Vega G L, Grundy S M
JAMA. 1985 Apr 26;253(16):2398-403.
Certain primary hypertriglyceridemias cause abnormalities in lipoproteins that seemingly predispose patients to coronary heart disease. We examined metabolism of low-density lipoproteins (LDL) in 11 men with both hypertriglyceridemia and coronary heart disease and compared them with that of controls. The LDL turnover was measured during placebo and gemfibrozil therapy. With placebo, LDL-cholesterol level usually was normal, but production and fractional clearance of LDL were high. The LDL composition also was abnormal. Gemfibrozil reduced triglycerides, lowered production and fractional clearance of LDL, and normalized LDL composition. The LDL-cholesterol level usually rose, but generally not to abnormally high levels. Therefore, normalization of LDL metabolism and marked reduction of triglycerides by gemfibrozil suggest benefit to hypertriglyceridemic patients who are at high risk for coronary heart disease. However, when LDL-cholesterol level rises excessively, gemfibrozil may not be sufficient therapy.
某些原发性高甘油三酯血症会导致脂蛋白异常，这似乎使患者易患冠心病。我们研究了11名患有高甘油三酯血症和冠心病的男性的低密度脂蛋白（LDL）代谢情况，并将其与对照组进行比较。在安慰剂和吉非贝齐治疗期间测量LDL周转率。使用安慰剂时，LDL胆固醇水平通常正常，但LDL的生成和分数清除率较高。LDL的组成也异常。吉非贝齐降低了甘油三酯，降低了LDL的生成和分数清除率，并使LDL组成正常化。LDL胆固醇水平通常会升高，但一般不会升至异常高水平。因此，吉非贝齐使LDL代谢正常化并显著降低甘油三酯，这表明对处于冠心病高风险的高甘油三酯血症患者有益。然而，当LDL胆固醇水平过度升高时，吉非贝齐可能不是足够的治疗方法。
