title: Evaluation of effects of unmodified niacin on fasting and postprandial plasma lipids in normolipidemic men with hypoalphalipoproteinemia.
abstract: OBJECTIVE
  The aim of this study was to define the effects of unmodified niacin on basal lipids and lipoproteins and on the plasma triglyceride response to a fatty meal--postprandial or alimentary lipemia--in individuals with low levels of high-density lipoprotein cholesterol (HDL-C) and normal fasting cholesterol and triglyceride concentrations (normolipidemic hypoalphalipoproteinemia, isolated low HDL-C).
  
  
  METHODS
  Twenty-eight normolipidemic men (total plasma cholesterol concentration [TC] < 230 mg/dL [< 6 mmol/L], plasma triglyceride [Tg] < 250 mg/dL [2.75 mmol/L]) with low plasma concentrations of HDL-C were randomly assigned to increasing doses of crystalline niacin (up to 3,000 mg/d) or no drug for 12 weeks, then crossed over to the alternate regimen. Outcome measures included changes in plasma lipoproteins and alimentary lipemia.
  
  
  RESULTS
  Fifteen participants completed the study. Mean baseline HDL-C +/- SD was 31.7 +/- 6.2 mg/dL (0.82 +/- 0.16 mmol/L). Mean baseline TC, plasma concentration of low-density lipoprotein cholesterol (LDL-C), and Tg were 192 +/- 29.4 mg/dL (4.97 +/- 0.76 mmol/L), 123 +/- 27 mg/dL (3.17 +/- 0.69 mmol/L), and 197 +/- 75 mg/dL (2.17 +/- 0.83 mmol/L), respectively. Unmodified niacin treatment resulted in significant (P < 0.001) reductions of 14% in TC (to 165 mg/dL, 4.26 mmol/L), 40% in Tg (to 119 mg/dL, 1.31 mmol/L), and 18% in LDL-C (to 101 mg/dL, 2.60 mmol/L) and significant increases of 30% in HDL-C (to 42 mg/dL, 1.07 mmol/L), 100% in HDL2 cholesterol (from 5 mg/dL to 9 mg/dL, 0.12 mmol/L to 0.24 mmol/L), and 21% in HDL3 cholesterol (from 27 mg/dL to 33 mg/dL, 0.70 mmol/L to 0.85 mmol/L). Unmodified niacin treatment reduced alimentary lipemia by 45% (P < 0.02).
  
  
  CONCLUSIONS
  Crystalline niacin effectively raises HDL-C, lowers LDL-C, and reduces alimentary lipemia in patients with isolated low HDL-C. However, many patients have difficulty tolerating the drug, and supervision may be required to sustain patient compliance and avoid toxicity.
authors.affiliation: Departments of Medicine, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1047.
authors.forename: J M
authors.initials: JM
authors.lastname: King
authors.forename: J R
authors.initials: JR
authors.lastname: Crouse
authors.forename: J G
authors.initials: JG
authors.lastname: Terry
authors.forename: T M
authors.initials: TM
authors.lastname: Morgan
authors.forename: B J
authors.initials: BJ
authors.lastname: Spray
authors.forename: N E
authors.initials: NE
authors.lastname: Miller
mesh_terms: D004041:Dietary Fats / Q000008:administration & dosage; D005215:Fasting; D015248:Gemfibrozil / Q000494:pharmacology; D006801:Humans; D007009:Hypolipoproteinemias / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood* / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000494:pharmacology* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D004041:Dietary Fats; D008055:Lipids; D008075:Lipoproteins, HDL; D014280:Triglycerides; D009525:Niacin; D015248:Gemfibrozil