INFLUENCE OF NICOTINIC ACID ON SUBFRACTIONAL SPECTRUM OF LOW, INTERMEDIATE AND HIGH DENSITY LIPOPROTEINS IN PATIENTS WITH HYPERLIPOPROTEINEMIA(а)

Aim. To evaluate the influence of nicotinic acid (NA) on subfractional spectrum of proand antiatherogenic lipoproteides in hyperlipoproteidemia (a) patients.

Material and methods. Totally, 78 patients included, with Lp(a) level more than 20 mg/dL, taking either combinational statin and NA therapy (n=43), or on monotherapy by statins (n=13), or monotherapy by NA (n=22). Lipid profile parameters were analyzed with the assays “Biocon/Analyticon” (Germany), quantitative subfractional contents were assessed with the system Lipoprint® (Quantimetrix,USA), Lp(a) concentriation — with immune enzyme assay.

Results. Results. In combinational therapy and monotherapy groups of NA the baseline Lp(a) levels were 98,0±44,8 and 71,3±21,8 mg/dL, respectively, р<0,0001; total cholesterol (TC) 4,6±0,9 and 5,8±1,2 mM/L, р<0,0001 and low density lipoproteides cholesterol (LDL-C) 2,7±0,8 and 3,6±1,2 mM/L, р<0,05. Patients from the statins monotherapy and NA groups had significant differences by TC (4,6±1,1 and 5,8±1,2, р<0,05) and LDL-C (2,6±0,9 and 3,6±1,2, р<0,0001).  In NA responders, the decrease of Lp(a) was 38%, p<0,05, in combination therapy group, and 32%, p<0,01, in monotherapy by NA group. In statin monotherapy group the Lp(a) level did not decrease. The differences were found, in the parameters of lipid profile and lipoproteides (LP) subfractions depending on the type of treatment used. In the general group of combination therapy there was significant decrease of TC, TG, LDL-C and very low density lipoproteides, and there was decline of the levels of antiatherogenic subfractions of high density lipoproteides (HDL). In monotherapy by NA group there was significant decrease of atherogenic small LDL (sLDL) from 6,9±6,7 to 3,9±4,1 mg/dL, р=0,012, and there was increase of antiatherogenic HDL subfractions. In patients on monotherapy by statins, the LP subfractions profile did not differ significantly.

Conclusion. The decrease of Lp(a), atherogenic sLDL and potentially atherogenic small HDL, increase of antiathrogenic LP subfractions makes it to conclude on complex positive influence of NA on the lipoproteid subfractional profile in patients with increased Lp(a) levels, not taking statins

atherosclerosis, lipoprotein (a), lipoprotein subfractions, nicotinic acid, CHD

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