Pronounced lowering of serum levels of lipoprotein Lp(a) in hyperlipidaemic subjects treated with nicotinic acid

Abstract

Thirty-one consecutive unselected hyperlipidaemic patients were treated daily with 4 g of nicotinic acid for 6 weeks. The concentrations in serum of lipoprotein Lp(a), and the major lipoprotein classes, were determined before and after the treatment. Nicotinic acid significantly reduced the serum levels of Lp(a) in the whole patient group. Linear regression analysis showed a strong negative relationship between the percentage reduction of Lp(a) and the serum triglyceride level before treatment (r = -0.78), which implied that for patients with a serum triglyceride concentration above 7.5 mmol l-1 there was a rise of Lp(a). The average individual percentage decrease of the concentration of Lp(a) was calculated after the exclusion of four patients who had serum triglyceride levels above 10 mmol l-1. The decrease was 38% with a 95% confidence interval of 28-47%. The absolute decrease of Lp(a) was correlated with the pretreatment levels of Lp(a) (r = 0.91). Within the whole group of patients there was a linear relationship between the percentage decrease of Lp(a) and that of LDL cholesterol (r = 0.88). This latter strong relationship might be due to an inhibition of the synthesis of the protein common to the two lipoproteins, apolipoprotein B.

Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes

“…In addition, the relatively small size of the population may also be a factor. With the exception of nicotinic acid [27], no hypolipidaemic agent has as yet been proven to consistently modify circulating Lp(a) levels. Similarly, anti-hypertensive treatment, such as beta-blockers which are known to modify plasma lipid levels, was more frequent in the CHD + group.…”

Glucocorticoid Therapy Decreases Serum Lipoprotein(a) Concentration in Rheumatic Diseases.

“…Stanazolol decreases both Lp(a) and HDLcholesterol levels, but does not change the apolipoprotein B level in plasma (13). Nicotinic acid treatments combined with and without neomycin decrease serum Lp(a) and LDLcholesterol concentrations in patients with hyperlipidemia (14,15). While N-acetylcysteine, a disulphide bond-reducing agent, reduces the serum levels of Lp(a), it was shown to increase the LDL cholesterol level in 2 patients with hyperlipidemia (16).…”

“…Lp(a) is not affected by most cholesterol-lowering drugs (9,12), however, stanazolol (13), neomycin and niacin in combination (14), nicotinic acid (15), N-acetylcysteine (16), and diethylstilbesterol ( 17) are reported to reduce serum or plasma Lp(a) levels. Stanazolol decreases both Lp(a) and HDLcholesterol levels, but does not change the apolipoprotein B level in plasma (13).…”

Alcohol Withdrawal–Induced Change in Lipoprotein(a)

“…6 Dietary and pharmacological attempts to reduce Lp(a) have been mainly unsuccessful. 7 Nicotinic acid, 8,9 estrogen, 10,11 and alcohol [12][13][14][15] are among the few factors that appear to lower Lp(a) levels. Lowered Lp(a) levels have also been observed during IGF-I administration.…”