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Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients

Serum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we... Full description

Journal Title: European journal of clinical pharmacology 1994, Vol.47 (2), p.169-176
Main Author: VANHANEN, H
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Heidelberg: Springer
ID: ISSN: 0031-6970
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recordid: cdi_proquest_miscellaneous_77732825
title: Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients
format: Article
creator:
  • VANHANEN, H
subjects:
  • Anticholesteremic Agents - pharmacology
  • Anticholesteremic Agents - therapeutic use
  • Biological and medical sciences
  • Cholesterol - metabolism
  • Drug Therapy, Combination
  • Female
  • General and cellular metabolism. Vitamins
  • Humans
  • Hypercholesterolemia - drug therapy
  • Hypercholesterolemia - metabolism
  • Hyperlipoproteinemia Type II - drug therapy
  • Hyperlipoproteinemia Type II - metabolism
  • Intestinal Absorption - drug effects
  • Male
  • Medical sciences
  • Middle Aged
  • Neomycin - pharmacology
  • Neomycin - therapeutic use
  • Pharmacology. Drug treatments
  • Pravastatin - therapeutic use
  • Sitosterols - pharmacology
  • Sitosterols - therapeutic use
ispartof: European journal of clinical pharmacology, 1994, Vol.47 (2), p.169-176
description: Serum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we measured serum cholesterol, cholesterol precursors (reflecting cholesterol synthesis), cholestanol and plant sterols (reflecting cholesterol absorption and biliary secretion) for up to 6 weeks in pravastatin-treated patients with familial hypercholesterolaemia (FH, n = 13) and with and without ileal bypass during addition of neomycin (1.5 g per day) and in another patient population of non-FH (n = 14) subjects during addition of sitostanol ester (1.5 g per day). Addition of neomycin lowered serum total, LDL and HDL cholesterol by a further 20%, and increased the pravastatin-lowered precursor:cholesterol ratios by 20% (irrespective of ileal bypass). It also reduced by 20% the plant sterol:cholesterol ratio (irrespective of ileal bypass) which was markedly increased by pravastatin alone. Pravastatin and neomycin in combination lowered total, LDL and HDL cholesterol by 45%, 53% and 17%, respectively. This combined regimen reduced the serum lathosterol:cholesterol ratio to about half of the reduction caused by pravastatin, while the elevation of the plant sterols:cholesterol ratio was less with the combination than with pravastatin alone. Changes in serum cholesterol precursor:cholesterol and plant sterol:cholesterol ratios during the combined treatment were smaller in the subgroup with ileal bypass. Addition of sitostanol ester did not lower serum total or LDL cholesterol nor the precursor:cholesterol ratios significantly, while the reduction observed in the plant sterols:cholesterol ratios was similar to that achieved with neomycin addition.
language: eng
source:
identifier: ISSN: 0031-6970
fulltext: no_fulltext
issn:
  • 0031-6970
  • 1432-1041
url: Link


