Masamichi Fujiyama

Hypolipidemic effect of beraprost sodium in patients with arteriosclerosis obliterans accompanied by hyperlipidemia

Abstract The effect of beraprost sodium, a stable prostaglandin I 2 analog, on plasma lipids and apolipoproteins was examined in 18 patients with arteriosclerosis obliterans (Fontaine I) accompanied by hyperlipidemia. Twelve weeks of therapy with beraprost sodium at 120 μg daily significantly decreased plasma total cholesterol and low-density lipoprotein (LDL) cholesterol levels without a deleterious effect on plasma triglyceride, high-density lipoprotein (HDL) cholesterol, or apolipoprotein levels. A positive correlation was observed between the change in plasma total cholesterol and that in plasma LDL cholesterol due to the administration of beraprost sodium. Although this is a preliminary study, the results suggest beraprost sodium exerts an antiatherogenic effect. By lowering plasma total cholesterol and LDL cholesterol levels, beraprost sodium may prove to be important in the control of arteriosclerosis obliterans with hyperlipidemia.

Effect of clinofibrate, a new hypelipidemic agent, on biliary and serum lipids in patients with hyperlipidemia

Clinofibrate was given to 15 patients with hyperlipidemia, for 6-8 weeks at the daily dose of 600 mg, and its effect on 3 biliary lipid components (cholesterol, bile acids and phospholipids) and on the lithogenic index was investigated. After clinofibrate treatment, 6 of the patients were given 1.5 g/day clofibrate for 6-8 weeks to compare the effect of clofibrate with that of clinofibrate. The molar percentages of biliary cholesterol and phospholipids to the total mol number of the 3 biliary lipid components decreased, and that of bile acids increased during clinofibrate administration. In this way, the molar ratio of bile acids to cholesterol increased during the treatment. Neither the lithogenic index calculated by the formula of Admirand and Small nor that of Hegardt, Dam and Holzbach was altered significantly by the treatment. There was no apparent relationship between the effect of the drug on the lithogenic index and any of the factors initial lithogenic index, rate of decrease of serum lipids, or type of hyperlipidemia. Although clofibrate had no significant effect on the maximum solubility of cholesterol in the bile, the molar percentage of biliary cholesterol was elevated and the lithogenic index increased as compared with the control and clinofibrate period. No significant influence on bile acid composition in the bile was observed, with either clinofibrate or clofibrate.

Serum lipids and lipoproteins in patients with gallstone (relationship between serum lipids and types of stones in roentgenograms and sectional views)

SummarySerum lipids and lipoproteins of gallstone patients were analyzed and compared with lithogenesity of bile and type of stones by roentgenographic and cross-sectional views.Incidences of hypercholesterolemia and triglyceridemia were higher in patients with radiolucent gallstones than with radiopaque stones. Furthermore, an incidence of hypertriglyceridemia was higher in patients with radiolucent solitary stones than with radiolucent multiple stones. The degrees of hyperlipidemia were moderate.Lipoprotein disc electrophoresis of sera of hyperlipidemic patients revealed type IIa, IIb or IV. More solitary and less multiple stones were seen in the hyperlipoproteinemic patients than normolipoproteinemic. Multiple stones with normolipoproteinemia were more accompanied by unsaturated bile (lithogenic index <1.0) than those with hyperlipoproteinemia and solitary stones with hyperlipoproteinemia or without.Solitary stones obtained surgically from normolipoproteinemic patients were pure cholesterol, combination or mixed stones, while multiple stones not including pure cholesterol and combination stones with pure cholesterol in the center. Solitary stones in hyperlipoproteinemic patients proved mostly either pure cholesterol or combination stones with pure cholesterol in the center, while multiple stones containing all types of stones inclusive of a small number of other miscellaneous stones except cholesterol stones. Collectively more mixed and other miscellaneous stones except cholesterol stones, and less pure cholesterol and combination stones with pure cholesterol in the center were shown in normolipidemic patients, and vice versa in hyperlipoproteinemic patients.These results suggested serum lipids and lipoproteins being closely related to the initial precipitation, aggregation of cholesterol crystals and development of cholesterol gallstones through lipid metabolism of the whole body.