Gemfibrozil treatment potentiates oxidative resistance of high-density lipoprotein in hypertriglyceridemic patients

BACKGROUND

Studies suggest that both oxidized low and high density lipoprotein (LDL and HDL) play a role in the pathogenesis of atherosclerosis. Gemfibrozil is widely used and is reported to increase cholesterol of LDL and HDL in hypertriglyceridemic patients. The aim of this study was to investigate the effect of gemfibrozil treatment on the oxidative status of lipoprotein particles in Fredrickson phenotype IV hypertriglyceridemic patients.

METHODS

Twenty-two patients, aged 38-64 years, with fasting plasma triglyceride concentrations between 2.90 and 8.97 mmol L(-1), were recruited and were given gemfibrozil 300 mg three times daily for 12 weeks. Venous blood samples were collected before gemfibrozil treatment, after 4, 8, or 12 weeks of treatment, and 4 weeks after termination of treatment, and used to analyse the plasma lipid profile, isolate lipoproteins, and analyse the chemical composition and in vitro oxidation of lipoprotein particles.

RESULTS

Gemfibrozil treatment resulted in a decrease in plasma total triglyceride levels and the triglyceride content of all lipoproteins. Plasma total cholesterol levels were decreased as a result of a decrease in very low density lipoprotein (VLDL) cholesterol levels. A slight increase in LDL cholesterol levels was observed, whereas the thiobarbituric acid-reactive substances (TBARS) of LDL were decreased and the lag and peak time of LDL to oxidation were unchanged and maximal diene production was decreased. Plasma HDL cholesterol levels, the surface-to-core ratio of HDL particles, and the resistance of HDL to oxidation were increased.

CONCLUSION

The decreased TBARS and diene production of LDL, increased HDL cholesterol levels, and increased resistance of HDL to oxidation may, in part, explain why gemfibrozil treatment was found to be generally beneficial in terms of protection against coronary heart disease.

Age-related increased susceptibility of high-density lipoproteins (HDL) to in vitro oxidation induced by gamma-radiolysis of water

In the present study, we investigated the age-related susceptibility of high-density lipoproteins (HDL) to oxidation. HDL were obtained from healthy, normolipidemic young, middle-aged and elderly subjects. Oxidation of HDL was induced in vitro by oxygen free radicals generated by water gamma-radiolysis, and followed by the decrease of endogenous vitamin E and the formation of conjugated dienes and thiobarbituric acid-reactive substances, as well as the alterations of apolipoproteins A-I/A-II. The resistance of HDL to oxidation, evaluated by the length of the lag phase, decreased with aging. This increased oxidizability of HDL with aging could have a dramatic impact on the development of atherosclerosis in the elderly population.

alpha-tocopherol enrichment of high-density lipoproteins: stabilization of hydroperoxides produced during copper oxidation

In the aim to study the effect of an in vitro enrichment of high-density lipoprotein (HDL) with alpha-tocopherol in alcoholic solution on a copper-induced peroxidation, we monitored several markers of lipid peroxidation (alpha-tocopherol consumption, formation of conjugated dienes and of fatty acid hydroperoxides, production of thiobarbituric acid-reactive substances) and the integrity of apolipoprotein A-I. High-density lipoproteins (1.063 < d < 1.21) with a mean of 0.58 alpha-tocopherol molecules per HDL particle were enriched with alpha-tocopherol in alcoholic solution to obtain an average of 3.7 and 21 alpha-tocopherol molecules per HDL particle. HDL oxidation with 5 microM CuSO4 at 37 degrees C resulted in the total disappearance of endogenous alpha-tocopherol after 2 h, but after 24 h about 19% of alpha-tocopherol remained in the most enriched HDL. In agreement with the tocopherol-mediated peroxidation, the formation of conjugated dienes and of fatty acid hydroperoxides was very fast and increased with alpha-tocopherol concentration, whereas TBARS production decreased. These results showed that alpha-tocopherol enrichment stabilized the production of hydroperoxides in HDL and decreased the formation of secondary oxidation products. These latter products are known for deleterious effects towards apolipoproteins. This could explain why we observed that the apolipoprotein A-I of the most enriched HDL was only slightly altered after incubation with CuSO4.