Gemfibrozil decreases autoantibodies against oxidized low-density lipoprotein in men with combined hyperlipidaemia.
OBJECTIVE
Gemfibrozil is the most widely used fibric acid for the management of combined hyperlipidaemia. It has beneficial effects in the prevention of coronary heart disease (CHD). The mechanisms by which it exerts this effect are not completely resolved. We studied whether gemfibrozil affects low-density lipoprotein (LDL) size and LDL oxidation parameters in males with a moderate combined hyperlipidaemia at high risk for progressive atherosclerosis.


METHODS
Open treatment with 2 x 600 mg gemfibrozil daily for 12 weeks.


METHODS
Outpatient lipid clinic of a tertiary referral centre.


METHODS
Twenty-three patients with combined hyperlipidaemia and CHD or a positive family history for both CHD and hyperlipidaemia.


METHODS
Effects on triglyceride (TG), autoantibodies to oxidized LDL, LDL pattern and resistance to oxidative modification.


RESULTS
During treatment with gemfibrozil, plasma TG concentration decreased from 2.83 +/- 0.85 to 2.02 +/- 0.89 mmol L-1 (P < 0.001). All but one patient were shown to have LDL pattern B. The LDL pattern did not change upon treatment with gemfibrozil. The resistance to oxidation, reflected in the lagtime during in-vitro oxidation slightly decreased from 105 +/- 22 to 99 +/- 18 min (P = 0.01). The concentration of autoantibodies against oxidized LDL indicates the rate of LDL oxidation in vivo. This concentration significantly decreased from 14.2 +/- 9.9 to 13.1 +/- 9.2 mg L-1 (P < 0.01).


CONCLUSIONS
The beneficial effect of gemfibrozil in reducing CHD may at least in part depend on a decrease of the rate of LDL oxidation in vivo.
Hoogerbrugge
N
N
University Hospital Dijkzigt, Rotterdam, The Netherlands.
Kerkhofs
L G
LG
Jansen
H
H
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D018450:Disease Progression; D015248:Gemfibrozil / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D015227:Lipid Peroxidation; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012306:Risk; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001323:Autoantibodies; D000960:Hypolipidemic Agents; D008055:Lipids; D008077:Lipoproteins, LDL; D015248:Gemfibrozil