INCREASED SERUM TRIGLYCERIDE CLEARANCE, UNCHANGED CHOLESTERYL ESTER TRANSFER PROTEIN-ACTIVITY, AND ELEVATED HDL CHOLESTEROL DURING TREATMENT OF HYPERTRIGLYCERIDEMIA WITH BEZAFIBRATE

The effects of bezafibrate on lipid metabolism were evaluated in 22 pa tients with type IIb or type IV hypertriglyceridemia. Bezafibrate 400 mg/d was administered for 8 weeks. A fat emulsion tolerance test (FETT ) to evaluate serum triglyceride (TG) clearance (fractional removal ra te = K-2) and measurement of cholesteryl ester transfer protein (CETP) activity were performed before bezafibrate administration and after t he 8-week treatment period using blood samples obtained after overnigh t fasting. Statistically significant reductions were observed in serum TG (P < 0.01), apolipoprotein (apo) B (P < 0.01), apo C-II (P < 0.05) , apo C-III (P < 0.001), and apo E (P < 0.05). Significant increases w ere seen in high-density lipoprotein cholesterol (HDL-C) (P < 0.001), apo A-I (P < 0.001), and apo A-II (P < 0.001). K-2 was significantly e levated (P < 0.001). CETP activity declined slightly, but the change w as not statistically significant. Strong positive correlations were ev ident between the absolute value of increased K-2 and the increase in both HDL-C (r = .67, P < 0.005) and apo A-I (r = .53, P < 0.05). It ca n be inferred from these findings that the bezafibrate-induced reducti on in serum TG and increase in HDL-C observed in patients with hypertr iglyceridemia arise from an acceleration in TG-rich lipoprotein metabo lism.