Comparison of clofibrate and caloric restriction on kinetics of very low density lipoprotein triglycerides.
This study of 12 patients with mild-to-moderate hypertriglyceridemia compares the mechanisms of triglyceride (TG) lowering by caloric restriction and by clofibrate. Turnover rates of very low density lipoprotein triglycerides (VLDL-TG) were determined by using 3H-glycerol as a precursor. Radioactivity-time curves of VLDL-TG were analyzed with a multicompartmental model. Hypertriglyceridemia in these patients was due mainly to overproduction of VLDL-TG. Clofibrate therapy for 1 month had a variable effect on VLDL-TG levels. A group of relatively poor responders to the drug had a mild increase in the fractional catabolic rate (FCR) of VLDL-TG, but no change in production rates. The remaining patients were relatively good responders; they had increased FCR and modest reductions in synthetic rates of VLDL-TG. However, clofibrate largely failed to correct the primary defect in this group of patients, namely, the overproduction of VLDL-TG. Almost all patients responded to 1 month of caloric restriction (1000 cal/day) with marked reductions in VLDL-TG levels. The major response to reduced caloric intake was a decrease in production of VLDL-TG, although FCR was also increased to some extent. Despite these differences in mechanisms for VLDL-TG lowering, both regimens tended to raise levels of LDL and HDL.
D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002994:Clofibrate / Q000494:pharmacology*; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007700:Kinetics; D008079:Lipoproteins, VLDL / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000096:biosynthesis* / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008079:Lipoproteins, VLDL; D014280:Triglycerides; D002994:Clofibrate