[Changes in lipoproteins and hormones induced by diet and drugs in patients with polygenic hypercholesterolemia. Predictive value of the determination of low density lipoprotein receptor activity]

Abstract

To assess its hypolipidemic predictive value, maximally induced low density lipoprotein receptor activity was measured in vitro in peripheral blood lymphocytes from 20 polygenic hypercholesterolemic patients prior to their recruitment into a rigorous dietary and pharmacological treatment program. The subjects in the diet program demonstrated significant beneficial changes in plasma, LDL and HDL cholesterol concentrations. After 12 weeks, those patients who had not had reductions in LDL cholesterol to within the reference range had cholestyramine and/or bezafibrate supplements to the diet for a further 6 weeks. The beneficial trends continue. The initial LDL receptor values correlated well with pre-treatment LDL cholesterol and plasma cholesterol and apoprotein B concentrations, and with the percentage change induced by diet and by diet supplemented with bezafibrate and cholestyramine. During the trial the only significant variations in plasmatic hormones were observed in TSH and T3 concentrations, but always within the reference range. In polygenic hypercholesterolemic patients in whom LDL receptor activity is high, treatment with diet alone may be sufficient whereas those with low receptor activity would require specific pharmacological intervention.