Reduction of plasma high-density lipoprotein 2 cholesterol and increase of postheparin plasma hepatic lipase activity during progestin treatment

Abstract

Twenty-seven menopausal women were given the synthetic progestin levonorgestrel for two weeks. The mean plasma high-density lipoprotein (HDL) cholesterol concentration decreased from 1.32 mmol/l to 1.01 mmol/l ( p < 0.001) during treatment. This was due to the selective reduction in plasma HDL 2 cholesterol from 0.73 mmol/l to 0.44 mmol/l, whereas the plasma hdl-(cholesterol was not changed. The mean hepatic lipase (HL) activity of postheparin plasma increased from 20.6 to 35.3 μmol·h −1·ml −1 ( p < 0.001) while the lipoprotein lipase (LPL) activity was not changed. A significant inverse correlation existed between the HDL 2 cholesterol concentration and HL activity both before ( r = −0.49, p < 0.01) and after ( r = −0.39, p < 0.05) treatment, and a significant correlation was observed between the changes in these two variables ( r = 0.39, p < 0.05). These results are compatible with the hypothesis that HL participates in the regulation of plasma HDL 2 levels and they suggest that progestin treatment reduces plasma HDL 2 cholesterol concentration by increasing the hepatic lipase activity. It is not known whether this type of HDL 2 reduction is accompanied by increased atherogenesis but as long as the issue is unresolved some caution is needed in the long-term use of levonorgestrel, particularly in women who simultaneously are given some other drug depressing plasma HDL 2 concentration.