Teramoto T, Yamada N, Shimano H, Oka Y, Itakura H, Saito Y, Morisaki N, Shirai K, Ishikawa T, Tada N, Ito H, Yamanouchi T, Matsushima T, Kawakami M, Murase T, Okubo M, Totsuka Y, Kikuchi M
First Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Scand J Clin Lab Invest. 1996 Jul;56(4):359-65. doi: 10.3109/00365519609090588.
Lipoprotein-a, Lp(a), is a variant form of low density lipoprotein (LDL) that contains apolipoprotein-a, whose structure has 75-85% homology with plasminogen. Elevated plasma levels of Lp(a) are considered to be one of the independent risk factors for cardiovascular disease. We studied the effects of niceritrol, a nicotinic acid derivative, on plasma Lp(a) levels in 72 patients with hypercholesterolaemia. The dose of niceritrol was increased every 4 weeks, from 750 to 1500 and then to 2250 mg day-1. The final dose was adjusted to obtain a plasma cholesterol level less than 5.69 mmol l-1. Niceritrol led to significant decreases in plasma levels of median Lp(a), from 16.1 mg dl-1 (interquartile intervals, 8.7 to 32.8) to 11.1 mg dl-1 (interquartile intervals, 6.6 to 21), the mean reduction rate being 17.6%. In the group with pretreatment Lp(a) levels of over 20 mg dl-1, Lp(a) decreased by 10.0, 22.0 and 31.8% at the doses of 750, 1500, and 2250 mg day-1, respectively. In the group with levels less than 20 mg dl-1, only the dose of 2250 mg day-1 was effective in the reduction of Lp(a). The results suggest that the reduction of Lp(a) was dependent on the dose of niceritrol and on the pretreatment level of Lp(a). In conclusion, niceritrol is effective, in a dose-dependent manner, for reducing Lp(a) levels.
脂蛋白A [Lp(a)]是低密度脂蛋白（LDL）的一种变体形式，它含有载脂蛋白A，其结构与纤溶酶原具有75 - 85%的同源性。血浆Lp(a)水平升高被认为是心血管疾病的独立危险因素之一。我们研究了烟酸衍生物尼可占替诺对72例高胆固醇血症患者血浆Lp(a)水平的影响。尼可占替诺的剂量每4周增加一次，从750毫克/天增加到1500毫克/天，然后增加到2250毫克/天。最终剂量根据血浆胆固醇水平低于5.69毫摩尔/升进行调整。尼可占替诺使血浆Lp(a)中位数水平显著降低，从16.1毫克/分升（四分位间距，8.7至32.8）降至11.1毫克/分升（四分位间距，6.6至21），平均降低率为17.6%。在预处理Lp(a)水平超过20毫克/分升的组中，在750、1500和2250毫克/天的剂量下，Lp(a)分别降低了10.0%、22.0%和31.8%。在水平低于20毫克/分升的组中，只有2250毫克/天的剂量对降低Lp(a)有效。结果表明，Lp(a)的降低取决于尼可占替诺的剂量和Lp(a)的预处理水平。总之，尼可占替诺以剂量依赖的方式有效降低Lp(a)水平。
