title: Comparative effects of gemfibrozil and clofibrate in type III hyperlipoproteinemia.
abstract: Type III hyperlipoproteinemia (dysbetalipoproteinemia) is characterized by elevated concentrations of plasma cholesterol and triglycerides due to an increase in very low density lipoprotein (VLDL) remnant lipoproteins. In a retrospective analysis we observed that in 12 patients with this disorder, gemfibrozil reduced concentrations of total cholesterol, VLDL cholesterol and triglycerides by 48%, 72% and 68%, respectively. These changes were greater than those reported in a similar number of patients treated with clofibrate. Comparative data on the efficacy of different fibrates in this disorder are very limited; to assess this further we have compared the hypolipidemic effects of gemfibrozil (600 mg twice daily) and clofibrate (1 g twice daily) in six patients with well-characterized type III hyperlipoproteinemia. Baseline values were obtained after at least 8 weeks on diet and treatment values were obtained after 6 and 8 weeks of treatment with each drug. Treatment with clofibrate and gemfibrozil both resulted in significant reductions in the plasma concentrations of total cholesterol (40% and 54%), VLDL cholesterol (59% and 79%) and total triglycerides (48% and 70%), as well as a significant increase in HDL cholesterol (9% and 7%). Gemfibrozil was, however, significantly (P < 0.05) more effective in reducing plasma concentrations of total cholesterol, VLDL cholesterol and triglycerides than was clofibrate, in the same patients.
authors.affiliation: Department of Medicine, Oregon Health Sciences University, Portland 97201-3098.
authors.forename: M L
authors.initials: ML
authors.lastname: Larsen
authors.forename: D R
authors.initials: DR
authors.lastname: Illingworth
authors.forename: J P
authors.initials: JP
authors.lastname: O'Malley
mesh_terms: D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D002994:Clofibrate / Q000627:therapeutic use*; D005260:Female; D015248:Gemfibrozil / Q000627:therapeutic use*; D006801:Humans; D006952:Hyperlipoproteinemia Type III / Q000097:blood / Q000188:drug therapy*; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D008079:Lipoproteins, VLDL; D014280:Triglycerides; D002784:Cholesterol; D002994:Clofibrate; D015248:Gemfibrozil