Effect of fluvastatin or bezafibrate on the distribution of high density lipoprotein subpopulations in patients with familial hypercholesterolemia

In eight patients with familial hypercholesterolemia the effects of two lipid reducing drugs on subpopulations of high density lipoproteins (HDL) were examined. After a 14-week period of diet and diet/placebo a 12-week therapy followed with either bezafibrate (CAS 41859-67-0) or fluvastatin (CAS 93957-55-2). Throughout both treatments a significant decrease of total and low density lipoprotein (LDL)-cholesterol, apolipoprotein B and triglycerides during both therapies were noted as well as an insignificant increase of HDL-cholesterol during bezafibrate. The nondenaturating gradient gel electrophoresis is a valid method for the investigation of the behaviour of HDL and was therefore chosen for this investigation. The individual HDL pattern and HDL diameters did not change in these subjects. The effect on the amounts of HDL 3b and HDL 3c was significantly more extensive during fluvastatin (+ 2.4% resp. + 2.9%) as compared to during bezafibrate therapy (+ 1.7% resp. + 2.9%). The changes noted in the HDL subclasses are probably due to a variable lipoprotein metabolism, for example increased activity of lipoprotein lipase, hepatic triglyceride lipase, lecithin-cholesterol acyltransferase and cholesterol ester transfer protein.