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April 1, 1987Journal of Clinical InvestigationOpen Access

Different patterns of postprandial lipoprotein metabolism in normal, type IIa, type III, and type IV hyperlipoproteinemic individuals. Effects of treatment with cholestyramine and gemfibrozil.

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Why the study?

How do postprandial lipoprotein metabolism patterns differ among normal and hyperlipoproteinemic individuals, and what are the effects of cholestyramine and gemfibrozil?

Population

Normal subjects and individuals with type IIa, type III, and type IV hyperlipoproteinemia.

Comparison

Vitamin A-fat loading test with retinyl… vs Normal subjects and pre-treatment baseline.

Design

Cohort

Follow-up

14 hours

Authors

MWMoshe WeintraubSES EisenbergJBJ L Breslow

Discussion

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Overview

Distinct postprandial patterns by hyperlipoproteinemia type respond differentially to gemfibrozil versus cholestyramine; hypothesis-generating and should not yet change practice.

Key Points

  • To characterize postprandial exogenous fat metabolism across normal individuals and different types of hyperlipoproteinemia, and to assess the impact of cholestyramine and gemfibrozil treatments.
  • Administered an oral vitamin A-fat loading test utilizing retinyl palmitate (RP) to label intestinally derived lipoproteins.
  • Tracked postprandial RP concentrations over >14 hours in total plasma, chylomicron (Sf > 1,000), and nonchylomicron (Sf < 1,000) fractions among normal subjects and patients with type IIa, type III, and type IV hyperlipoproteinemia.
  • Assessed postprandial lipemia modifications following gemfibrozil therapy in type IV patients and cholestyramine therapy in type IIa patients.
  • In normal subjects, postprandial lipoproteins persisted for >14 hours, with chylomicron levels inversely correlating with lipoprotein lipase activity and fasting HDL cholesterol, and nonchylomicron levels inversely correlating with hepatic triglyceride lipase activity.
  • Type IV patients exhibited a 5.6-fold increase in the chylomicron fraction, type III patients showed a 6.4-fold increase in nonchylomicrons, and type IIa patients showed abnormally low chylomicron fractions.
  • Gemfibrozil treatment decreased the chylomicron fraction by 66% in type IV patients, whereas cholestyramine increased the chylomicron fraction by 88% in type IIa patients.

Structured PICO

How do postprandial lipoprotein metabolism patterns differ among normal and hyperlipoproteinemic individuals, and what are the effects of cholestyramine and gemfibrozil?

P
Population
Normal subjects and individuals with type IIa, type III, and type IV hyperlipoproteinemia.
I
Intervention
Vitamin A-fat loading test with retinyl palmitate; treatment with cholestyramine (in type IIa patients) or gemfibrozil (in type IV patients).
C
Comparator
Normal subjects (for baseline comparisons) and pre-treatment baseline (for drug effects).
O
Outcome
Postprandial retinyl palmitate (RP) concentrations in total plasma, chylomicron (Sf > 1,000), and nonchylomicron (Sf < 1,000) fractions.surrogate

Postprandial lipemia has a large magnitude and long duration in both normal and hyperlipoproteinemic subjects, with distinct patterns across hyperlipoproteinemia types that are modifiable by lipid-lowering therapies.

Cite This Study

Weintraub et al. (1987) studied this question.

synapsesocial.com/papers/6a1bc063ea84844e355ee2a6https://doi.org/10.1172/jci112926
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparison of cholesteryl ester transfer from chylomicrons and other plasma lipoproteins to aortic intima media of cholesterol-fed rabbits.1982 · 48 citations
  2. 2SITES OF LIPOPROTEIN LIPASE ACTIVITY IN ADIPOSE TISSUE PERFUSED WITH CHYLOMICRONS1971 · 170 citations
  3. 3Lipoprotein Metabolism during Acute Inhibition of Hepatic Triglyceride Lipase in the Cynomolgus Monkey1982 · 262 citations
  4. 4The content of apolipoprotein B in chylomicron particles.1981 · 32 citations
  5. 5Effect of Gemfibrozil on Lipoprotein Concentrations in Different Types of Hyperlipoproteinæmia1976 · 26 citations