This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Parhofer, K. G. Articles by Schwandt, P. Search for Related Content PubMed PubMed Citation Articles by Parhofer, K. G. Articles by Schwandt, P. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB ATORVASTATIN CHOLESTEROL HEPTANOIC ACID PYRROLE Medline Plus Health Information Statins

Atorvastatin Improves Postprandial Lipoprotein Metabolism in Normolipidemic Subjects¹

Department of Internal Medicine II, Klinikum Grosshadern, Ludwig-Maximilians University (K.G.P., P.S.), 81377 Munich, Germany; and Department of Medicine, University of Western Australia (P.H.R.B.), Perth, Western Australia 6000

Address correspondence and requests for reprints to: Klaus G. Parhofer, M.D., Medical Department II, Klinikum Grosshadern, Marchioninistr. 15, 81377 Munich, Germany. E-mail: parhofer{at}med2.med

Atorvastatin is a potent HMG-CoA reductase inhibitor that decreases low-density lipoprotein (LDL) cholesterol and fasting triglyceride concentrations. Because of the positive association between elevated postprandial lipoproteins and atherosclerosis, we investigated the effect of atorvastatin on postprandial lipoprotein metabolism. The effect of 4 weeks of atorvastatin therapy (10 mg/day) was evaluated in 10 normolipidemic men (30 ± 2 yr; body mass index, 22 ± 3 kg/m²; cholesterol, 4.84 ± 0.54 mmol/L; triglyceride, 1.47 ± 0.50 mmol/L; high-density lipoprotein cholesterol, 1.17 ± 0.18 mmol/L; LDL-cholesterol, 3.00 ± 0.49 mmol/L). Postprandial lipoprotein metabolism was evaluated with a standardized fat load (1300 kcal, 87% fat, 7% carbohydrates, 6% protein, 80,000 IU vitamin A) given after 12 h fast. Plasma was obtained every 2 h for 14 h. A chylomicron (CM) and a chylomicron-remnant (CR) fraction was isolated by ultracentrifugation, and triglycerides, cholesterol, apolipoprotein B, apoB-48, and retinyl-palmitate were determined in plasma and in each lipoprotein fraction. Atorvastatin therapy significantly (P < 0.001) decreased fasting cholesterol (-28%), triglycerides (-30%), LDL- cholesterol (-41%), and apolipoprotein B (-39%), whereas high-density lipoprotein cholesterol increased (4%, not significant). The area under the curve for plasma triglycerides (-27%) and CR triglycerides (-40%), cholesterol (-49%), and apoB-48 (-43%) decreased significantly (P < 0.05), whereas CR retinyl-palmitate decreased (-34%) with borderline significance (P = 0.08). However, none of the CM parameters changed with atorvastatin therapy. This indicates that, in addition to improving fasting lipoprotein concentrations, atorvastatin improves postprandial lipoprotein metabolism presumably by increasing CR clearance or by decreasing the conversion of CMs to CRs, thus increasing the direct removal of CMs from plasma.

This article has been cited by other articles:

				M. Miller, C. P. Cannon, S. A. Murphy, J. Qin, K. K. Ray, E. Braunwald, and for the PROVE IT-TIMI 22 Investigators Impact of Triglyceride Levels Beyond Low-Density Lipoprotein Cholesterol After Acute Coronary Syndrome in the PROVE IT-TIMI 22 Trial. J. Am. Coll. Cardiol., February 19, 2008; 51(7): 724 - 730. [Abstract] [Full Text] [PDF]

				A. Pocathikorn, R. R. Taylor, I. James, and C. D. S. Mamotte LDL-Receptor mRNA Expression in Men Is Downregulated within an Hour of an Acute Fat Load and Is Influenced by Genetic Polymorphism J. Nutr., September 1, 2007; 137(9): 2062 - 2067. [Abstract] [Full Text] [PDF]

				S. Bansal, J. E. Buring, N. Rifai, S. Mora, F. M. Sacks, and P. M Ridker Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women JAMA, July 18, 2007; 298(3): 309 - 316. [Abstract] [Full Text] [PDF]

				A. J. Hooper, K. Robertson, P. H. R. Barrett, K. G. Parhofer, F. M. van Bockxmeer, and J. R. Burnett Postprandial Lipoprotein Metabolism in Familial Hypobetalipoproteinemia J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1474 - 1478. [Abstract] [Full Text] [PDF]

				K. G. Parhofer and P. H. R. Barrett Thematic review series: Patient-Oriented Research. What we have learned about VLDL and LDL metabolism from human kinetics studies J. Lipid Res., August 1, 2006; 47(8): 1620 - 1630. [Abstract] [Full Text] [PDF]

				M. Castro Cabezas, C. Verseyden, S. Meijssen, H. Jansen, and D. W. Erkelens Effects of Atorvastatin on the Clearance of Triglyceride-Rich Lipoproteins in Familial Combined Hyperlipidemia J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 5972 - 5980. [Abstract] [Full Text] [PDF]

				C. Verseyden, S. Meijssen, H. van Dijk, H. Jansen, and M. C. Cabezas Effects of atorvastatin on fasting and postprandial complement component 3 response in familial combined hyperlipidemia J. Lipid Res., November 1, 2003; 44(11): 2100 - 2108. [Abstract] [Full Text] [PDF]

				K. G. Parhofer, E. Laubach, and P. H. R. Barrett Effect of atorvastatin on postprandial lipoprotein metabolism in hypertriglyceridemic patients J. Lipid Res., June 1, 2003; 44(6): 1192 - 1198. [Abstract] [Full Text] [PDF]

				M. Guerin, P. Egger, W. Le Goff, C. Soudant, R. Dupuis, and M. J. Chapman Atorvastatin Reduces Postprandial Accumulation and Cholesteryl Ester Transfer Protein-Mediated Remodeling of Triglyceride-Rich Lipoprotein Subspecies in Type IIB Hyperlipidemia J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 4991 - 5000. [Abstract] [Full Text] [PDF]

				D. C. Chan, G. F. Watts, P. H. R. Barrett, I. J. Martins, A. P. James, J. C. L. Mamo, T. A. Mori, and T. G. Redgrave Effect of atorvastatin on chylomicron remnant metabolism in visceral obesity: a study employing a new stable isotope breath test J. Lipid Res., May 1, 2002; 43(5): 706 - 712. [Abstract] [Full Text] [PDF]

				D. T. Stein, S. Devaraj, D. Balis, B. Adams-Huet, and I. Jialal Effect of Statin Therapy on Remnant Lipoprotein Cholesterol Levels in Patients With Combined Hyperlipidemia Arterioscler Thromb Vasc Biol, December 1, 2001; 21(12): 2026 - 2031. [Abstract] [Full Text] [PDF]