3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and hepatic apolipoprotein B secretion

Important advances in our understanding of the regulation of hepatic apolipoprotein B secretion have been made in the past year. A diverse group of studies have provided evidence that the inhibition of cholesterol synthesis by 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors decreases the hepatic assembly and secretion of apolipoprotein B-containing lipoproteins. Apolipoprotein B kinetic studies performed in animals and human individuals indicate that inhibition of VLDL-apolipoprotein Ef secretion is an important mechanism whereby reductase inhibitors decrease plasma concentrations of these lipoproteins. Studies in cultured hepatocytes and in-vivo animal models have provided insights into how reduction of cholesterol synthesis decreases apolipoprotein Ef secretion. A decrease in hepatic acyl-coenzyme A:cholesterol acyltransferase activity, secondary to reduced microsomal cholesterol concentrations, has been implicated.