The effect of clofibrate on whole-body cholesterol synthesis was studied in cholestyramine-treated hypercholesterolemic male Yorkshire swine and swine with normocholesterolemia or mild hypercholesterolemia. Daily whole-body synthesis rates were calculated by methods developed for the non-steady-state condition using various parameters of cholesterol balance; dietary cholesterol intake, fecal excretion of steroids, and cholesterol retention or loss in the body. After 16 days of treatment, the cholestyramine group showed reductions in serum cholesterol level and carcass cholesterol concentration, and increases in fecal steroid excretion and whole-body cholesterol synthesis, as compared with pretreatment values. The group which received both cholestyramine and clofibrate showed the same changes in all parameters listed above, but showed a greater reduction in serum cholesterol levels and greater increases in fecal excretion and whole-body cholesterol synthesis as compared with the group receiving cholestyramine alone. Unfortunately for the therapeutic implications, the increased output of steroids resulting from treatment with the combination of the two drugs was largely offset by a corresponding increase in cholesterol synthesis. The increase in synthesis might have been caused by a direct effect of clofibrate on the biosynthetic process. However, it seemed more likely that the increased synthesis was secondary to the increased output of steroids. The effect of clofibrate alone in hypercholesterolemic swine treated for 64 days revealed restraint in increase of serum cholesterol levels as compared to untreated controls, and an increase in total steroid excretion. No reduction in the whole-body cholesterol synthesis was observed in the clofibrate-treated group. In the other experiment, clofibrate even under mildly hypercholesterolemic or normocholesterolemic conditions did not result in a reduction of whole-body cholesterol synthesis, although serum cholesterol levels were reduced under both conditions.
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