Ispaghol Fibers For Decreasing Hyperlipidemia

estimated by enzymatic calorimetric method, using kit Cat. # 304710050 by Eli Tech Diagnostic. France. HDL- C was determined by using kit Cat. # 303210040 by Eli Tech Diagnostic, France. Serum LDL-cholesterol was calculated by Friedwald formula described by Davidson et al11 (LDL-Cholesterol = Total Cholesterol-(Triglycerides/5 +HDL-Cholesterol) also quoted by  Delong et al (1986)12 and Beamount et al (1970).13   Data were expressed as the mean ± SD and “t” test was applied to determine statistical significance as the difference. A probability value of

RESULTS
Out of 40 patients, 38 completed the over all study period. Two patients withdrew from one group (Psyllium group) due to metallic taste of Psyllium husk. Tables showing base line and post treatment values are self explanatory. When results were summed up and test parameters were compared, it was seen that, after 90 days of treatment with Psyllium, serum total cholesterol decreased from 228.27±4.89 mg/dl to 199.22±2.30 mg/dl, which is highly significant statistically (P0.05).

DISCUSSION
There are various groups of drugs which are used for the treatment of hyperlipidemia. HMG-Co reductase inhibitors (Statins), fibric acids, Niacin and psyllium hydrophilic mucilloids are important lipid lowering drugs.14 Among these lipid lowering drugs, Psyllium has its own remarkable role to decrease serum total cholesterol and LDL- cholesterol.15 In our study, serum total cholesterol decreased 12.72 % in 90 days of treatment with Psyllium husk in  hyperlipidemic patients. Our study matches with the study of Anderson et al16 who observed almost same changes in serum total cholesterol and LDL- Cholesterol of 26 male patients, treated with 3.4 grams of Psyllium thrice daily for eight weeks. Our study also matches with the study of Maciejko et al17  who observed 12.00 % decrease in serum total cholesterol and 16.12 % decrease in LDL-Cholesterol in 40 hyperlipidemic patients treated with 4 grams Psyllium husk for the period of 16 weeks. He also included other parameters in his study, like body weight and systolic/diastolic blood pressure which were also significantly reduced. Our results regarding decrease in serum total cholesterol level contrasts with the results of research study conducted by Haskell et al18who observed only 6.11 % decrease in total cholesterol levels in 40 hyperlipidemic patients, when they used 2 gram Psyllium husk in 18 female patients for the period of eight weeks. This remarkable change in results may be due to changes in gender of patients, and duration of drug used. He has mentioned the mechanism of action of Psyllium husk that these Psyllium fibers stimulate bile acid synthesis in liver (7 ?-hydroxylase activity). Second mechanism, he mentioned is diversion of hepatic cholesterol for bile acid synthesis. Effect of Psyllium husk on absorption of cholesterol and fat appeared minimal but may make a small contribution to cholesterol lowering. Additional mechanisms such as inhibition of hepatic cholesterol synthesis by propionate and secondary effects of slowing glucose absorption may also play a role.19 In our study placebo group shows 3.35 % reduction in serum total cholesterol and 1.29 % reduction in LDL-Cholesterol. These results matches with the study of Spence et al20 who observed same effects of placebo given to 44 male and female hyperlipidemic patients having moderately high lipid profile. Their study shows 2.89 % reduction in serum total cholesterol and 2.21 % reduction in LDL-Cholesterol. Results of research study conducted at Lipid Research Centre held by Levy et al21 do not match with our results of research. They observed 5.98 %  and 9.97 % reduced levels of serum total cholesterol and LDL-Cholesterol, respectively, in 109 hyperlipidemic patients treated by Psyllium husk 3 gram daily for the period of 24 weeks. Their study was double blind placebo controlled. These changes in results may be due to double blind research design, large sample size and environmental factors like in that study all hyperlipidemic patients were admitted at Lipid Research Centre, so were closely observed and advised for brisk walk and to take controlled step-1 diet.22 Drug compliance between our and their study was same, i.e. in our study patients discontinued taking Psyllium due to its metallic taste. In their study 11 patients discontinued to take Psyllium fibers, mostly due to same reasons of its metallic taste. Another study conducted by Kane et al23 also contradicts with our study as they observed only 12.22 % reduction in LDL- Cholesterol when 3 gram Psyllium husk was administered in 14 female hyperlipidemic patients above the age of 40 years. Our study proved 18.88 % reduction in LDL-Cholesterol levels which is much higher than 12.22 %. Change in these results may be due only female gender and age which was specifically above 4o years. Our study

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