Marked removal of bezafibrate-induced high-density lipoprotein-cholesterol by low-density lipoprotein apheresis.
BACKGROUND
A case of marked reduction of the bezafibrate-induced increase of high-density lipoprotein (HDL)-cholesterol by low-density lipoprotein apheresis (LDL-apheresis) has not been previously reported.


METHODS
A 68-year-old Japanese man with arteriosclerosis obliterans (ASO), diabetes mellitus, and hyperlipidemia underwent LDL-apheresis, followed by the concomitant bezafibrate administration. Plasma lipids of pre- and post-LDL-apheresis were measured and apolipoprotein E (apoE) localization of the pre- and post-LDL-apheresis was detected by agarose gel electrophoresis.


RESULTS
Plasma concentrations of the total cholesterol, LDL-cholesterol, triglyceride, and HDL-cholesterol of pre-LDL-apheresis were 4.78 +/- 0.36, 2.74 +/- 0.24, 2.44 +/- 0.52, and 0.92 +/- 0.10 mmol/l, respectively; those of the post-LDL-apheresis were 1.94 +/- 0.31, 0.72 +/- 0.13, 0.81 +/- 0.38, and 0.86 +/- 0.11 mmol/l, respectively. LDL-apheresis reduced HDL-cholesterol by 6.4% (p=0.346). During the bezafibrate administration, plasma concentrations of the above of pre-LDL-apheresis were 5.24 +/- 0.34, 3.28 +/- 0.22, 1.26 +/- 0.25, and 1.39 +/- 0.21 mmol/l, respectively; those of the post-LDL-apheresis were 2.25 +/- 0.44, 0.80 +/- 0.12, 0.58 +/- 0.19, and 1.18 +/- 0.16 mmol/l, respectively. LDL-apheresis reduced HDL-cholesterol by 15.2% (p<0.01). Plasma apolipoprotein E detected between the prebeta- and alpha-mobility was markedly lower after the LDL-apheresis in the agarose gel electrophoresis.


CONCLUSIONS
The removal of the bezafibrate induced an increase of the HDL-cholesterol by LDL-apheresis.
Kawano
Mikihiko
M
Integrated Medicine, Omiya Medical Center, Jichi Medical School, Japan. mkkawano@jichi.ac.jp
Kuroda
Yutaka
Y
Terao
Motohiko
M
Yaginuma
Toshio
T
Kawakami
Masanobu
M
Kanazawa
Yasunori
Y
D000368:Aged; D001057:Apolipoproteins E / Q000097:blood; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000188:drug therapy; D001629:Bezafibrate / Q000627:therapeutic use*; D001781:Blood Component Removal / Q000009:adverse effects*; D008076:Cholesterol, HDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D004587:Electrophoresis, Agar Gel; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D008077:Lipoproteins, LDL; D001629:Bezafibrate