INCREASED TURNOVER OF VERY LOW-DENSITY-LIPOPROTEIN TRIGLYCERIDE DURING TREATMENT WITH CHOLESTYRAMINE IN FAMILIAL HYPERCHOLESTEROLEMIA

Abstract. Kinetics of very low density lipoprotein (VLDL) triglyceride were determined in seven patients with heterozygous familial hypercholesterolaemia, using a 3H‐glycerol technique. The study was repeated after 5–7 weeks of therapy with the bile acid‐binding resin, cholestyramine. The rate of synthesis of VLDL triglyceride was increased by 85% (P < 0.05) during resin therapy. Simultaneously, the fractional catabolic rate of VLDL was increased by 40% (P < 0.02), so that only a moderate increase in plasma concentration was observed. Repeated measurements of VLDL size by electron microscopy (before, 1 week, and 5–7 weeks after initiation of therapy) indicated that a transient increase in VLDL size occurred in response to cholestyramine. The results are consistent with a stimulatory effect of bile acid sequestrants on VLDL triglyceride production and indicate that, in most subjects, a compensatory increase in VLDL triglyceride removal occurs. 1990 Blackwell Publishing Ltd