Impact of bezafibrate and atorvastatin on lipoprotein subclass in patients with type III hyperlipoproteinemia: Result from a crossover study

• Published in: Clinica chimica acta 2011-05, Vol.412 (11-12), p.1068-1075
• Main Authors: Kawashiri, Masa-aki, Kobayashi, Junji, Nohara, Atsushi, Noguchi, Tohru, Tada, Hayato, Nakanishi, Chiaki, Inazu, Akihiro, Mabuchi, Hiroshi, Yamagishi, Masakazu
• Format: Article
• Language: English
• Subjects: Aged; Apolipoprotein E; Apolipoprotein E2 - blood; Apolipoprotein E2 - genetics; Apolipoprotein E3 - blood; Apolipoprotein E3 - genetics; Atorvastatin; Atorvastatin Calcium; Bezafibrate; Bezafibrate - adverse effects; Bezafibrate - pharmacology; Bezafibrate - therapeutic use; Chromatography, High Pressure Liquid; Cross-Over Studies; Female; Heptanoic Acids - adverse effects; Heptanoic Acids - pharmacology; Heptanoic Acids - therapeutic use; Humans; Hyperlipoproteinemia Type III - blood; Hyperlipoproteinemia Type III - drug therapy; Hyperlipoproteinemia Type III - genetics; Hypolipidemic Agents - adverse effects; Hypolipidemic Agents - pharmacology; Hypolipidemic Agents - therapeutic use; Lipoprotein subclass; Lipoproteins - blood; Male; Middle Aged; Phenotype; Pyrroles - adverse effects; Pyrroles - pharmacology; Pyrroles - therapeutic use; Remnant lipoprotein; Type III hyperlipoproteinemia
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2011.02.026

We elucidated the difference between the effects of bezafibrate and atorvastatin in hypertriglyceridemia with apoE2/2 and 3/3. An open randomized crossover study consisted of a 4-week treatment period with bezafibrate (400mg daily) or atorvastatin (10mg daily) and a 4-week wash-out period. Bezafibrate significantly decreased serum concentrations of triglyceride (apoE2/2, E3/3: −49.2%, −39.0%) and significantly increased high-density lipoprotein (HDL) cholesterol (+28.5%, +26.1%) in both apoE phenotypes but did not change serum concentrations of low-density lipoprotein (LDL) cholesterol. Atorvastatin significantly decreased serum concentrations of LDL cholesterol (−34.0%, −30.0%) and triglyceride (−27.6%, −25.8%) in both apoE phenotypes but did not change HDL cholesterol concentrations. Changes in cholesterol in lipoprotein subfractions were not different between apoE2/2 and E3/3. Bezafibrate changed cholesterol distribution from small- to large-sized LDL and from large- to small-sized HDL. On the other hand, atorvastatin decreased cholesterol in all apoB-containing lipoprotein subfractions but did not change any of the HDL subfractions. Bezafibrate and atorvastatin improve atherogenic dyslipidemia in considerably different ways. Extrapolating from the present data, we presume that the combination of these drugs may contribute to reduce LDL-C/HDL-C ratio effectively as well as lowering concentrations of serum triglyceride.