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High density lipoproteins during hypolipidemic therapy. A comparative study of four drugs
Insights
Clofibrate increased HDL cholesterol and apolipoproteins A-I and A-II in hyperlipidemic subjects, while oxandrolone decreased them. Other agents had minimal effects on HDL levels.
Area of Science:
- Lipid metabolism and cardiovascular health
Background:
- Hyperlipidemia is a major risk factor for cardiovascular disease.
- High-density lipoprotein (HDL) cholesterol plays a protective role in cardiovascular health.
- Understanding the effects of hypolipidemic agents on HDL is crucial for managing hyperlipidemia.
Purpose of the Study:
- To investigate the impact of four different hypolipidemic agents on HDL cholesterol and its apolipoproteins (A-I and A-II) in hyperlipidemic subjects.
- To compare the efficacy of clofibrate, colestipol, para-amino salicylic acid--ascorbate (PAS-C), and oxandrolone on HDL parameters.
Main Methods:
- A serial measurement study involving 14 hyperlipidemic subjects.
- Subjects received four hypolipidemic agents (clofibrate, colestipol, PAS-C, oxandrolone) for 3 months each in a random sequence, with 2-month washout periods.
- Measurements included HDL cholesterol, apolipoprotein A-I, and apolipoprotein A-II levels before and during treatment.
Main Results:
- Clofibrate significantly increased HDL cholesterol (16%), apolipoprotein A-I (11%), and apolipoprotein A-II (39%).
- Oxandrolone significantly decreased HDL cholesterol (36%), apolipoprotein A-I (21%), and apolipoprotein A-II (16%).
- Para-amino salicylic acid--ascorbate (PAS-C) and colestipol showed minimal effects on HDL parameters, with a slight increase in the A-I/A-II ratio.
Conclusions:
- Clofibrate demonstrates a beneficial effect on HDL metabolism in hyperlipidemic individuals.
- Oxandrolone adversely affects HDL cholesterol and its apolipoproteins.
- PAS-C and colestipol are not effective in altering HDL parameters in this population.
Abstract:
The high density lipoprotein HDL) response of 14 hyperlipidemic subjects to four hypolipidemic agents was studied through serial measurement of HDL cholesterol and apolipoproteins A-I and A-II before and during 3 months each (separated by 2 months off drug) of clofibrate (2 g/day, n = 14), colestipol (20 g/day, n = 12), para-amino salicylic acid--ascorbate (PAS-C, 6--8 g/day, n = 14) taken in random sequence and oxandrolone (7.5 mg/day, n = 11) as the final drug. The maximal effect of each drug appeared by the first monthly evaluation, and A-1, A-II and HDL cholesterol levels returned to pretreatment levels by one month after discontinuation of each agent. With clofibrate, HDL cholesterol increased by 16 +/- 20% from baseline (mean +/- SD) (P less than 0.05), A-I by 11 +/- 13% (P less than 0.05) and A-II by 39 +/- 17% (P less than 0.01). During oxandrolone HDL cholesterol declined by 36 +/- 20% from baseline (P less than 0.01), A-I by 21 +/- 13% (P less than 0.01), and A-II by 16 +/- 11% (P less than 0.025). Neither PAS-C nor colestipol exerted major effects on HDL, or any of the variables although both were associated with a slight rise in the A-I/A-II ratio (11 +/- 15% and 12 +/- 12%, respectively).