Tilly-Kiesi M, Tikkanen M J
Third Department of Medicine, University of Helsinki, Finland.
J Lab Clin Med. 1992 Jul;120(1):103-10.
The effects of gemfibrozil and lovastatin treatment on composition and hydrated density distribution of high-density lipoprotein (HDL) were studied in 21 patients with heterozygous familial hypercholesterolemia with the use of HDL density gradient ultracentrifugation. At baseline the patients with familial hypercholesterolemia had a markedly reduced or missing HDL2 subfraction and their HDL3 was more dense with reduced content of cholesteryl ester and increased content of triglyceride compared with HDL of control subjects with normal lipid values. Gemfibrozil and lovastatin caused primarily similar alterations in HDL components in HDL2 and HDL3 subfractions. Both agents increased apolipoprotein AI and apolipoprotein AII concentrations significantly in HDL2, whereas the apolipoprotein changes in HDL3 were relatively smaller. The difference between the effects of these two agents was related to the HDL lipid composition. Gemfibrozil increased the cholesterol concentrations of HDL2 and HDL3 (p less than 0.05 for both), and lovastatin caused significant increases in HDL2 (p less than 0.05) and HDL3 phospholipids (p less than 0.01). The observed similarity of qualitative alterations in HDL subfractions produced by these two agents in patients with familial hypercholesterolemia differs from those reported in other types of hyperlipidemia and is probably a consequence of the basic abnormalities in HDL that are characteristic of familial hypercholesterolemia.
采用高密度脂蛋白（HDL）密度梯度超速离心法，对21例杂合子家族性高胆固醇血症患者进行研究，以探讨吉非贝齐和洛伐他汀治疗对HDL组成及水合密度分布的影响。基线时，家族性高胆固醇血症患者的HDL2亚组分明显减少或缺失，与血脂正常的对照受试者的HDL相比，其HDL3密度更高，胆固醇酯含量降低，甘油三酯含量增加。吉非贝齐和洛伐他汀对HDL2和HDL3亚组分中的HDL成分产生的改变基本相似。两种药物均使HDL2中的载脂蛋白AI和载脂蛋白AII浓度显著升高，而HDL3中的载脂蛋白变化相对较小。这两种药物作用效果的差异与HDL的脂质组成有关。吉非贝齐使HDL2和HDL3的胆固醇浓度升高（两者均P<0.05），洛伐他汀使HDL2（P<0.05）和HDL3磷脂显著升高（P<0.01）。在家族性高胆固醇血症患者中，这两种药物对HDL亚组分产生的定性改变具有相似性，这与其他类型高脂血症中报道的情况不同，这可能是家族性高胆固醇血症所特有的HDL基本异常的结果。
