Division of Cardiology , Tufts Medical Center and Tufts University School of Medicine, 800 Washington Street, Box 315, Boston, MA 02111 USA.
J Clin Lipidol. 2009 Feb;3(1):45-50. doi: 10.1016/j.jacl.2008.12.003. Epub 2008 Dec 13.
The importance of the number of circulating low-density lipoprotein (LDL) cholesterol particles, in addition to total LDL level, has been increasingly recognized. The effects of extended-release niacin (ERN) on LDL particle numbers have not been studied.
To evaluate ERN's effects on LDL particle numbers.
Fifty-four patients with stable coronary artery disease (CAD) and well-controlled LDL levels were randomly assigned to 3 months of ERN (1 g/day) or placebo in addition to their baseline medications. Lipoprotein particle number was analyzed by proton nuclear magnetic resonance spectroscopy at baseline and after 3 months.
Compared to baseline, the addition of ERN had no significant effect on total LDL cholesterol levels; however, ERN decreased the number of medium and small LDL particles (P < .005). After 3 months, ERN decreased the number of medium and small LDL particles compared to placebo-treated patients (P < .05). ERN raised HDL cholesterol levels by 2.7%, significantly increased the number of large HDL particles (P < .001), and decreased the number of small HDL particles (P = .027) compared to placebo. There were no significant changes in lipid values or particle numbers in the placebo-treated patients. In patients with stable coronary artery disease and well-controlled LDL cholesterol levels, ERN reduced the number of circulating particles of the more atherogenic subtypes of LDL, despite having no effect on total LDL cholesterol levels. ERN also favorably altered the number of HDL particles.
ERN-induced alterations in lipoprotein particle numbers may contribute to its anti-atherosclerotic effects, and these effects may not be evident from the standard lipid profile.
除了总 LDL 水平外，循环中低密度脂蛋白（LDL）胆固醇颗粒的数量也越来越受到重视。尚未研究过烟酸持续释放制剂（ERN）对 LDL 颗粒数的影响。
评估 ERN 对 LDL 颗粒数的影响。
54 例稳定性冠心病（CAD）且 LDL 水平得到良好控制的患者在基线治疗药物的基础上，随机分为 ERN（1 g/天）组或安慰剂组，治疗 3 个月。采用质子磁共振波谱分析方法在基线和 3 个月时分析脂蛋白颗粒数。
与基线相比，ERN 加用对总 LDL 胆固醇水平没有显著影响；但ERN 降低了中、小 LDL 颗粒数（P <.005）。与安慰剂组相比，ERN 组在 3 个月时降低了中、小 LDL 颗粒数（P <.05）。ERN 组使 HDL 胆固醇水平升高 2.7%，显著增加了大 HDL 颗粒数（P <.001），并降低了小 HDL 颗粒数（P =.027），而安慰剂组的血脂值和颗粒数没有显著变化。在 LDL 胆固醇水平得到良好控制的稳定性 CAD 患者中，ERN 降低了循环中更具致动脉粥样硬化作用的 LDL 亚类的颗粒数，尽管对总 LDL 胆固醇水平没有影响。ERN 还可有利地改变 HDL 颗粒数。
ERN 引起的脂蛋白颗粒数变化可能有助于其抗动脉粥样硬化作用，而这些作用可能无法从标准血脂谱中体现。
