***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This double-blind , r and omized crossover study investigated the effects of 6 weeks of treatment with prescription omega-3-acid ethyl esters ( POM3 , 4 g/day ) versus placebo ( soy oil ) on low-density lipoprotein cholesterol ( LDL-C ) and other aspects of the fasting lipid profile in 31 men and women with primary , isolated hypercholesterolemia ( LDL-C 130 - 220 mg/dL and triglycerides less than 150 mg/dL while free of lipid-altering therapies ) . Mean ± st and ard error of the mean baseline concentrations of total cholesterol , LDL-C , high-density lipoprotein cholesterol ( HDL-C ) , very-low-density lipoprotein cholesterol , and triglycerides were 229 ± 3 , 146 ± 3 , 60 ± 2 , 23 ± 2 , and 113 ± 8 mg/dL , respectively . POM3 produced a modest increase from baseline in LDL-C ( 3.4 % ) versus the placebo response ( -0.7 % , P = 0.010 ) . Significant changes ( P < 0.05 ) for POM3 ( placebo-corrected ) were observed for very-low-density lipoprotein cholesterol ( -18.8 % ) , triglycerides ( -18.7 % ) , and HDL-C ( 3.3 % ) . Nuclear magnetic resonance-determined very-low-density lipoprotein particle concentration and size and HDL particle concentration decreased significantly more with POM3 versus placebo , whereas LDL and HDL particle sizes increased significantly more with POM3 versus placebo . Total cholesterol , non-HDL-C , apolipoproteins A1 and B , and LDL particle concentration responses did not differ between treatments . These results did not confirm the hypothesis that POM3 treatment would lower LDL-C in primary , isolated hypercholesterolemia . Effects on other variables were consistent with prior results in mixed dyslipidemia High doses of n-3 PUFA found in fish oils can reduce the circulating concentration of triacylglycerol ( TG ) , which may contribute to the positive impact of these fatty acids on the risk of CVD . The present study aim ed to establish the differential impact of EPA and docosahexaenoic ( DHA ) on plasma lipids and apo in adults . Forty-two normolipidaemic adult subjects completed a double-blind placebo controlled parallel study , receiving an EPA-rich oil ( 4.8 g EPA/d ) , DHA-rich oil ( 4.9 g DHA/d ) or olive oil as control , for a period of 4 weeks . No effects of treatment on total cholesterol , LDL-cholesterol or HDL-cholesterol were evident . There was a significant 22 % reduction in TG level relative to the control value following the DHA treatment ( P=0.032 ) , with the 15 % decrease in the EPA group failing to reach significance ( P=0.258 ) . There were no significant inter-group differences in response to treatment for plasma apoA1 , -C3 or -E levels , although a significant 15 % within-group increase in apoE was evident in the EPA ( P=0.006 ) and DHA ( P=0.003 ) groups . In addition , a within-group decrease in the apoA1:HDL-cholesterol ratio was observed in the DHA group , suggesting a positive impact of DHA on HDL particle size . The DHA intervention result ed in a significant increase in the proportion of EPA P=0.000 and DHA P=0.000 in plasma phospholipids , whilst significant increases in EPA P=0.000 and docosapentaenoic acid P=0.002 , but not DHA P=0.193 , were evident following EPA supplementation ( P<0.05 ) . Our present results indicate that DHA may be more efficacious than EPA in improving the plasma lipid profile CONTEXT High-density lipoprotein ( HDL ) cholesterol is an inverse predictor of coronary atherosclerotic disease . Preliminary data have suggested that HDL infusions can induce atherosclerosis regression . OBJECTIVE To investigate the effects of reconstituted HDL on plaque burden as assessed by intravascular ultrasound ( IVUS ) . DESIGN AND SETTING A r and omized placebo-controlled trial was conducted at 17 centers in Canada . Intravascular ultrasound was performed to assess coronary atheroma at baseline and 2 to 3 weeks after the last study infusion . PATIENTS Between July 2005 and October 2006 , 183 patients had a baseline IVUS examination and of those , 145 