Bezafibrate therapy in patients with isolated low high-density lipoprotein cholesterol levels may have a beneficial effect in prevention of atherosclerosis.
Although a low plasma high-density lipoprotein cholesterol (HDL-C) level is a well-accepted risk factor for coronary artery disease (CAD), it is unclear whether pharmacologic agents can effectively increase HDL-C levels and/or reduce the incidence of CAD in patients with isolated low HDL-C levels. An important determinant of HDL levels is the efficiency of postprandial lipoprotein catabolism. The purpose of the present study was to evaluate the efficacy of bezafibrate therapy in increasing HDL-C levels in these patients and to examine its effect on postprandial lipoprotein levels. Fasting and postprandial lipid and lipoprotein levels were studied in 23 patients with isolated low HDL-C levels before and during 3 and 6 months of bezafibrate treatment. Postprandial lipoprotein levels were evaluated using the vitamin A-fat loading test, in which these intestinally derived lipoproteins are specifically labeled with retinyl palmitate (RP). Patients with isolated low HDL had significantly higher levels of chylomicron RP than a control group of 19 normolipidemic subjects. The area below the chylomicron RP curve was 17,773 +/- 6,821 versus 13,936 +/- 6,217 micrograms/L.h, respectively (P < .005). No differences were found in chylomicron remnant levels between the groups. Bezafibrate therapy reduced the chylomicron RP area by 27%, from 17,773 +/- 6,821 to 12,895 +/- 2,576, and the nonchylomicron RP area by 25%, from 6,059 +/- 3,310 to 4,430 +/- 1,963 (P < .0001). It increased fasting HDL-C levels from 35 +/- 3 to 38 +/- 1.4 mg/dL after 3 months (P < .001) and to 40 +/- 2.2 mg/dL after 6 months (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D001629:Bezafibrate / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood*; D002914:Chylomicrons / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood / Q000517:prevention & control*; D003327:Coronary Disease / Q000097:blood; D004224:Diterpenes; D004435:Eating / Q000502:physiology; D005215:Fasting / Q000502:physiology; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007009:Hypolipoproteinemias / Q000097:blood / Q000188:drug therapy*; D008074:Lipoproteins / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000084562:Retinyl Esters; D014280:Triglycerides / Q000097:blood / Q000378:metabolism; D014801:Vitamin A / Q000031:analogs & derivatives / Q000378:metabolism / Q000494:pharmacology
D008076:Cholesterol, HDL; D002914:Chylomicrons; D004224:Diterpenes; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D000084562:Retinyl Esters; D014280:Triglycerides; D014801:Vitamin A; C014794:retinol palmitate; D001629:Bezafibrate