RAMPRATAP S. KUSHWAHA, Ph.D.; WILLIAM R. HAZZARD, M.D.; CLAUDE GAGNE, M.D.; ALAN CHAIT, M.D., M.R.C.P.; JOHN J. ALBERS, Ph.D.
Exogenous estrogens (ethinyl estradiol, 1 µg/kg body weight per day), which stimulate triglyceride production in normal women and those with endogenous hypertriglyceridemia, were found to exert a paradoxical, hypolipidemic effect in six subjects (five women, one man) with type III hyperlipoproteinemia on diets both of normal and of fat-free, high-carbohydrate composition. Moreover, very low-density (VLD) lipoprotein lipid and apolipoprotein composition and electrophoretic mobility became normal during estrogen administration in these subjects. Levels of normal VLD lipoproteins remained mildly to moderately elevated in a type IV lipoprotein pattern. Estrogen withdrawal promptly restored the type III pattern with its abnormal enrichment of VLD lipoproteins with apolipoprotein E (the arginine-rich peptide). These findings suggest that estrogens facilitate the assimilation of chylomicron and VLD lipoprotein remnants, a defect that appears likely to represent the metabolic abnormality underlying type III hyperlipoproteinemia.
KUSHWAHA RS, HAZZARD WR, GAGNE C, et al. Type III Hyperlipoproteinemia: Paradoxical Hypolipidemic Response to Estrogen. Ann Intern Med. 1977;87:517–525. doi: 10.7326/0003-4819-87-5-517
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Published: Ann Intern Med. 1977;87(5):517-525.
Cardiology, Coronary Risk Factors, Dyslipidemia.
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