Effects of long-term, low-fat diet on plasma apo E in familial LCAT deficiency.
To study the metabolic abnormalities in familial lecithin-cholesterol acyltransferase (LCAT) deficiency, the effects of a long-term, low-fat diet and LCAT replacement therapy on plasma lipids and apolipoproteins were investigated in a patient with LCAT deficiency. The patient had elevated triglycerides (TG, 543.7 mg/dl) and phospholipids (PL, 350.3 mg/dl) and normal total cholesterol (TC, 206.9 mg/dl). Change to a low-fat diet reduced TC and TG by 20% and 75%, respectively. These reductions occurred mainly in the d < 1.006 fraction. At baseline, the patient had normal apolipoprotein B (apo B), low apolipoprotein A-I (apoA-I) and apolipoprotein A-II (apoA-II) and elevated apolipoprotein E (apo E). Long-term treatment with a low-fat diet increased plasma apoA-I and decreased apo E. However, urinary protein excretion did not change throughout the observed period. LCAT replacement with fresh frozen plasma (FFP) after the low-fat diet further reduced plasma apo E to the normal range. These results indicate that the elevated plasma apo E in LCAT deficiency was related not only to the lack of LCAT in the plasma, but also to fat intake. A low-fat diet may be effective in correcting lipid abnormalities. Moreover, plasma apo E may be a good indicator of the efficacy of diet therapy.
Homma
S
S
Department of Internal Medicine, Jichi Medical School, Tochigi, Japan.
Murayama
N
N
Kodama
T
T
Yamada
N
N
Takahashi
K
K
Asano
Y
Y
Hosoda
S
S
Murase
T
T
Akanuma
Y
Y
D001057:Apolipoproteins E / Q000032:analysis*; D004041:Dietary Fats / Q000008:administration & dosage*; D006801:Humans; D007863:Lecithin Cholesterol Acyltransferase Deficiency / Q000097:blood / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D007862:Phosphatidylcholine-Sterol O-Acyltransferase / Q000008:administration & dosage; D010949:Plasma
D001057:Apolipoproteins E; D004041:Dietary Fats; D007862:Phosphatidylcholine-Sterol O-Acyltransferase