Witztum J L, Dillingham M A, Giese W, Bateman J, Diekman C, Blaufuss E K, Weidman S, Schonfeld G
N Engl J Med. 1980 Oct 16;303(16):907-14. doi: 10.1056/NEJM198010163031603.
High-density-lipoprotein (HDL) cholesterol protects against coronary heart disease, and ways to raise low HDL values are being sought. Cross-sectional population surveys have shown that HDL cholesterol is inversely related to plasma triglycerides, yet to our knowledge no longitudinal studies have shown that a decrease in elevated triglycerides will raise depressed HDL levels. We therefore used dietary therapy to lower the triglyceride levels of 29 men with Type IV hyperlipoproteinemia and evaluated the effects on HDL-cholesterol levels. Despite a reduction in triglyceride levels from 697 +/- 90 to 333 +/- 37 mg per deciliter (P < 0.01), initially low HDL-cholesterol values did not change (29 +/- 1 to 30 +/- 1 mg per deciliter). Even in a subgroup of 12 men whose triglyceride levels fell to normal (from 670 +/- 99 to 170 +/- 7, P < 0.01) and whose weight and triglycerides remained stable for two years, HDL cholesterol remained unchanged (29 +/- 1 vs. 32 +/- 1). The persistently low HDL-cholesterol level in the presence of normalization of triglycerides suggests that depressed HDL cholesterol may be an independent metabolic abnormality in Type IV hyperlipoproteinemia.
高密度脂蛋白（HDL）胆固醇可预防冠心病，人们一直在寻找提高低HDL值的方法。横断面人群调查显示，HDL胆固醇与血浆甘油三酯呈负相关，但据我们所知，尚无纵向研究表明甘油三酯升高的降低会提高降低的HDL水平。因此，我们采用饮食疗法降低了29名IV型高脂蛋白血症男性的甘油三酯水平，并评估了其对HDL胆固醇水平的影响。尽管甘油三酯水平从每分升697±90毫克降至333±37毫克（P<0.01），但最初较低的HDL胆固醇值并未改变（从每分升29±1毫克升至30±1毫克）。即使在12名男性亚组中，其甘油三酯水平降至正常（从670±99降至170±7，P<0.01），体重和甘油三酯在两年内保持稳定，HDL胆固醇仍未改变（29±1对32±1）。甘油三酯正常化时HDL胆固醇水平持续较低，这表明HDL胆固醇降低可能是IV型高脂蛋白血症中一种独立的代谢异常。
