Effect of statin versus fibrate on postprandial endothelial dysfunction: role of remnant-like particles

Background: Postprandial lipemia is associated with endothelial dysfunction . Remnant-like particles (RLP) have been suggested to contribute to these a dverse vascular-effects. We investigated the effect of cerivastatin and gem fibrozil upon oral fat load induced changes in endothelial function and pos tprandial lipid profile in vivo. Methods: In a randomized cross-over trial, 15 healthy volunteers received cerivastatin (0.4 mg once daily), gemfibroz il (900 mg once daily) or placebo for 3 weeks. Lipid profiles and flow medi ated dilation (FMD) were assessed before and 4 h after an oral fat load. En dothelium-independent dilation was tested after nitroglycerine 0.4 mg subli ngual spray. Results: After the placebo period, the oral fat load induced a n increase in triglycerides (TG) and RLP-cholesterol (RLP-C) (0.9 +/-0.7 an d 0.08 +/-0.04 mmol/l, respectively) and a significant decrease in FMD (9.1 +/-3.4 to 4.3 +/-3.3%, P<0.05). After gemfibrozil, TG increase was attenua ted (0.5<plus/minus>0.5 mmol/l), whereas RLP-C increase (0.05 +/-0.09 mmol/ l) and FMD decrease (9.0 +/-3.8 to 5.2 +/-2.6%, P<0.05) were not different from placebo therapy. Cerivastatin did not affect TG increase (0.7<plus/min us>0.8 mmol/l). RLP-C increase (0.02 +/-0.07 mmol/l) and FMD (7.9 +/-2.6 to 8.4 +/-2.8%) change were attenuated significantly compared to placebo. End othelium-independent vasodilatation remained unaltered throughout the proto col. Conclusion: Cerivastatin, but not gemfibrozil significantly reduces RL P-C increase after an oral fat load in combination with a reversal of fat-l oad induced endothelial dysfunction. The present data imply that lowering o f RLP-C, rather than lowering of total TG levels, may contributes to the pr evention of endothelial dysfunction after an oral fat load during statin us e. (C) 2001 Elsevier Science B.V. All rights reserved.