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Effects on Metabolism of Low-Density Lipoproteins

Gloria Lena Vega, PhD; Scott M. Grundy, MD, PhD

JAMA. 1985;253(16):2398-2403.

Abstract
Certain primary hypertriglyceridemias cause abnormalities in lipoproteins that seemingly predispose patients to coronary heart disease. We examined metabolism of low-density lipoproteins (LDL) in 11 men with both hypertriglyceridemia and coronary heart disease and compared them with that of controls. The LDL turnover was measured during placebo and gemfibrozil therapy. With placebo, LDL-cholesterol level usually was normal, but production and fractional clearance of LDL were high. The LDL composition also was abnormal. Gemfibrozil reduced triglycerides, lowered production and fractional clearance of LDL, and normalized LDL composition. The LDL-cholesterol level usually rose, but generally not to abnormally high levels. Therefore, normalization of LDL metabolism and marked reduction of triglycerides by gemfibrozil suggest benefit to hypertriglyceridemic patients who are at high risk for coronary heart disease. However, when LDL-cholesterol level rises excessively, gemfibrozil may not be sufficient therapy.

(JAMA 1985;253:2398-2403)

Author Affiliations
From the Center for Human Nutrition (Drs Vega and Grundy) and the Departments of Internal Medicine (Dr Grundy) and Biochemistry (Drs Vega and Grundy), University of Texas Health Science Center, Dallas.

Footnotes
Reprint requests to Center for Human Nutrition, University of Texas Health Science Center, 5323 Harry Hines Blvd, Room G4-100, Dallas, TX 75235 (Dr Grundy).

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