抄録
Plasma lipids, lipoproteins and apolipoproteins (apo) were measured in 17 patients (4 males and 13 females) with nonfamilial type II hyperlipoproteinemia over a 6 month-period during treatment with eptastatin (10-30mg orally daily). Patients were classified into two groups; types IIa (n=7) and IIb (n=10). None had hypothyroidism, renal, gastrointestinal or liver diseases. Six were diabetic but their glycemic control had been good. At the entry of the study, type IIa had greater HDL-cholesterol (65±3 vs. 47±3mg/dl) and lower plasma triglyceride (TG) (98±6 vs. 277±38mg/dl) than type IIb, whereas no difference was found in total and LDL-cholesterol between the two. Eptastatin produced a 20%-decrease in total cholesterol even at 1 month which continued until 6 months after the initiation of treatment. These responses were the same in both types and were associated with a concomitant decrease in LDL-cholesterol (from 195±11mg/dl to 138±9 and 141±7mg/dl at 3 and 6 months, respectively). Apo B was decreased in type IIa while there was no significant changes in type IIb. HDL-cholesterol rose from 47±3 to 57±3mg/dl at 3 months in type IIb. This was associated with an elevation of apo A-I (from 137±5 to 157±7mg/dl) and apo A-II (from 34±2 to 40±3 mg/dl). In addition, eptastatin produced a 20%-decrease in plasma TG, followed by its further decrease (by 30%) at 6 months. They were accompanied by a reduction in apo C-II and C-III. HDL-cholesterol, however, returned to the pretreatment levels at 6 months. In contrast to type IIb, type IIa had no significant changes in HDL-cholesterol and plasma TG throughout the study. The drug was well tolerated in all patients and produced no abnormalities in serum chemistry screening and urine analysis. Eptastatin is useful in lowering plasma LDL-cholesterol without reducing HDL-cholesterol in nonfamilial type II hyperlipoproteinemia.