had evaluable serial IVUS examinations after 6 weeks . INTERVENTION Sixty patients were r and omly assigned to receive 4 weekly infusions of placebo ( saline ) , 111 to receive 40 mg/kg of reconstituted HDL ( CSL-111 ) ; and 12 to receive 80 mg/kg of CSL-111 . MAIN OUTCOME MEASURES The primary efficacy parameter was the percentage change in atheroma volume . Nominal changes in plaque volume and plaque characterization index on IVUS and coronary score on quantitative coronary angiography were also prespecified end points . RESULTS The higher-dosage CSL-111 treatment group was discontinued early because of liver function test abnormalities . The percentage change in atheroma volume was -3.4 % with CSL-111 and -1.6 % for placebo ( P = .48 between groups , P<.001 vs baseline for CSL-111 ) . The nominal change in plaque volume was -5.3 mm3 with CSL-111 and -2.3 mm3 with placebo ( P = .39 between groups , P<.001 vs baseline for CSL-111 ) . The mean changes in plaque characterization index on IVUS ( -0.0097 for CSL-111 and 0.0128 with placebo ) and mean changes in coronary score ( -0.039 mm for CSL-111 and -0.071 mm with placebo ) on quantitative coronary angiography were significantly different between groups ( P = .01 and P = .03 , respectively ) . Administration of CSL-111 40 mg/kg was associated with mild , self-limiting transaminase elevation but was clinical ly well tolerated . CONCLUSIONS Short-term infusions of reconstituted HDL result ed in no significant reductions in percentage change in atheroma volume or nominal change in plaque volume compared with placebo but did result in statistically significant improvement in the plaque characterization index and coronary score on quantitative coronary angiography . Elevation of HDL remains a valid target in vascular disease and further studies of HDL infusions , including trials with clinical end points , appear warranted . TRIAL REGISTRATION clinical trials.gov Identifier : In a r and omized , cross-over feeding trial involving 10 men with polygenic hypercholesterolemia , a control , Mediterranean-type cholesterol-lowering diet , and a diet of similar composition in which walnuts replaced approximately 35 % of energy from unsaturated fat , were given for 6 weeks each . Compared with the control diet , the walnut diet reduced serum total and LDL cholesterol by 4.2 % ( P = 0.176 ) , and 6.0 % ( P = 0.087 ) , respectively . No changes were observed in HDL cholesterol , triglycerides , and apolipoprotein A-I levels or in the relative proportion of protein , triglycerides , phospholipids , and cholesteryl esters in LDL particles . The apolipoprotein B level declined in parallel with LDL cholesterol ( 6.0 % reduction ) . Whole LDL , particularly the triglyceride fraction , was enriched in polyunsaturated fatty acids from walnuts ( linoleic and alpha-linolenic acids ) . In comparison with LDL obtained during the control diet , LDL obtained during the walnut diet showed a 50 % increase in association rates to the LDL receptor in human hepatoma HepG2 cells . LDL uptake by HepG2 cells was correlated with alpha-linolenic acid content of the triglyceride plus cholesteryl ester fractions of LDL particles ( r(2 ) = 0.42 , P < 0.05 ) . Changes in the quantity and quality of LDL lipid fatty acids after a walnut-enriched diet facilitate receptor-mediated LDL clearance and may contribute to the cholesterol-lowering effect of walnut consumption Clinical trials have shown that soya protein reduces the concentrations of some atherogenic lipids in subjects with normal renal function . The present study examined the effects of soya protein on serum lipid concentrations and lipoprotein metabolism in patients on hypercholesterolaemic haemodialysis . Twenty-six hypercholesterolaemic ( total cholesterol > or = 6.21 mmol/l ) patients on haemodialysis were studied in a r and omized , double-blind , placebo-controlled clinical trial . After a 4-week run-in phase , the subjects were r and omly assigned to two groups . Isolated soya protein or milk protein 