[Effect of clofibric acid on fatty acid metabolism in HLP patients in the 2d half of life].

Ten patients with primary type IIb hyperlipoproteinemia and one hundred patients with primary type IV hyperlipoproteinemia (sixty-seven men and forty-three women aged forty-three to seventy-four) were treated with clofibric acid (Regadrin) for three years. Gas chromatographic analysis of the composition of cholesterol ester and triglyceride fatty acids in serum were done prior to and at four-month intervals during therapy. During treatment of type IIb and type IV hyperlipoproteinemia there was observed a decrease of palmitic, stearic, palmitoleic, oleic, and eicosane-tetraenoic acids as well as an increase of linoleic, linolenic, arachidonic, and eicosane-pentaenoic acids in the triglyceride fraction. These changes manifest themselves most conspicuously in the effect of clofibric acid upon the hepatogenic fatty acid metabolism (increased synthesis or reduced catabolization of polyunsaturated fatty acids and increased oxidation or reduced formation of monounsaturated and saturated fatty acids, increased esterification of polyenic acids). In addition, these is the possibility of selective displacement of saturated and monounsaturated fatty acids of the unsaturated fatty acids fraction as well as specific inhibition of their esterification with glycerol by clofibric acid. Treatment with clofibric acid over a long period of time may well give rise to additional reactions through influences exerted upon the insulin level.