295
Atherosclerosis, 33 (1979) 295-300 0 Elsevier/North-Holland Scientific
Publishers,
Ltd.
THE EFFECT OF CHOLESTYRAMINE ON LIPOPROTEIN LIPIDS IN PATIENTS WITH PRIMARY TYPE IIA HYPERLIPOPROTEINEMIA
P. WEISWEILER,
G. NEUREUTHER
and P. SCHWANDT
2nd Medical Clinic, Klinikum Grosshadern, 8000 Munich 70 (F. R.G.) (Received 1 December, 1978) (Revised, received 23 January, (Accepted 24 January, 1979)
University of Munich, Marchioninistrasse
15,
1979)
summary The effect of 3 months’ treatment with cholestyramine on lipoprotein lipids was investigated in 12 patients. VLDL, LDL and HDL were separated by preparative ultracentrifugation. There was a significant decrease of serum cholesterol and phospholipids and an increase of serum triglycerides. All the VLDL-lipids increased by nearly 30%. The LDL-lipids decreased with a tendency for normalisation of their atypical lipid composition. The small but significant alterations of HDL triglycerides and cholesterol are correlated with the corresponding alterations of the other lipoproteins; the HDL-phospholipids were unchanged. The LDL/HDL-lipid ratios were decreased but not normalised. The 30% decrease of LDLcholesterol is negatively correlated with an increase in all the VLDL-lipids. Key words:
Cholestyramine
- Hyperlipoproteinemia
type IIa -Lipoprotein
lipids
Introduction The anion exchange resin cholestyramine is an effective cholesterol-lowering agent which sometimes leads to an increase of triglycerides [l-lo]. There are some data about the influence of cholestyramine on lipoprotein lipids, but they are partially controversial [ 4,6,9,10]. We therefore investigated the changes of cholesterol, triglycerides and phospholipids in very low density (VLDL), low density (LDL) and high density lipoproteins (HDL) after 3 months’ treatment with cholestyramine in primary type IIa hyperlipoproteinemia.
296
Materials and Methods Twelve outpatients with primary type IIa hyperlipoproteinemia (5 males and 7 females, mean age 52 + 5 years) were studied. They had a constant weight several months before and during therapy (Broca index 91.4 f 6.8%). Patients were on a diet poor in cholesterol and rich in polyunsaturated fatty acids. They had not taken hypolipidemic drugs for at least two months. Lipoprotein analyses were performed when serum lipid concentrations were stable in at least two determinations (cholesterol !: lo%, triglycerides + 20%) within 4 weeks. After the first lipoprotein analysis cholestyramine was given in a daily dose of 12-16 g. The patients were seen every 4 weeks and a second lipoprotein analysis was performed after treatment for 3 months. Except for slight constipation in some cases the drug was well tolerated. Blood samples were taken in the morning after an overnight fast. The fractionation of serum lipoproteins by preparative ultracentrifugation at densities
Atherosclerosis, 33 (1979) 295-300 0 Elsevier/North-Holland Scientific
Publishers,
Ltd.
THE EFFECT OF CHOLESTYRAMINE ON LIPOPROTEIN LIPIDS IN PATIENTS WITH PRIMARY TYPE IIA HYPERLIPOPROTEINEMIA
P. WEISWEILER,
G. NEUREUTHER
and P. SCHWANDT
2nd Medical Clinic, Klinikum Grosshadern, 8000 Munich 70 (F. R.G.) (Received 1 December, 1978) (Revised, received 23 January, (Accepted 24 January, 1979)
University of Munich, Marchioninistrasse
15,
1979)
summary The effect of 3 months’ treatment with cholestyramine on lipoprotein lipids was investigated in 12 patients. VLDL, LDL and HDL were separated by preparative ultracentrifugation. There was a significant decrease of serum cholesterol and phospholipids and an increase of serum triglycerides. All the VLDL-lipids increased by nearly 30%. The LDL-lipids decreased with a tendency for normalisation of their atypical lipid composition. The small but significant alterations of HDL triglycerides and cholesterol are correlated with the corresponding alterations of the other lipoproteins; the HDL-phospholipids were unchanged. The LDL/HDL-lipid ratios were decreased but not normalised. The 30% decrease of LDLcholesterol is negatively correlated with an increase in all the VLDL-lipids. Key words:
Cholestyramine
- Hyperlipoproteinemia
type IIa -Lipoprotein
lipids
Introduction The anion exchange resin cholestyramine is an effective cholesterol-lowering agent which sometimes leads to an increase of triglycerides [l-lo]. There are some data about the influence of cholestyramine on lipoprotein lipids, but they are partially controversial [ 4,6,9,10]. We therefore investigated the changes of cholesterol, triglycerides and phospholipids in very low density (VLDL), low density (LDL) and high density lipoproteins (HDL) after 3 months’ treatment with cholestyramine in primary type IIa hyperlipoproteinemia.
296
Materials and Methods Twelve outpatients with primary type IIa hyperlipoproteinemia (5 males and 7 females, mean age 52 + 5 years) were studied. They had a constant weight several months before and during therapy (Broca index 91.4 f 6.8%). Patients were on a diet poor in cholesterol and rich in polyunsaturated fatty acids. They had not taken hypolipidemic drugs for at least two months. Lipoprotein analyses were performed when serum lipid concentrations were stable in at least two determinations (cholesterol !: lo%, triglycerides + 20%) within 4 weeks. After the first lipoprotein analysis cholestyramine was given in a daily dose of 12-16 g. The patients were seen every 4 weeks and a second lipoprotein analysis was performed after treatment for 3 months. Except for slight constipation in some cases the drug was well tolerated. Blood samples were taken in the morning after an overnight fast. The fractionation of serum lipoproteins by preparative ultracentrifugation at densities
