Effects of gemfibrozil or simvastatin on apolipoprotein-B-containing lipoproteins, apolipoprotein-CIII and lipoprotein(a) in familial combined hyperlipidaemia

Autor: A.F.H. Stalenhoef, H.C. Knipscheer, J.J.P. Kastelein, H. T. Westerveld, T.W.A. de Bruin, S.J.H. Bredie
Přispěvatelé: Faculteit der Geneeskunde, Other departments
Rok vydání: 1996
Předmět:
Adult
Male
medicine.medical_specialty
Very low-density lipoprotein
Simvastatin
biochemical
metabolic and hereditary aspects. [Familial combined hyperlipidemia (FCH)]

Apolipoprotein B
Hyperlipidemia
Familial Combined

chemistry.chemical_compound
Double-Blind Method
Internal medicine
biochemische
metabole en erfelijke aspecten. [Familiaire Gecombineerde Hyperlipidemie (FGH)]

Internal Medicine
medicine
Gemfibrozil
Humans
Lovastatin
cardiovascular diseases
Enzyme Inhibitors
Apolipoproteins C
GeneralLiterature_REFERENCE(e.g.
dictionaries
encyclopedias
glossaries)

Triglycerides
Apolipoproteins B
Hypolipidemic Agents
Apolipoprotein C-III
biology
Triglyceride
Cholesterol
business.industry
nutritional and metabolic diseases
Lipoprotein(a)
Middle Aged
Endocrinology
chemistry
biology.protein
Female
lipids (amino acids
peptides
and proteins)

sense organs
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
medicine.drug
Lipoprotein
Zdroj: The Netherlands Journal of Medicine, 49, 59-67. Van Zuiden Communications BV
Netherlands Journal of Medicine, 49, pp. 59-67
Netherlands Journal of Medicine, 49, 59-67
Netherlands journal of medicine, 49(2), 59-67. Van Zuiden Communications BV
ISSN: 0300-2977
Popis: Background: Familial combined hyperlipidaemia (FCH), characterized by elevated very-low-density lipoprotein (VLDL) and/or low-density lipoprotein (LDL), is associated with an increased prevalence of premature cardiovascular disease. Therefore, lipid-lowering is frequently indicated. Methods; We evaluated in a parallel, double-blind randomized fashion the effect of gemfibrozil (1200 mg/day) (n = 40) or simvastatin (20 mg/day) (n — 41) on lipids, apolipoprotein-B (apo-B)-containing lipoproteins, apo-CIII and lipoprotein(a) [Lp(a)], in 81 well-defined FCH patients. Results: While both drugs lowered plasma cholesterol and triglyceride levels, gemfibrozil lowered plasma triglycerides more effectively by reduction of triglycerides in VLDL and LDL, whereas simvastatin was more effective in its reduction of total plasma cholesterol by exclusively decreasing LDL cholesterol. High-density lipoprotein (HDL) increased to an equal extent on both therapies. Total serum apo-B levels were reduced with both drugs; however, gemfibrozil decreased apo-B only in VLDL + IDL, whereas simvastatin decreased apo-B in both VLDL -1- IDL and LDL. In keeping with a more effective reduction of VLDL particles, a more pronounced reduction of apo-CIII also was observed after gemfibrozil, which correlated with the reduction in plasma triglycerides. Baseline concentrations of Lp(a) showed a wide range in both treatment groups. Median Lp(a) levels increased after simvastatin, but were not affected by gemfibrozil. Conclusion: Both therapies exhibited their specific effects, although none of the drugs alone completely normalized the lipid profiles of these patients with FCH. Therefore, the choice of treatment should be based on the most elevated lipoprotein fraction, and in some cases a combination of the two drugs may be indicated.
Databáze: OpenAIRE