Increase in lipoprotein lipase during clofibrate treatment of hypertriglyceridemia in patients on hemodialysis

N Engl J Med. 1979 Nov 15;301(20):1073-6. doi: 10.1056/NEJM197911153012001.

Abstract

In 11 hypertriglyceridemic patients on hemodialysis, clofibrate (1 to 1.50 g per week) reduced plasma triglyceride (-40 +/- 20%, P less than 0.001), very-low-density-lipoprotein triglyceride (-44 +/- 20%, P less than 0.001) and very-low-density lipoprotein cholesterol (-39 +/- 25%, P less than 0.01), and it increased high-density-lipoprotein cholesterol (82 +/- 106%, P less than 0.005). Low pretreatment lipoprotein-lipase activity in adipose-tissue specimens and postheparin plasma increased to normal with clofibrate, whereas low hepatic triglyceride lipase activity did not change. The reduced very-low-density-lipoprotein triglyceride correlated with the increased lipoprotein-lipase activity in adipose tissue (rs = 0.792, P less than 0.02, n = 8) and postheparin plasma (rs = 0.851, P less than 0.02, n = 8), whereas increased high-density-lipoprotein cholesterol correlated with changes in this activity in adipose tissue (rs = 0.696, P less than 0.06) and post-heparin plasma (rs = 0.679, P less than 0.10). There was no correlation between changes in hepatic triglyceride lipase activity and plasma lipids during treatment. Reduced lipoprotein-lipase activity may cause hypertriglyceridemia and decreased high-density-lipoprotein cholesterol in patients on hemodialysis; clofibrate may correct these abnormalities by increasing lipoprotein-lipase activity to normal.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adipose Tissue / enzymology
  • Cholesterol / blood
  • Clofibrate / administration & dosage
  • Clofibrate / therapeutic use*
  • Drug Evaluation
  • Humans
  • Hyperlipidemias / drug therapy*
  • Hyperlipidemias / enzymology
  • Lipoprotein Lipase / blood
  • Lipoprotein Lipase / metabolism*
  • Lipoproteins, HDL / blood
  • Lipoproteins, VLDL / blood
  • Renal Dialysis*
  • Time Factors
  • Triglycerides / blood*

Substances

  • Lipoproteins, HDL
  • Lipoproteins, VLDL
  • Triglycerides
  • Cholesterol
  • Lipoprotein Lipase
  • Clofibrate