Comparison of the effect of fluvastatin, an hydroxymethyl glutaryl coenzyme A reductase inhibitor, and cholestyramine, a bile acid sequestrant, on lipoprotein particles defined by apolipoprotein composition
| Autor: | P. Pfister, Jean Dallongeville, L. Ose, Patrick Duriez, E. Hagen, J.M. Bard, Jean-Charles Fruchart |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male Apolipoprotein E medicine.medical_specialty Indoles Adolescent Apolipoprotein B Lipoproteins Endocrinology Diabetes and Metabolism Cholestyramine Resin Hypercholesterolemia education Lipoprotein particle Bile Acids and Salts Fatty Acids Monounsaturated chemistry.chemical_compound Apolipoproteins E Endocrinology Double-Blind Method Internal medicine medicine Humans Enzyme Inhibitors Apolipoproteins C Fluvastatin Apolipoproteins A Triglycerides Aged Cholestyramine biology Cholesterol Anticholesteremic Agents Middle Aged Hydroxymethylglutaryl-CoA reductase Apolipoproteins chemistry biology.protein Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors medicine.drug Lipoprotein |
| Zdroj: | Metabolism. 44:1447-1454 |
| ISSN: | 0026-0495 |
| Popis: | In a double-blind, parallel-group, randomized study, the effects of fluvastatin (FLUV) 20 and 40 mg/d on lipoprotein particle levels were compared with those of cholestyramine (CME) 16 g/d. Lipoparticles were defined by apolipoprotein composition as either those containing both apolipoprotein (apo) B and apo E or CHI (lipoprotein [Lp] E-B or Lp CIII-B) or those containing apo Al alone (Lp AI) or in association with apo AII (Lp AI-AII). After an 8-week dietary stabilization period, 100 hypercholesterolemic patients were treated with FLUV 20 mg/d for 6 weeks and 40 mg/d for an additional 6 weeks and were compared with 48 hypercholesterolemic subjects treated with CME 16 g/d. Treatment with FLUV (40 mg/d) or CME (16 g/d) for 12 weeks was associated with a significant reduction in plasma cholesterol and low-density lipoprotein (LDL) cholesterol and a significant increase in high-density lipoprotein (HDL) cholesterol. However, plasma triglyceride levels decreased following FLUV treatment, whereas they increased with CME. These changes were associated with a significant reduction in the levels of apo B (FLUV, −24%, P < .001; CME, −26%, P < .001), apo E (FLUV, −36%, P < .001; CME, −32%, P < .001), and apo CIII (FLUV, −21%, P < .001; CME, −6%, NS). The decreased levels of apo E and apo CIII were mainly due to a decrease in the apo B-containing fraction as assessed by the decrease in apo E (FLUV, −40%, P < .001; CME, −24.4%, P < .001) and apo CIII (FLUV, −50%, P < .05; CME, −33%, NS) that coprecipitated with apo B-containing lipoproteins and by the decrease in plasma levels of Lp E-B (FLUV, −25.8%, P < .001; CME, 2.3%, NS) and Lp CIII-B (FLUV, −48.8%, P < .001; CME, −34.1%, P < .001). With regard to apo AI-containing particles, significant effects were observed. Treatment with FLUV or CME increased plasma levels of apo AI (FLUV, +4.7%, P < .001; CME, +8.7%, P < .001) and Lp AI (FLUV, +10%, P < .001; CME, +25.5%, P < .001) and decreased Lp AI-AII (FLUV, −5.7%, NS; CME, −11.5%, P < .05). FLUV or CME decreased apo E bound to HDL (−36.8%, P < .001, and −50%, P < .001, respectively). In summary, treatment with FLUV or CME was associated with beneficial changes in plasma lipid, lipoprotein, apolipoprotein, and lipoparticle levels. FLUV is more efficient in reducing levels of atherogenic apo B-containing particles, whereas CME has a greater effect in increasing the levels of Lp AI. |
| Databáze: | OpenAIRE |
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