MODULATION OF CHYLOMICRON REMNANT METABOLISM BY AN HEPATIC HYDROXYMETHYLGLUTARYL COENZYME-A REDUCTASE INHIBITOR

This study was designed to test the hypothesis that in patients with elevated plasma low-density lipoprotein (LDL) apolipoprotein-apoB, chylomicron remnant clearance can be modulated by therapy with a hepatic hydroxymethyl glutaryl coenzyme A reductase inhibitor. Accordingly, chylomicron triglyceride and remnant clearance were determined following a vitamin-A fat load in 12 such patients, before and after therapy with Lovastatin (Merck, Sharp & Dohme, Rahway, NJ). Such therapy had no significant overall effect on plasma triglyceride clearance, although there was a trend to lower levels of Sf >400 triglycerides at the later time points. By contrast, retinol clearance in plasma and Sf >400 lipoproteins was markedly increased (30% and 40%, respectively). The data indicate, therefore, that following therapy with Lovastatin in this group of patients, chylomicron plasma remnant clearance was significantly enhanced. The exact mechanisms responsible remain to be explicated. © 1990.