TREATMENT OF PRIMARY MIXED HYPERLIPIDEMIA WITH ETOPHYLLINE CLOFIBRATE- EFFECTS ON LIPOPROTEIN-MODIFYING ENZYMES, POSTPRANDIAL LIPOPROTEIN METABOLISM, AND LIPOPROTEIN DISTRIBUTION AND COMPOSITION
B. Foger et al., TREATMENT OF PRIMARY MIXED HYPERLIPIDEMIA WITH ETOPHYLLINE CLOFIBRATE- EFFECTS ON LIPOPROTEIN-MODIFYING ENZYMES, POSTPRANDIAL LIPOPROTEIN METABOLISM, AND LIPOPROTEIN DISTRIBUTION AND COMPOSITION, Atherosclerosis, 117(2), 1995, pp. 253-261
In 17 patients with primary mixed hyperlipidemia we studied levels and
composition of lipoproteins in fasting plasma,;lipoprotein-modifying
enzymes, and postprandial lipoprotein metabolism after an oral fat-tol
erance test supplemented with vitamin A before, and 12 weeks after tre
atment with etophylline clofibrate. With treatment, fasting plasma cho
lesterol, triglycerides, and the levels of very low density lipoprotei
ns (VLDL), intermediate density lipoproteins (IDL), and low density li
poproteins (LDL) decreased significantly; high density lipoprotein (HD
L) cholesterol increased significantly, Treatment caused also an incre
ase in the protein content of IDL, a decrease in the triglyceride cont
ent of LDL, and an increase in the size of LDL as assessed by gradient
gel electrophoresis. Concentrations of triglycerides, chylomicrons, a
nd chylomicron remnants after an oral fat load supplemented with vitam
in A decreased by 33%, 30%, and 6%, respectively (P < 0.005; P < 0.01;
and P < 0.05). The activity of lipoprotein lipase and hepatic lipase
in postheparin plasma increased by 51% and 45%, respectively (P < 0.01
; P < 0.05). We found a decrease in the mass concentration of choleste
ryl ester transfer protein (P < 0.05). Stepwise multiple regression an
alysis showed that the triglyceride content of LDL is determined prima
rily by fasting triglycerides (r = +0.53, P < 0.05; baseline) and chol
esteryl ester transfer protein (r = +0.49, P < 0.05; 12 weeks); in con
trast, the triglyceride content of HDL, is determined exclusively by a
ccumulation of postprandial triglycerides (r = +0.67; P < 0.05; baseli
ne) and postprandial chylomicrons (r = +0.87; P < 0.005; 12 weeks). We
conclude that hypolipidemic treatment with etophylline clofibrate fav
orably affects the cardiovascular risk factor profile in primary mixed
hyperlipidemia.