慢性透析患者におけるIIbおよびIV型高脂血症に対する Pantethine の効果

Abstract

Pantethine (600mg/day) was administered perorally to hemodialysis patients with type IIb and IV hyperlipidemia for three months. Various lipoprotein parameters before and after the drug administration were determined. VLDL (d< 1.006g/ml) and intermediate density lipoproteins (IDL)(d=1.006-1.019g/ml) were isolated by preparative ultracentrifugation. High density lipoproteins (HDL) were separated by magnesium dextransulfate precipitation method. The measurement of sialic acid in VLDL was performed according to Warren's thiobarbituric acid assay. Lipid levels in VLDL, IDL and HDL were determined by routine methods, and protein concentration in VLDL and IDL by Lowry's method. The percent distribution of apo C-II and apo C-III in VLDL was estimated by Kane's polyacrylamide gel electrophoresis, and apo B levels in VLDL were determined by single radial immunodiffusion method.Consequently, the following results were summarized.1) Sialic acid content in VLDL of hemodialysis patients increased not only in the levels but also in the ratio of sialic acid to protein, while pantethine did not affect these changes. With respect to apoproteins containing sialic acid, apo B levels significantly decreased but the percentage of apo C-III tended to increase after pantethine administration.2) Pantethine normalized an increase in the total amounts of VLDL and IDL of hemodialysis patients.3) Pantethine increased HDL cholesterol and phospholipid levels which usually decreased in hemodialysis patients.These results led us to a conclusion that pantethine had no effect on VLDL sialic acid levels but increased HDL in parallel to the normalization of the deranged VLDL and IDL metabolism, regardless of a decrease in the apo C-II/C-III ratio of VLDL, in hemodialysis patients.