Reducing hyperlipidaemia.
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Biomedical subjects
Publications and source records attributed to E R Nye.
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Anthropometric data, plasma lipoprotein lipid levels, and post-heparin lipoprotein lipase (PHLPL) activity were measured in nine patients with type III hyperlipoproteinemia (HLP) and two hypocholesterolemic subjects with the apo-E2/2 phenotype. Five type III HLP patients were treated with clofibrate. Log PHLPL activity was inversely correlated (r = -0.667, p less than 0.05) and age was positively correlated (r = 0.706, p less than 0.05) with cholesterol levels in the VLDL fraction of plasma from type III HLP patients. The correlation between log PHLPL and VLDL cholesterol levels remained significant when age was held constant in partial correlation analysis. Together age and log PHLPL activity accounted for 77% of individual variation in VLDL cholesterol levels in the type III patients. Clofibrate treatment raised PHLPL activity (+48%, p less than 0.05) and reduced the levels of VLDL cholesterol (-67%, P less than 0.05), VLDL triglycerides (-40%, P less than 0.02), and the ratio cholesterol/triglyceride in VLDL (-50%, P less than 0.05) in five type III HLP patients. Mean PHLPL activity was higher in the hypocholesterolemic subjects with the apo-E2/2 phenotype compared to the type III HLP patients. These results suggest that lipoprotein lipase activity and factors associated with age modulate the levels of abnormal and atherogenic remnant particles (beta-VLDL) in the VLDL plasma fraction of type III HLP patients.
Thirty sedentary men aged 25-52 participated in a 4-month randomized and controlled study of the effects of exercise on plasma lipoproteins and faecal steroid excretion. After 4 months the aerobic training group showed a significant (P = 0.047) increase in physical work capacity (+38 watts) and a significant (P = 0.025) decrease in faecal total steroid excretion (-257 mg/day) compared to corresponding changes in the control group. The drop in faecal total steroid excretion in the men who trained was mainly due to a significant (P less than 0.05) fall in faecal neutral sterol excretion (-240 mg/day). Plasma lipoprotein lipid concentrations did not change significantly during the study although plasma levels of very low density lipoprotein (VLDL) cholesterol and low density lipoprotein (LDL) cholesterol tended to fall in the men who trained. In the aerobic training group individual changes in plasma LDL cholesterol levels were significantly correlated with decreases in faecal total steroid excretion (p = 0.615, P less than 0.05) and faecal neutral sterol excretion (p = 0.627, P less than 0.05). The results of this study show that regular exercise is associated with a drop in faecal neutral sterol excretion which, if sufficiently large, may be associated with a decrease in plasma LDL cholesterol concentration.
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Hyperchylomicronaemia and elevated very low density lipoproteins were found in relatively obese 47 year old identical twin brothers. Lipoprotein apoprotein studies showed the presence of apoprotein CII, the activator of lipoprotein lipase, and both men were homozygous E2/2. Studies on the ability of the brothers to clear triglyceride rich particles showed some impairment of post heparin lipase activity, and a slower clearance of infused fat emulsion. The values improved after weight loss. There was some evidence of impaired capacity of the patients' high density lipoprotein to activate post heparin lipoprotein lipase.
Plasma lipoprotein lipid levels including IDL cholesterol concentration, physical fitness parameters, and anthropometric data were measured in 10 men with primary hypertriglyceridemia during a 12 week program of moderate physical training. Reduced pulse rate at submaximal workload and increased work performed on the treadmill indicated that the men had increased their physical fitness during the training period. Body weight (-4.9%) and total skinfold thickness (-15.6%) fell during the training program. A characteristic fall (-23%) in plasma triglyceride levels was seen over the first 8 weeks training. Plasma IDL cholesterol concentration fell (-18%) after 2 weeks training but then rose after 8 weeks to levels which tended to be higher than baseline values. Our data suggest that regular physical exercise is more likely to raise levels of the "proatherogenic" IDL than to lower them in hypertriglyceridemic patients.
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This study has measured plasma lipoprotein lipid levels and the in vitro rate of cholesterol synthesis from [2(-14)C]acetate by mononuclear leukocytes in blood from normolipidemic subjects and two patients with Tangier disease. The rate of cholesterol synthesis in blood was related inversely to plasma levels of HDL cholesterol in the normolipidemic subjects. This relationship was mainly due to a similar correlation in the women. The rate of blood cholesterol synthesis was raised in a woman with Tangier disease, which is consistent with the above correlation, but not in a man with this disease. We suggest that this correlation reflects an association between plasma HDL cholesterol levels and whole-body sterol synthesis.
Plasma lipids and lipoprotein lipids, body characteristics, serum insulin concentration, distance run during training and haematological variables were determined in nine men aged between 62 and 72 years and who were regular runners. Multiple regression analysis showed that much of the variation in HDL cholesterol levels was explained by plasma triglycerides, and, to a lesser extent, by the distance run during training; although these variables contributed about equally to the variation in plasma HDL2 cholesterol levels. The effects on measured variables of a 2100 km relay, run over a 17-day period, were also studied. During the relay the men were running an average 20% further, per week, than during their training before the relay. Plasma LDL cholesterol concentration, red blood cell volume, red cell count and haemoglobin levels fell significantly during the relay, and in three men raised serum insulin levels were reduced to within the normal range. Reticulocyte counts were not raised after the relay which suggests that the anaemia, seen in these men, was not due to erythrocyte destruction. The results indicate that in elderly runner, plasma triglycerides are an important predictor of plasma HDL cholesterol levels.
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Thirty males with familial hypercholesterolaemia were divided on the basis of levels of high-density lipoprotein cholesterol into tertiles of high, middle and low values. Symptoms and signs were scored on an arbitrary system by three methods which either included or excluded angiographic findings. Symptomatic severity and clinical manifestations of hyperlipidaemia were related to high-density lipoprotein cholesterol levels irrespective of the effect of age, level of the blood pressure, or levels of other lipoproteins. The association was not improved by adding weightings drawn from coronary angiographic findings.
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Plasma post-heparin hepatic lipase (PHHL) activity, plasma lipids, and high density lipoprotein cholesterol (HDL-C) levels, pulse rate at submaximal workload, and body weight were measured in 12 men during the 18 weeks physical training for their first marathon run. Reduced pulse rate at submaximal workload indicated that the men increased their physical fitness during the training period. Plasma HDL-C levels (+27%) and PHHL activity (+29%) also increased significantly after 18 weeks training. These changes were not in accord with the inverse correlation between plasma HDL-C levels and PHHL activity which was observed before training. The results of this study do not support the concept that reduced PHHL activity is mainly responsible for increased levels of plasma HDL-C with training.
The present study examined fasting serum insulin levels in relation to body composition and dietary intake during the initial 4 weeks of a 12-week physical training programme in 26 previously sedentary men. Fasting serum insulin concentrations decreased markedly during the first 4 weeks of training and remained at these reduced levels for the rest of the study. The early fall in serum insulin concentration was significantly correlated with the concomitant decrease in body fat, the increase in lean body weight and the age of the subjects. Body weight and reported dietary intake on the other hand, did not change significantly over this period. These results indicate that the decrease in fasting serum insulin in previously sedentary men with physical training is associated with the concomitant changes in body composition. Increased muscle tissue in particular may contribute to this training-induced decrease in serum insulin.