[Modification of pathologic fatty acid patterns in old age by combined clofibrinic and nicotinic acid treatment]

71 patients (42 men and 29 women, aged between 45 and 76) with primary hyperlipoproteinaemia (HLP) types IIa, IIb and IV, were treated with clofibric acid (Regadrin) and nicotinic acid derivatives (Radecol, Jupol) over a three-year period. Every four months, they underwent gas chromatographic analyses of the fatty acid spectrum (fa) in the fractions of cholesterol ester (Chol.E) and triglyceride (TGL) of the serum. The therapy resulted in an increase in the linoleic, linolenic, arachidonic, and eicosapentaenoic acids, and a fall in the palmitic, palmitoleic, stearic, oleic and eicosatrienic acid levels in the Chol.E fraction in the case of HLP types IIa and IIb, and in the TGL fraction in the case of HLP types IIb and IV. Selective competitive inhibition by unesterified fatty acids, blocked lipolysis, an impaired hepatogenic fatty-acid metabolism, an affected LCAT and an increased esterification of polyunsaturated fatty acids are discussed as possible mechanisms. The increase in polyunsaturated fatty acids and the decrease of saturated and monounsaturated fatty acids must be considered, as they are interrelated with the prostaglandin metabolism, to be a positive and vasoprotective effect which assumes special importance in middle and older age.