Goldberg A P, Applebaum-Bowden D M, Bierman E L, Hazzard W R, Haas L B, Sherrard D J, Brunzell J D, Huttunen J K, Ehnholm C, Nikkila E A
N Engl J Med. 1979 Nov 15;301(20):1073-6. doi: 10.1056/NEJM197911153012001.
In 11 hypertriglyceridemic patients on hemodialysis, clofibrate (1 to 1.50 g per week) reduced plasma triglyceride (-40 +/- 20%, P less than 0.001), very-low-density-lipoprotein triglyceride (-44 +/- 20%, P less than 0.001) and very-low-density lipoprotein cholesterol (-39 +/- 25%, P less than 0.01), and it increased high-density-lipoprotein cholesterol (82 +/- 106%, P less than 0.005). Low pretreatment lipoprotein-lipase activity in adipose-tissue specimens and postheparin plasma increased to normal with clofibrate, whereas low hepatic triglyceride lipase activity did not change. The reduced very-low-density-lipoprotein triglyceride correlated with the increased lipoprotein-lipase activity in adipose tissue (rs = 0.792, P less than 0.02, n = 8) and postheparin plasma (rs = 0.851, P less than 0.02, n = 8), whereas increased high-density-lipoprotein cholesterol correlated with changes in this activity in adipose tissue (rs = 0.696, P less than 0.06) and post-heparin plasma (rs = 0.679, P less than 0.10). There was no correlation between changes in hepatic triglyceride lipase activity and plasma lipids during treatment. Reduced lipoprotein-lipase activity may cause hypertriglyceridemia and decreased high-density-lipoprotein cholesterol in patients on hemodialysis; clofibrate may correct these abnormalities by increasing lipoprotein-lipase activity to normal.
在11名接受血液透析的高甘油三酯血症患者中，氯贝丁酯（每周1至1.50克）可降低血浆甘油三酯（-40±20%，P<0.001）、极低密度脂蛋白甘油三酯（-44±20%，P<0.001）和极低密度脂蛋白胆固醇（-39±25%，P<0.01），并增加高密度脂蛋白胆固醇（82±106%，P<0.005）。氯贝丁酯可使脂肪组织标本和肝素后血浆中预处理时较低的脂蛋白脂肪酶活性恢复正常，而肝脏甘油三酯脂肪酶活性较低则无变化。极低密度脂蛋白甘油三酯的降低与脂肪组织（rs=0.792，P<0.02，n=8）和肝素后血浆（rs=0.851，P<0.02，n=8）中脂蛋白脂肪酶活性的增加相关，而高密度脂蛋白胆固醇的增加与脂肪组织（rs=0.696，P<0.06）和肝素后血浆（rs=0.679，P<0.10）中该活性的变化相关。治疗期间肝脏甘油三酯脂肪酶活性的变化与血脂之间无相关性。脂蛋白脂肪酶活性降低可能导致血液透析患者出现高甘油三酯血症和高密度脂蛋白胆固醇降低；氯贝丁酯可能通过将脂蛋白脂肪酶活性提高至正常水平来纠正这些异常情况。
