum phosphorus in patients with chronic kidney disease. Kidney Research and Clinical Practice. 2013;32(1):21-26.
  • Ahn JY, Kim IS, Lee JS. Relationship of riboflavin and niacin with cardiovascular disease. Korean Journal of Clinical Laboratory Science. 2019;51(4):484-494.
  • Garg A, Sharma A, Krishnamoorthy P, et al. Role of niacin in current clinical practice: A systematic review. The American Journal of Medicine. 2017;130(2):173-187.
  • Shoukat M, Yasmin R, Zaib T, Batool H. Serum HDL cholesterol levels in adult hyperlipidemic patients before and after treatment with niacin in combination with statin. Pakistan Journal of Pathology. 2018;29(4):61-64.

Is Niacine a Potential Agent to Decrease Dyslipidemia Risk?

Yıl 2022, Sayı: 17, 626 - 635, 29.08.2022
https://doi.org/10.38079/igusabder.1112685

Öz

Cardiovascular diseases are the most common non-communicable diseases with the highest prevalence and mortality rate in the all around the world. There are some risk factors -such as modifiable and non-modifiable- which are effective on the development of these diseases. Modifiable risk factors are closely related to dyslipidemia, which forms the basis of cardiovascular diseases. Dyslipidemia is characterized by high triacylglycerol (TAG) and free fatty acids, decreased high density lipoprotein (HDL) level and function, increased low density lipoprotein (LDL) level and apolipoprotein B (Apo B) production. There is a relation between dyslipidemia with nutritional and physical activity behaviors. In particular, adherence to the Mediterranean diet and lifestyle behaviors instead of the Western diet can potentially decrease dyslipidemia risk. On the other hand, some of micronutrients such as niacin can potentially decrease dyslipidemia risk as a nutritional supplement. Niacin -which is a water-soluble, B group vitamin- can potentially decrease TAG, free fatty acids, Apo B, very low density lipoprotein (VLDL) and LDL levels and increase HDL and apolipoprotein A (Apo A) levels in plasma. Due to these potential beneficial effects, niacin acts a pharmacological agent to decrease both of dyslipidemia risk and symptoms. However, niacin is used more than tolerable upper intake level (35 mg/day) to show these potential effects (1-3 g). This situation may cause to ‘niacin flush’ symptom. In addition, there is a need for the studies which aim to determine the negative effects of high dose niacin intake on human’s health in long-term. In this review article, potential effects of the niacin on dyslipidemia are examined within the current literature.

