title: Impact of bezafibrate and atorvastatin on lipoprotein subclass in patients with type III hyperlipoproteinemia: result from a crossover study.
abstract: BACKGROUND
  We elucidated the difference between the effects of bezafibrate and atorvastatin in hypertriglyceridemia with apoE2/2 and 3/3.
  
  
  METHODS
  An open randomized crossover study consisted of a 4-week treatment period with bezafibrate (400 mg daily) or atorvastatin (10 mg daily) and a 4-week wash-out period.
  
  
  RESULTS
  Bezafibrate significantly decreased serum concentrations of triglyceride (apoE2/2, E3/3: -49.2%, -39.0%) and significantly increased high-density lipoprotein (HDL) cholesterol (+28.5%, +26.1%) in both apoE phenotypes but did not change serum concentrations of low-density lipoprotein (LDL) cholesterol. Atorvastatin significantly decreased serum concentrations of LDL cholesterol (-34.0%, -30.0%) and triglyceride (-27.6%, -25.8%) in both apoE phenotypes but did not change HDL cholesterol concentrations. Changes in cholesterol in lipoprotein subfractions were not different between apoE2/2 and E3/3. Bezafibrate changed cholesterol distribution from small- to large-sized LDL and from large- to small-sized HDL. On the other hand, atorvastatin decreased cholesterol in all apoB-containing lipoprotein subfractions but did not change any of the HDL subfractions.
  
  
  CONCLUSIONS
  Bezafibrate and atorvastatin improve atherogenic dyslipidemia in considerably different ways. Extrapolating from the present data, we presume that the combination of these drugs may contribute to reduce LDL-C/HDL-C ratio effectively as well as lowering concentrations of serum triglyceride.
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, and Department of Internal Medicine, KKR Hokuriku Hospital, Kanazawa, Japan. mk@med.kanazawa-u.ac.jp
authors.forename: Masa-aki
authors.initials: MA
authors.lastname: Kawashiri
authors.forename: Junji
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nohara
authors.forename: Tohru
authors.initials: T
authors.lastname: Noguchi
authors.forename: Hayato
authors.initials: H
authors.lastname: Tada
authors.forename: Chiaki
authors.initials: C
authors.lastname: Nakanishi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Inazu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mabuchi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000368:Aged; D053329:Apolipoprotein E2 / Q000097:blood / Q000235:genetics; D053318:Apolipoprotein E3 / Q000097:blood / Q000235:genetics; D000069059:Atorvastatin; D001629:Bezafibrate / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002851:Chromatography, High Pressure Liquid; D018592:Cross-Over Studies; D005260:Female; D006538:Heptanoic Acids / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D006952:Hyperlipoproteinemia Type III / Q000097:blood* / Q000188:drug therapy / Q000235:genetics; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011758:Pyrroles / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D006538:Heptanoic Acids; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D011758:Pyrroles; D000069059:Atorvastatin; D001629:Bezafibrate