1979 Volume 6 Issue 4 Pages 567-579
A variety of drugs is currently in use for treatment of the various forms of hyperlipoproteinemia (HLP) with the ultimate purpose of preventing and regressing atherosclerosis. In man, clofibrate, nicotinic acid, metformin, colestipol resin and propranolol have been reported to affect the lipoprotein patterns and compositions. The purpose of the present study was to investigate the effects of oxandrolone (OX) on plasma lipids and lipoprotein compositions in patients with type IIa, IIb and IV HLP. Subjects were three males and nineteen females. Their mean age was 63 years, ranging from 30 to 78 years old. They had been admitted in the hospital and had constant diet. Types of HLP were defined according to the WHO recommendation and criteria of Lipid Research Clinics Program. The patients had been selected on the basis of elevation of low-density-lipoprotedin cholesterol (LDL-Ch) above 150mg/100ml and/or plasma triglyceride (plasma-TG) above 160mg/100ml which were decided according to our data of lipid values in healthy men and women. (i) A patient with type IIa HLP was characterized by predominant increase in LDL-Ch and normal plasma-TG. (ii) A patient with type IIb HLP was characterized by increase both in LDL-Ch and plasma-TG. (iii) A patient with type IV HLP was characterized by predominant increase in plasma-TG and normal LDL-Ch. (iv) A patient with type III HLP was excluded by patterns of agarose gel electrophoresis and chemical indices which were calculated by cholesterol and triglyceride values in lipoprotein fractions. Oxandrolone, 4mg/day was given for 28 days. Blood was obtained from patients who had been fasted for more than 14 hours before and after treatment with oxandrolone. Plasma lipoproteins were fractionated by sequential ultracentrifugation at densities 1.006 and 1.063g/ml in a Type 40.3 rotor on the Beckman L5-50 ultracentrifuge. Ch and TG concentrations of very low density lipoprotein (VLDL), LDL and high density lipoprotein (HDL) fractions were determined. Ch and TG were measured according to the methods of Zlatkis A. and Zak B. and Fletcher M. J., respectively. Apolipoprotein B (Apo B) concentrations in plasma and three major lipoprotein classes were determined according to the method of Curry M. D. et al based on the electroimmunoassay of Laurell.
In patients with type ha HLP, plasma-Ch decreased significantly. LDL-Ch, HDL-Ch and VLDL-Ch showed a tendency to decrease, while LDL-Ch/HDL-Ch ratio increased. In patients with type IIb HLP, plasma TG, VLDL-TG and VLDL-Ch decreased significantly. There were no significant changes in plasma-Ch, LDL-Ch, HDL-Ch and LDL-Ch/HDL-Ch ratio, whereas LDL-TG and HDL-TG tended to decrease. In patients with type IV HLP, reduction of plasma-TG, VLDL-TG and HDL-TG were significant. VLDL-Ch was significantly reduced and reciprocal elevation of LDL-Ch was observed. HDL-CH was significantly lowered. Consequently, LDL-CH/HDL-Ch ratio was significantly elevated.
There was a positive correlation between the changes in LDL-Ch and the pretreatment VLDL-TG so that higher pretreatment VLDL-TG levels responded with an increase of LDL-Ch and lower pretreatment VLDL-TG responded with a decrease of LDL-Ch. This regression predicts that, when pretreatment VLDL-TG is greater than 138mg/100ml, treatment with oxandrolone will cause an increase in LDL. There was the inverse correlation between the changes in LDL-Ch and the pretreatment LDL-Ch. Subjects with higher pretreatment LDL-Ch concentrations manifested a decrease of LDL-Ch and vice versa. This regression predicts that when LDL-Ch is above 154mg/100ml, a decrease in LDL will be induced by treatment with OX. When LDL starts at lower levels, an increase of LDL will occur. In patients with type IV HLP, significant reduction of plasma-Apo B and VLDL-Apo B and inverse LDL-Apo B increment was observed after treatment.
Ehnholm C. et al reported that OX increases the activities of postheparin plasma hepatic lipase. It is sugg
