| Effect of combination nicotinic acid and gemfibrozil treatment on intermediate density lipoprotein, and subclasses of low density lipoprotein and high density lipoprotein in patients with combined hyperlipidemia. | |
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MedLine Citation:
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PMID: 19166694 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The goal of this study was to determine, using analytic ultracentrifugation, the effect of nicotinic acid alone or nicotinic acid added to gemfibrozil on lipoprotein subclass distribution, including intermediate-density lipoprotein (IDL; low-density to very low density flotation rate [S(f)] 12 to 20); low-density lipoprotein (LDL) subfractions LDL-I (S(f) 7 to 12), LDL-II (S(f) 5 to 7), LDL-III (S(f) 3 to 5), and LDL-IV (S(f) 0 to 3); and high-density lipoprotein (HDL) subfractions HDL(2) (high-density flotation rate 3.5 to 9.0) and HDL(3) (high-density flotation rate 0 to 3.5). Patients with combined hyperlipidemia were randomized to nicotinic acid (1,500 mg/day) plus placebo or nicotinic acid plus gemfibrozil (1,200 mg/d) for 12 weeks. Baseline characteristics were similar between the 2 groups, and mean LDL cholesterol (180 +/- 33 mg/dl) and triglycerides (310 +/- 126 mg/dl) were typical for patients with combined hyperlipidemia. Treatment with nicotinic acid resulted in a reduction in dense LDL (S(f) 5 to 7; p = 0.02), which was counterbalanced by an increase in buoyant LDL (S(f) 7 to 12; p = 0.03) that resulted in no significant LDL mass or LDL cholesterol change. IDL was reduced (p = 0.005) and HDL(2) increased by 143% (p = 0.004). The combination of nicotinic acid and gemfibrozil resulted in a further 17.8% reduction in apolipoprotein B (p = 0.06), a further 33.8% reduction in IDL (p = 0.06), and a greater reduction in the apolipoprotein B/apolipoprotein A-I ratio (p = 0.02). The combination of nicotinic acid and gemfibrozil reduced atherogenic by IDL 71%, dense LDL-III by 52%, and apolipoprotein B by 37% and increased protective HDL(2) by 90%. In conclusion, this investigation revealed that a combination of a fibric acid derivative and nicotinic acid offers greater improvement in detailed lipoprotein subclass distribution and apolipoprotein ratios than monotherapy. |
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Authors:
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H Robert Superko; Brenda C Garrett; Spencer B King; Kathryn M Momary; Nicolas A Chronos; Peter D Wood |
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Publication Detail:
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Type: Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2008-11-27 |
Journal Detail:
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Title: The American journal of cardiology Volume: 103 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-26 Completed Date: 2009-02-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 387-92 Citation Subset: AIM; IM |
Affiliation:
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Saint Joseph's Translational Research Institute, Atlanta, GA, USA. rsuperko@sjha.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Antilipemic Agents / administration & dosage* Apolipoproteins / blood Double-Blind Method Drug Therapy, Combination Female Gemfibrozil / administration & dosage* Humans Hyperlipidemia, Familial Combined / blood, drug therapy* Lipoproteins / blood* Lipoproteins, HDL / blood Lipoproteins, IDL / blood Lipoproteins, LDL / blood Male Middle Aged Niacin / administration & dosage* Triglycerides / blood Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Apolipoproteins; 0/Lipoproteins; 0/Lipoproteins, HDL; 0/Lipoproteins, IDL; 0/Lipoproteins, LDL; 0/Triglycerides; 25812-30-0/Gemfibrozil; 59-67-6/Niacin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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