30 g was consumed daily as a beverage at breakfast or post-dialysis for 12 weeks . Soya protein substitution result ed in significant reductions in total cholesterol ( 17.2 ( sd 8.9 ) % ) , LDL-cholesterol ( 15.3 ( sd 12.5 ) % ) , apo B ( 14.6 ( sd 12.1 ) % ) and insulin ( 23.8 ( sd 18.7 ) % ) concentrations . There were no significant changes in HDL-cholesterol or apo A-I. These results indicate that replacing part of the daily protein intake with soya protein has a beneficial effect on atherogenic lipids and favourably affects lipoprotein metabolism in hypercholesterolaemic patients undergoing haemodialysis BACKGROUND In observational analyses , higher levels of high-density lipoprotein ( HDL ) cholesterol have been associated with a lower risk of coronary heart disease events . However , whether raising HDL cholesterol levels therapeutically reduces cardiovascular risk remains uncertain . Inhibition of cholesteryl ester transfer protein ( CETP ) raises HDL cholesterol levels and might therefore improve cardiovascular outcomes . METHODS We r and omly assigned 15,871 patients who had had a recent acute coronary syndrome to receive the CETP inhibitor dalcetrapib  , at a dose of 600 mg daily , or placebo , in addition to the best available evidence -based care . The primary efficacy end point was a composite of death from coronary heart disease , nonfatal myocardial infa rct ion , ischemic stroke , unstable angina , or cardiac arrest with resuscitation . RESULTS At the time of r and omization , the mean HDL cholesterol level was 42 mg per deciliter ( 1.1 mmol per liter ) , and the mean low-density lipoprotein ( LDL ) cholesterol level was 76 mg per deciliter ( 2.0 mmol per liter ) . Over the course of the trial , HDL cholesterol levels increased from baseline by 4 to 11 % in the placebo group and by 31 to 40 % in the dalcetrapib group . Dalcetrapib had a minimal effect on LDL cholesterol levels . Patients were followed for a median of 31 months . At a prespecified interim analysis that included 1135 primary end-point events ( 71 % of the projected total number ) , the independent data and safety monitoring board recommended termination of the trial for futility . As compared with placebo , dalcetrapib did not alter the risk of the primary end point ( cumulative event rate , 8.0 % and 8.3 % , respectively ; hazard ratio with dalcetrapib , 1.04 ; 95 % confidence interval , 0.93 to 1.16 ; P=0.52 ) and did not have a significant effect on any component of the primary end point or total mortality . The median C-reactive protein level was 0.2 mg per liter higher and the mean systolic blood pressure was 0.6 mm Hg higher with dalcetrapib as compared with placebo ( P<0.001 for both comparisons ) . CONCLUSIONS In patients who had had a recent acute coronary syndrome , dalcetrapib increased HDL cholesterol levels but did not reduce the risk of recurrent cardiovascular events . ( Funded by F. Hoffmann-La Roche ; dal- OUTCOMES Clinical Trials.gov number , NCT00658515 . ) Objective —To determine mechanisms contributing to decreased high-density lipoprotein cholesterol ( HDL-C ) and increased low-density lipoprotein cholesterol ( LDL-C ) concentrations associated with hydrogenated fat intake , kinetic studies of apoA-I , apoB-100 , and apoB-48 were conducted using stable isotopes . Methods and Results —Eight postmenopausal hypercholesterolemic women were provided in r and om order with 3 diets for 5-week periods . Two-thirds of the fat was soybean oil ( unsaturated fat ) , stick margarine ( hydrogenated fat ) , or butter ( saturated fat ) . Total and LDL-C levels were highest after the saturated diet ( P < 0.05 ; saturated versus unsaturated ) whereas HD 
    Output:
    
We conclude that both dietary components and pharmacological approaches can be used to increase apoA-I concentrations or functionality .
For the dietary components in particular , more knowledge about the underlying mechanisms is necessary , as increasing apoA-I per se does not necessarily translate into a reduced CHD risk