Dyslipidemias with TG rich lipoprotein (TGRL) are regarded as powerful risk factors for atherosclerotic changes. PAGE is the usual method for detecting TGRL, especially remnant lipoprotein (RL).
The authors divided the shapes of LDL on a PAGE densitograph (Lipophor kit, Quantimetrix Co. CA, & Jokoh Co. Tokyo) into types S (symmetry), E (eminent), A (asymmetry), N (nodular) and D (disrupted) and propose the usefulness of this SEAND classification as a tool for the treatment of dyslipidemias at lipid clinics. Fenofibrate 150mg/day made a significant improvement in each lipoprotein component and changed PAGE patterns from D or N to A or S in most cases. LDL-migration index (LDL-MI), which is calculated as LDL peak distance from VLDL peak, is divided by HDL peak distance from VLDL peak, and which indicates LDL particle size, decreased (0.43-0.40) and LDL cholesterol/apoB, which also depicts LDL particle size, increased (1.03-1.20).
The effect of Fenofibrate was more potentiated in groups N and D than in S, E, A, significantly in the increment of HDL-cholesterol and decrement of apoB, C2, C3, E and LDL-MI, TG/apoB (1.86-1.25), TG/apoC2 (47.8-31.74), TG/apoC3 (17.69-13.14) and TG/apoE (40.31-27.64) which were thought to be important clinically noticeable markers for down sizing of the TGRL particle.
Levels of serum uric acid decreased in all cases which involved abnormally high levels.
In conclusion, this paper intended to clarify that for the evaluation of the effect of Fenofibrate on dyslipidemias, it would be useful to adopt the PAGE pattern classification and select cases with N, D and A as suitable indications.