O'Leary T J, Simo I E, Kanigsberg N, Walker J, Goodall J C, Ooi T C
Division of Endocrinology and Metabolism, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
Clin Invest Med. 1987 Jul;10(4):355-60.
Oral isotretinoin has been reported to increase serum total triglycerides (TG), cholesterol (TC), phospholipids (TPL), apoprotein B (apo B), and to reduce high-density lipoprotein cholesterol (HDL-C). To investigate the effects of isotretinoin on HDL, we measured HDL-C, HDL phospholipids (HDL-PL), apoprotein A1 (apo A-1), and HDL-C subfractions (HDL2-C and HDL3-C) in 24 healthy, male patients receiving a 16-week course of isotretinoin (1.0 mg/kg/day) for treatment of severe acne vulgaris. Patients were placed on a constant diet and fasting lipid parameters were measured every 4 weeks. Analysis of the data from the 20 patients who completed the study confirmed the reported increase in TG, TC, LDL-C, apo B, and LDL-C/HDL-C (all p less than 0.01) observed during isotretinoin therapy. Reduction occurred in HDL-C (p less than 0.05) and HDL2-C (p less than 0.01) while HDL3-C remained unchanged, indicating that the effect of isotretinoin is on the HDL2-C subfraction. Apo A-1 and HDL-PL did not change significantly, suggesting that the reduction in HDL-C represents cholesterol depletion of the HDL particle rather than a reduction in HDL mass. After discontinuing isotretinoin, serum lipid parameters returned to baseline levels.
据报道，口服异维甲酸会使血清总甘油三酯（TG）、胆固醇（TC）、磷脂（TPL）、载脂蛋白B（apo B）升高，并降低高密度脂蛋白胆固醇（HDL-C）。为了研究异维甲酸对HDL的影响，我们对24名健康男性患者进行了检测，这些患者正在接受为期16周的异维甲酸（1.0 mg/kg/天）治疗重度寻常痤疮。患者保持固定饮食，每4周测量一次空腹血脂参数。对完成研究的20名患者的数据进行分析，证实了在异维甲酸治疗期间观察到的TG、TC、低密度脂蛋白胆固醇（LDL-C）、apo B以及LDL-C/HDL-C升高（所有p值均小于0.01）。HDL-C（p值小于0.05）和HDL2-C（p值小于0.01）降低，而HDL3-C保持不变，这表明异维甲酸的作用靶点是HDL2-C亚组分。Apo A-1和HDL-PL没有显著变化，这表明HDL-C的降低代表HDL颗粒的胆固醇消耗，而非HDL质量的减少。停用异维甲酸后，血清脂质参数恢复到基线水平。
