Effects of Nicotinic Acid on Concentrations of Serum Apolipoproteins B, C‐I, C‐II, C‐III and E in Hyperlipidemic Patients

Abstract

Abstract. Twenty‐four patients with Type IIa, IIb, III and IV hyperlipoproteinemia (HLP) were treated with 4 g of nicotinic acid daily with the purpose to study its effect on serum apolipoprotein B, C‐I, C‐II, C‐III and E concentrations. Triglyceride and total cholesterol concentrations of whole serum and of different serum lipoprotein fractions were also determined. Analyses were performed prior to and after a drug treatment period of 6 weeks, during which all the patients were weight stable. Treatment caused a decrease in serum concentrations of apolipoproteins C‐I, C‐II, C‐III and E. These highly significant reductions were all positively correlated to a reduction of very low density lipoprotein triglyceride levels of serum (r‐values >0.76, p<0.001). There were highly significant decreases in serum levels of apolipoprotein B and low density lipoprotein total cholesterol. These reductions were positively intercorrelated (r=0.55; p<0.01). Similar effects were observed in the different HLP types and in both sexes. Treatment resulted in normolipidemia in 12 patients, who were hypercholesterolemic (7 type IIa, 3 type IIb, 2 type III hyperlipoproteinemia) prior to treatment. The serum apolipoprotein B concentrations of these 12 patients fell after therapy to values which, however, remained abnormally high. We suggest that serum lipid adjusting treatment should aim at a normalization not only of serum lipid concentrations but also of the serum apolipoprotein B concentration in order to achieve a maximal antiatherogenic effect.

Apolipoprotein C-III: understanding an emerging cardiovascular risk factor

“…Pioglitazone was shown to significantly decrease apoC-III concentrations by reducing its production rate [100]. The mechanism whereby [33,97] ↓ 36% ↓ 20-50% ↓ 5-20% ↑ 10-20% Thiazolidinediones [100] ↓ 20% ↓ 16-30% ↑ 0-8% ↑ 14-15% Ezetimibe [112] ↓ 21% ↓ 6-11% ↓ 12-14% ↑ 1-5% Niacin [119] ↓ 31 % * ↓ 20-50% ↓ 5-25% ↑ 15-35% Fish oil [113,114] ↓0-5% ↓ 25-44% ↓ 5-25% ↑ 0-8% Weight loss [123] ↓ 9%…”

“…In addition, niacin has been shown to reduce VLDL-apoC-III concentrations in subjects with hyperlipidaemia [119]. Niacin activates the Gprotein-coupled nicotinic acid receptor [120] and inhibits diacylglycerol acyltransferase 2, the key enzyme in triacylglycerols synthesis [121] and hormone-sensitive triacylglycerol lipase, a lipolytic enzyme [122].…”

An ABC of apolipoprotein C-III: a clinically useful new cardiovascular risk factor?

“…Nicotinic acid (or niacin) and cholesterol absorption inhibitor (ezetimibe) have also been shown to reduce VLDL‐apoC‐III concentrations in hyperlipidaemic subjects (87,88). Niacin activates the G protein‐coupled nicotinic acid receptor, and inhibits diacylglycerol acyltransferase 2, the key enzyme in triglycerides synthesis and hormone sensitive triglyceride lipase, a lipolytic enzyme (89,90).…”

The Apolipoprotein C-I Content of Very-Low-Density Lipoproteins Is Associated with Fasting Triglycerides, Postprandial Lipemia, and Carotid Atherosclerosis

“…Total plasma levels of apoC-I are increased in patients with hypertriglyceridemia [13, 14] and decreased in patients with Tangier's disease [15]. During postprandial elevation of triglyceride-rich lipoproteins (TRLs), apoC-I is transferred from HDL to VLDL (Svedberg flotation (Sf) 20–400) [16] without affecting total plasma levels of apoC-I [17].…”