Variability of the hypolipidemic action of simvastatin and fluvastatin in patients with primary hyperlipoproteinemia

Aim. To reveal the metabolic parameters of lipoproteins (L), which determin e the benefits of hypolipidemic effects of simvastatin (S) and fluvastatin (F); to trace changes in the activity of lecithin-cholesterol acyltransfera se (LCA) and cholesterol (C) eetherer transfer (CET) from high density lipo proteins to very low density lipoproteins (VLDL) and low density lipoprotei ns (LDL) and the levels of apoE in the blood and in some L classes during t herapy with the above drugs. Materials and methods. Thirty six patients took S, 10 mg/day, and 25 receiv ed F, 20 mg/day, for 3 months. The levels of lipids were measured by enzyme assays, apoprotein (apo) was determined by immunoturbidimetry and immunodi ffusion. Results. The hypocholesterolemic and hypotriglyceridemic effect of S (19.6 and 25.5, respectively) and F (19.0 and 30.5%) were similar. With S, the re duction in the blood levels of C and LDL C positively correlated with the b aseline apoE levels. With F, it did with C and LDL C before treatment Lower blood apoE was found with S and F and lower HDL apoE/(VLDL + LDL) ratio wa s detected only with F. F treatment significantly lowered the activity of C ET and LCA; before and after S treatment they did not differ significantly. Conclusion. Analyzing the relationship between the benefits of the hypolipi demic effect and the baseline parameters of L metabolism indicates that the changes in serum C, LDL C and HDL C are due to the composition of HDL part icles and the distribution of apoE among different L classes in the patient to a greater degree.