Gemfibrozil decreases autoantibodies against oxidized low-density lipoprotein in men with combined hyperlipidaemia

Area of Science:

• Cardiovascular Medicine
• Lipid Metabolism
• Pharmacology

Background:

• Gemfibrozil is a widely prescribed fibric acid derivative for managing combined hyperlipidaemia.
• It demonstrates efficacy in preventing coronary heart disease (CHD), but its precise mechanisms remain under investigation.
• Understanding gemfibrozil's effects on low-density lipoprotein (LDL) oxidation is crucial for patients at high risk of atherosclerosis.

Purpose of the Study:

• To investigate the impact of gemfibrozil on LDL size and oxidation parameters in male patients with moderate combined hyperlipidaemia.
• To assess gemfibrozil's influence on triglyceride levels, LDL oxidation markers, and LDL particle characteristics.

Main Methods:

• An open-label study involving 23 male patients with combined hyperlipidaemia and established or familial CHD.
• Participants received gemfibrozil at a dosage of 2 x 600 mg daily for 12 weeks.
• Evaluated outcomes included changes in triglyceride (TG) levels, autoantibodies to oxidized LDL, LDL pattern, and resistance to oxidative modification.

Main Results:

• Gemfibrozil significantly reduced plasma triglyceride (TG) concentrations (P < 0.001).
• LDL pattern B, indicative of smaller, denser LDL particles, was prevalent and did not change with treatment.
• A slight but significant decrease in LDL oxidation resistance (lagtime) was observed (P = 0.01), alongside a significant reduction in autoantibodies against oxidized LDL (P < 0.01), indicating reduced in vivo LDL oxidation.

Conclusions:

• The findings suggest that gemfibrozil's cardioprotective effects may be partly attributed to a reduced rate of LDL oxidation in vivo.
• Gemfibrozil effectively lowers triglycerides and modulates LDL oxidation markers in high-risk patients.