Ikewaki Katsunori, Noma Kenji, Tohyama Jun-Ichiro, Kido Toshimi, Mochizuki Seibu
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Int J Cardiol. 2005 Jun 8;101(3):441-7. doi: 10.1016/j.ijcard.2004.03.071.
Hypertriglyceridemia is often associated with elevated remnants, small dense LDL and decreased HDL-cholesterol (C). The objective of this study was to investigate the efficacy of bezafibrate on lipoprotein subfractions profile and inflammation markers in patients with hypertriglyceridemia.
Twenty-four hypertriglyceridemic subjects took bezafibrate, 400 mg daily, for 4 weeks. Lipoprotein subclasses were measured by nuclear magnetic resonance (NMR) spectroscopy. Inflammation markers including C-reactive protein (CRP), interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) were also determined.
Bezafibrate lowered triglyceride (TG) by 59% and increased HDL-C by 20%. NMR analysis revealed that bezafibrate lowered large TG-rich lipoproteins and IDL by 81% and 46%, respectively. Small LDL was selectively decreased by 53% with increase in large to intermediate LDL, thus altering the LDL distribution towards the larger particles (mean diameter 19.9 to 20.7 nm, p = 0.0001). Small (HDL1) and intermediate (HDL3) HDL significantly increased by 168% and 70%, whereby resulting in a significant reduction of the mean HDL particle size from 9.0 to 8.7 nm (p = 0.026). None of inflammation makers showed significant change by bezafibrate.
Bezafibrate effectively ameliorates atherogenic dyslipidemia by reducing remnants and small LDL as well as by increasing HDL particles in hypertriglyceridemic subjects.
高甘油三酯血症常与残余颗粒升高、小而密低密度脂蛋白以及高密度脂蛋白胆固醇（HDL-C）降低有关。本研究的目的是探讨苯扎贝特对高甘油三酯血症患者脂蛋白亚组分谱和炎症标志物的疗效。
24名高甘油三酯血症患者每日服用400mg苯扎贝特，持续4周。通过核磁共振（NMR）光谱法测量脂蛋白亚类。还测定了包括C反应蛋白（CRP）、白细胞介素-6（IL-6）和单核细胞趋化蛋白-1（MCP-1）在内的炎症标志物。
苯扎贝特使甘油三酯（TG）降低59%，HDL-C升高20%。NMR分析显示，苯扎贝特使富含大量TG的脂蛋白和中间密度脂蛋白（IDL）分别降低81%和46%。小LDL选择性降低53%，同时大LDL至中间LDL增加，从而使LDL分布向较大颗粒改变（平均直径从19.9nm至20.7nm，p=0.0001）。小（HDL1）和中（HDL3）HDL显著增加168%和70%，从而使平均HDL颗粒大小从9.0nm显著减小至8.7nm（p=0.026）。苯扎贝特对炎症标志物均未显示出显著变化。
苯扎贝特通过减少残余颗粒和小LDL以及增加高甘油三酯血症患者的HDL颗粒，有效改善动脉粥样硬化性血脂异常。
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