Eisenberg S, Gavish D, Oschry Y, Fainaru M, Deckelbaum R J
J Clin Invest. 1984 Aug;74(2):470-82. doi: 10.1172/JCI111444.
The effects of triglyceridemia on plasma lipoproteins were investigated in 16 hypertriglyceridemic (HTG) subjects (222-2,500 mg/dl) before and after the initiation of bezafibrate therapy. Bezafibrate caused a mean reduction of 56% in plasma triglyceride and increased the levels of lipoprotein and hepatic triglyceride lipases by 260 and 213%, respectively. The natures of very low density lipoprotein (VLDL), isolated at plasma density and of low and high density lipoprotein (LDL and HDL), separated by zonal ultracentrifugation, were determined. HTG-LDL appears as multiple fractions whereas HTG-HDL is seen predominantly as HDL3. HTG-VLDL is relatively poor in apoproteins and triglycerides but enriched in free and esterified cholesterol. HTG-LDL (main fraction) is depleted of free and esterified cholesterol but enriched in apoprotein and triglyceride. It is also denser and smaller than normal. HTG-HDL3 is denser than N-HDL3 and demonstrates compositional abnormalities similar to those of HTG-LDL. With the reduction of the VLDL mass, all abnormalities revert towards normal. This is accompanied by an increase in LDL-apoprotein B and cholesterol levels, which indicates an increased conversion of VLDL to LDL. Significant correlations between plasma triglyceride and the degree of all abnormalities are shown. The data obtained during treatment corroborate these relationships. The observations support the concept that most abnormalities reflect the degree of triglyceridemia. We suggest that plasma core-lipid transfer protein(s) is an effector of the abnormal cholesteryl ester distribution. Its prolonged action on increasingly large and slowly metabolized VLDL populations would entail a correspondingly excessive transfer of cholesteryl ester to VLDL and of triglyceride to LDL and HDL. It is calculated that, in moderate HTG, LDL and HDL contain only 50% of the normal cholesterol load. It is suggested that cholesteryl ester redistribution in HTG might be important in regulating metabolic events.
在16名高甘油三酯血症（HTG）患者（甘油三酯水平为222 - 2500mg/dl）中，研究了甘油三酯血症对血浆脂蛋白的影响，研究时间为服用苯扎贝特治疗前后。苯扎贝特使血浆甘油三酯平均降低了56%，并使脂蛋白脂肪酶和肝甘油三酯脂肪酶水平分别升高了260%和213%。测定了在血浆密度下分离的极低密度脂蛋白（VLDL）以及通过区带超速离心分离的低密度脂蛋白（LDL）和高密度脂蛋白（HDL）的性质。HTG - LDL表现为多个组分，而HTG - HDL主要表现为HDL3。HTG - VLDL的载脂蛋白和甘油三酯相对较少，但游离胆固醇和酯化胆固醇含量较高。HTG - LDL（主要组分）的游离胆固醇和酯化胆固醇含量较低，但载脂蛋白和甘油三酯含量较高。它也比正常的LDL密度更大、颗粒更小。HTG - HDL3比正常HDL3密度更大，并且表现出与HTG - LDL类似的成分异常。随着VLDL质量的降低，所有异常均恢复正常。这伴随着LDL载脂蛋白B和胆固醇水平的升高，表明VLDL向LDL的转化增加。血浆甘油三酯与所有异常程度之间存在显著相关性。治疗期间获得的数据证实了这些关系。这些观察结果支持了这样一种观点，即大多数异常反映了甘油三酯血症的程度。我们认为血浆核心脂质转运蛋白是胆固醇酯异常分布的效应器。它对越来越大且代谢缓慢的VLDL群体的长期作用将导致胆固醇酯向VLDL的过度转移，以及甘油三酯向LDL和HDL的过度转移。据计算，在中度HTG中，LDL和HDL仅含有正常胆固醇负荷的50%。有人提出，HTG中胆固醇酯的重新分布可能在调节代谢事件中起重要作用。
