Document Detail


Extended-release niacin acutely suppresses postprandial triglyceridemia.
MedLine Citation:
PMID:  22840917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Postprandial triglyceridemia predicts cardiovascular events. Niacin might lower postprandial triglycerides by restricting free fatty acids. Immediate-release niacin reduced postprandial triglycerides, but extended-release niacin failed to do so when dosed the night before a fat challenge. The study aims were to determine whether extended-release niacin dosed before a fat challenge suppresses postprandial triglycerides and whether postprandial triglycerides are related to free fatty acid restriction.
METHODS: A double-blinded, placebo-controlled, random-order crossover experiment was performed, in which healthy volunteers took 2 g extended-release niacin or placebo 1 hour before heavy cream. We sampled blood over 12 hours and report triglycerides and free fatty acid as means ± standard deviation for incremental area under the curve (AUC) and nadir.
RESULTS: By combining 43 fat challenges from 22 subjects, postprandial triglycerides incremental AUC was +312 ± 200 mg/dL*h on placebo versus +199 ± 200 mg/dL*h on extended-release niacin (33% decrease, P=.02). The incremental nadir for free fatty acid was -0.07 ± 0.15 mmol/L on placebo versus -0.27 ± 0.13 mmol/L on extended-release niacin (P<.0001), and free fatty acid incremental AUC decreased from +2.9 ± 1.5 mmol/L*h to +1.5 ± 1.5 mmol/L*h on extended-release niacin (20% decrease, P=.0015). The incremental AUC for triglycerides was strongly related to the post-dose decrease in free fatty acid (r = +0.58, P=.0007).
CONCLUSIONS: Given right before a fat meal, even a single dose of extended-release niacin suppresses postprandial triglyceridemia. This establishes that postprandial triglycerides suppression is an acute pharmacodynamic effect of extended-release niacin, probably the result of marked free fatty acid restriction. Further study is warranted to determine whether mealtime dosing would augment the clinical efficacy of extended-release niacin therapy.
Authors:
M Haris U Usman; Arman Qamar; Ramprasad Gadi; Scott Lilly; Harsh Goel; Jaison Hampson; Megan L Mucksavage; Grace A Nathanson; Daniel J Rader; Richard L Dunbar
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-25
Journal Detail:
Title:  The American journal of medicine     Volume:  125     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-24     Completed Date:  2012-11-26     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1026-35     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
African Americans
Biological Markers / blood
Cross-Over Studies
Delayed-Action Preparations
Double-Blind Method
Fatty Acids, Nonesterified / blood
Humans
Hypertriglyceridemia / blood,  ethnology,  prevention & control*
Hypolipidemic Agents / therapeutic use*
Niacin / therapeutic use*
Postprandial Period*
ROC Curve
Regression Analysis
Treatment Outcome
Triglycerides / blood
Grant Support
ID/Acronym/Agency:
5-K12-RR-017625-05/RR/NCRR NIH HHS; K12 RR017625/RR/NCRR NIH HHS; K23 HL091130/HL/NHLBI NIH HHS; K23HL091130/HL/NHLBI NIH HHS; KL2 RR024132/RR/NCRR NIH HHS; P50-HL-083799/HL/NHLBI NIH HHS; RFA-HL-05-002/HL/NHLBI NIH HHS; UL1RR024134/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Delayed-Action Preparations; 0/Fatty Acids, Nonesterified; 0/Hypolipidemic Agents; 0/Triglycerides; 59-67-6/Niacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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