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titleCholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients
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descriptionSerum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we measured serum cholesterol, cholesterol precursors (reflecting cholesterol synthesis), cholestanol and plant sterols (reflecting cholesterol absorption and biliary secretion) for up to 6 weeks in pravastatin-treated patients with familial hypercholesterolaemia (FH, n = 13) and with and without ileal bypass during addition of neomycin (1.5 g per day) and in another patient population of non-FH (n = 14) subjects during addition of sitostanol ester (1.5 g per day). Addition of neomycin lowered serum total, LDL and HDL cholesterol by a further 20%, and increased the pravastatin-lowered precursor:cholesterol ratios by 20% (irrespective of ileal bypass). It also reduced by 20% the plant sterol:cholesterol ratio (irrespective of ileal bypass) which was markedly increased by pravastatin alone. Pravastatin and neomycin in combination lowered total, LDL and HDL cholesterol by 45%, 53% and 17%, respectively. This combined regimen reduced the serum lathosterol:cholesterol ratio to about half of the reduction caused by pravastatin, while the elevation of the plant sterols:cholesterol ratio was less with the combination than with pravastatin alone. Changes in serum cholesterol precursor:cholesterol and plant sterol:cholesterol ratios during the combined treatment were smaller in the subgroup with ileal bypass. Addition of sitostanol ester did not lower serum total or LDL cholesterol nor the precursor:cholesterol ratios significantly, while the reduction observed in the plant sterols:cholesterol ratios was similar to that achieved with neomycin addition.
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languageeng
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subjectAnticholesteremic Agents - pharmacology ; Anticholesteremic Agents - therapeutic use ; Biological and medical sciences ; Cholesterol - metabolism ; Drug Therapy, Combination ; Female ; General and cellular metabolism. Vitamins ; Humans ; Hypercholesterolemia - drug therapy ; Hypercholesterolemia - metabolism ; Hyperlipoproteinemia Type II - drug therapy ; Hyperlipoproteinemia Type II - metabolism ; Intestinal Absorption - drug effects ; Male ; Medical sciences ; Middle Aged ; Neomycin - pharmacology ; Neomycin - therapeutic use ; Pharmacology. Drug treatments ; Pravastatin - therapeutic use ; Sitosterols - pharmacology ; Sitosterols - therapeutic use
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title
0Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients
1European journal of clinical pharmacology
addtitleEur J Clin Pharmacol
descriptionSerum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we measured serum cholesterol, cholesterol precursors (reflecting cholesterol synthesis), cholestanol and plant sterols (reflecting cholesterol absorption and biliary secretion) for up to 6 weeks in pravastatin-treated patients with familial hypercholesterolaemia (FH, n = 13) and with and without ileal bypass during addition of neomycin (1.5 g per day) and in another patient population of non-FH (n = 14) subjects during addition of sitostanol ester (1.5 g per day). Addition of neomycin lowered serum total, LDL and HDL cholesterol by a further 20%, and increased the pravastatin-lowered precursor:cholesterol ratios by 20% (irrespective of ileal bypass). It also reduced by 20% the plant sterol:cholesterol ratio (irrespective of ileal bypass) which was markedly increased by pravastatin alone. Pravastatin and neomycin in combination lowered total, LDL and HDL cholesterol by 45%, 53% and 17%, respectively. This combined regimen reduced the serum lathosterol:cholesterol ratio to about half of the reduction caused by pravastatin, while the elevation of the plant sterols:cholesterol ratio was less with the combination than with pravastatin alone. Changes in serum cholesterol precursor:cholesterol and plant sterol:cholesterol ratios during the combined treatment were smaller in the subgroup with ileal bypass. Addition of sitostanol ester did not lower serum total or LDL cholesterol nor the precursor:cholesterol ratios significantly, while the reduction observed in the plant sterols:cholesterol ratios was similar to that achieved with neomycin addition.
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0Anticholesteremic Agents - pharmacology
1Anticholesteremic Agents - therapeutic use
2Biological and medical sciences
3Cholesterol - metabolism
4Drug Therapy, Combination
5Female
6General and cellular metabolism. Vitamins
7Humans
8Hypercholesterolemia - drug therapy
9Hypercholesterolemia - metabolism
10Hyperlipoproteinemia Type II - drug therapy
11Hyperlipoproteinemia Type II - metabolism
12Intestinal Absorption - drug effects
13Male
14Medical sciences
15Middle Aged
16Neomycin - pharmacology
17Neomycin - therapeutic use
18Pharmacology. Drug treatments
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20Sitosterols - pharmacology
21Sitosterols - therapeutic use
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2Biological and medical sciences
3Cholesterol - metabolism
4Drug Therapy, Combination
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6General and cellular metabolism. Vitamins
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20Sitosterols - pharmacology
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abstractSerum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we measured serum cholesterol, cholesterol precursors (reflecting cholesterol synthesis), cholestanol and plant sterols (reflecting cholesterol absorption and biliary secretion) for up to 6 weeks in pravastatin-treated patients with familial hypercholesterolaemia (FH, n = 13) and with and without ileal bypass during addition of neomycin (1.5 g per day) and in another patient population of non-FH (n = 14) subjects during addition of sitostanol ester (1.5 g per day). Addition of neomycin lowered serum total, LDL and HDL cholesterol by a further 20%, and increased the pravastatin-lowered precursor:cholesterol ratios by 20% (irrespective of ileal bypass). It also reduced by 20% the plant sterol:cholesterol ratio (irrespective of ileal bypass) which was markedly increased by pravastatin alone. Pravastatin and neomycin in combination lowered total, LDL and HDL cholesterol by 45%, 53% and 17%, respectively. This combined regimen reduced the serum lathosterol:cholesterol ratio to about half of the reduction caused by pravastatin, while the elevation of the plant sterols:cholesterol ratio was less with the combination than with pravastatin alone. Changes in serum cholesterol precursor:cholesterol and plant sterol:cholesterol ratios during the combined treatment were smaller in the subgroup with ileal bypass. Addition of sitostanol ester did not lower serum total or LDL cholesterol nor the precursor:cholesterol ratios significantly, while the reduction observed in the plant sterols:cholesterol ratios was similar to that achieved with neomycin addition.
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