Kaynakça

  • World Health Organization. Cardiovascular diseases (CVDs). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)#:~:text=Cardiovascular%20diseases%20(CVDs)%20are%20the,%2D%20and%20middle%2Dincome%20countries. Published June 2021. Accessed April 2022.
  • Klop B, Elte JWF, Cabezas MC. Dyslipidemia in obesity: Mechanisms and potential targets. Nutrients. 2013;5(4):1218-1240.
  • Nouh F, Omar M, Younis M. Risk factors and management of hyperlipidemia (Review). Asian Journal of Cardiology Research. 2019;2(1):1-10.
  • Kizilaslan N. The Impact of The nutrition situations and physical activities of academicians on anthropometric measurements and blood parameters. Progress in Nutrition. 2022;24(1):1-16.
  • Guo Q, Ma Z, Zhu C, Zeng Q. Association of dietary pattern and physical activity with lipid-related indices among Chinese population: A cross-sectional study. Lipids in Health and Disease. 2020;19:1-13.
  • O’Connor EA, Evans CV, Rushkin MC, Redmond N, Lin JS. Behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors. Updated evidence report and systematic review for the US preventive services task force. Journal of American Medical Association. 2020;324(20):2076-2094.
  • Antoniazzi L, Arroyyo-Olivares R, Bittencourt MS, et al. Adherence to a mediterranean diet, dyslipidemia and inflammation in familial hypercholesterolemia. Nutrition, Metabolism & Cardiovascular Disease. 2021;31(7):2014-2022.
  • Shah AK, Dhalla NS. Effectiveness of some vitamins in the prevention of cardiovascular disease. A narrative review. Frontiers in Physiology. 2021;12:1-11.
  • Halawani AFM, Alahmari ZS, Asiri DA, et al. Diagnosis and management of dyslipidemia. Archives of Pharmacy Practice. 2019;10(4):67-70.
  • Yuan Y, Chen W, Luo L, Xu C. Dyslipidemia: Causes, symptoms and treatment. International Journal of Trend in Scientific Research and Development. 2021;5(2):1013-1016.
  • Fogacci F, Borghi C, Cicero AFG. Diets, foods and food components’ effect on dyslipidemia. Nutrients. 2021;13(3):1-3.
  • Rosa COB, dos Santos CA, Leite JIA, Caldas APS, Bressan J. Impact of nutrients and food components on dyslipidemias: What is the evidence? Advances in Nutrition. 2015;6(6):703-711.
  • Rader DJ. New therapeutic approaches to the treatment of dyslipidemia. Cell Metabolism. 2016;23(3):405-412.
  • Houston M. The role of nutrition and nutritional supplements in the treatment of dyslipidemia. Clinical Lipidology. 2014;9(3):333-354.
  • Wang Y, Xu D. Effects of aerobic exercise on lipids and lipoproteins. Lipids in Health and Disease. 2017;16(1):1-8.
  • Wu M, Lyons T. Treatment approaches for diabetes and dyslipidemia. Hormone Research in Pediatrics. 2011;76(1):76-80.
  • Çatak J. Determination of niacin profiles in some animal and plant-based foods by high performance liquid chromatography: association with healthy nutrition. Journal of Animal Science and Technology. 2019;61(3):138-146.
  • Türkiye Ulusal Gıda Kompozisyon Veri Tabanı (TürKomp). Niasin içeren besinler. TürKomp. http://www.turkomp.gov.tr/component_result-37. Erişim tarihi Nisan 2022.
  • TC Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu. Türkiye Beslenme Rehberi 2015 (TÜBER). Yayın no: 1031. Türkiye Cumhuriyeti, Ankara: Kayhan Ajans; 2016. https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/rehberler/2015-beslenme-rehberi.pdf. Yayınlanma tarihi 2016.
  • Meyer-Ficca M, Kirkland JB. Niacin. Advances in Nutrition. 2016;7(3):556-558.
  • Prousky J, Millman CG, Kirkland JB. Pharmacologic use of niacin. Journal of Evidence-Based Complementary & Alternative Medicine. 2011;16(2):91-101.
  • Sood A, Arora R. Mechanisms of flushing due to niacin and abolition of these effects. The Journal of Clinical Hypertension. 2009;11(11):685-689.
  • Kamanna VS, Ganji SH, Kashyap ML. The mechanism and mitigation of niacin-induced flushing. The International Journal of Clinical Practice. 2009;63(9):1369-1377.
  • Stone N, Robinson J, Lichtenstein A, et al. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Journal of American College of Cardiology. 2014;65(25-Part B):2889–2934.
  • Boden WE, Sidhu MS, Toth PP. The therapeutic role of niacin in dyslipidemia management. Journal of Cardiovascular Pharmacology and Therapeutics. 2014;19(2):141-158.
  • Zeman M, Vecka M, Perlík F, Hromάdka R, Stañkovά B, Tvrzickά E, et al. Niacin in treatment of hyperlipidemias in light of new clinical trials: Has niacin lost its place? Medical Sciences Monitor. 2015;21:2156-2162.
  • Naranjo MC, Millάn-Linares MC, Montserrat-de la Paz S. Niacin and Hyperlipidemia. In: Elsevier, ed. Molecular Nutrition: Vitamins. 1st ed. Spain: Academic Press; 2020.
  • Romani M, Hofer DC, Katsyuba E, Auwerx J. Niacin: An old lipid drug in a new NAD+ dress. Journal of Lipid Research. 2019;60(4):741-746.
  • Yu B, Zhao S. Anti-inflammatory effect is an important property of niacin on atherosclerosis beyond its lipid-altering effects. Medical Hypothesis. 2007;69(1):90-94.
  • Zeman M, Vecka M, Perlík F, Hromάdka R, Stañkovά B, Tvrzickά E, et al. Pleiotropic effects of niacin: Current possibilities for its clinical use. Acta Pharmaceutica. 2016;66(4)449-469.
  • Adiels M, Chapman JM, Robillard P, Krempf M, Laville M, Borén J. Niacin action in the atherogenic mixed dyslipidemia of metabolic syndrome: Insights from metabolic biomarker profiling and network analysis. Journal of Clinical Lipidology. 2018;12(3):810-821.
  • Song S, Lee CJ, Oh J, Park S, Kang SM, Lee SH. Effect of niacin on carotid atherosclerosis in patients at low-density lipoprotein-cholesterol goal but high lipoprotein (a) level: A 2-year follow-up study. Journal of Lipid and Atherosclerosis. 2019;8(1):58-66.
  • Xiang S, Zhang Q, Wang YT. Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Medicine. 2020;99(29):1-10.
  • Karacaglar E, Atar I, Altin C, Yetis B, Cakmak A, Bayraktar N, et al. The effects of niacin on inflammation in patients with non-ST elevated acute coronary syndrome. Acta Cardiologica Sinica. 2015;31(2):120-126.
  • Kang HJ, Kim DK, Lee SM, Kim KH, Han SH, Kim KH, et al. Effects of low-dose niacin on dyslipidemia and serum phosphorus in patients with chronic kidney disease. Kidney Research and Clinical Practice. 2013;32(1):21-26.
  • Ahn JY, Kim IS, Lee JS. Relationship of riboflavin and niacin with cardiovascular disease. Korean Journal of Clinical Laboratory Science. 2019;51(4):484-494.
  • Garg A, Sharma A, Krishnamoorthy P, et al. Role of niacin in current clinical practice: A systematic review. The American Journal of Medicine. 2017;130(2):173-187.
  • Shoukat M, Yasmin R, Zaib T, Batool H. Serum HDL cholesterol levels in adult hyperlipidemic patients before and after treatment with niacin in combination with statin. Pakistan Journal of Pathology. 2018;29(4):61-64.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler
Yazarlar

Taygun Dayı 0000-0003-2491-7609

Mustafa Hoca 0000-0003-3609-5868

Yayımlanma Tarihi 29 Ağustos 2022
Kabul Tarihi 9 Ağustos 2022
Yayımlandığı Sayı Yıl 2022 Sayı: 17

Kaynak Göster

JAMA Dayı T, Hoca M. Niasin Dislipidemi Riskini Azaltmada Potansiyel Bir Ajan Mıdır?. IGUSABDER. 2022;:626–635.

 Alıntı-Gayriticari-Türetilemez 4.0 Uluslararası (CC BY-NC-ND 4.0)