Extended-release wax-matrix nicotinic acid affects HDL cholesterol via plasma cholesterol esterification, study shows
Highlights
- Preliminary open-label study (n=69 men)
- Extended-release wax-matrix nicotinic acid supports HDL metabolism
- Effective dosage is 1,500 to 2,000 mg/day for 4 months
- Changes in HDL cholesterol mediated by plasma cholesterol esterification
Summary
The aim of this preliminary open-label study was to examine the effect of extended-release, wax-matrix nicotinic acid (WMNA) treatment on cholesterol esterification in the plasma of men with moderate hypercholesterolemia.
The study involved 44 men had coronary heart disease (CHD) and 25 men without CHD, aged 35-52 years, with total cholesterol levels above 225 mg/dl after a 2-month lipid-lowering diet. The men were treated with WMNA (1,500-2,000 mg/day) for 4 months. There were no between-group differences in lipid and apolipoprotein levels at baseline, except high-density lipoprotein (HDL) cholesterol, which was significantly lower in men with CHD (43 mg/dl) compared to men without CHD (49 mg/dl).
Results indicate that WMNA treatment had a beneficial effect on blood lipids and lipoproteins in both men with and without CHD (see Table 1). A treatment-mediated increase in lecithin-cholesterol acyltransferase (LCAT) activity was reported with an increase in the fractional esterification rate in the men with CHD (mean change 2.6% to 4.2%) and, to a lesser extent, in the men without CHD (from 2.5% to 3.9%). Molar esterification rates also rose in both groups.
| Table 1. Blood Lipid Changes with WMNA Treatment Based on Disease State | ||
| Parameter | Men with CHD | Men without CHD |
| Total Cholesterol | -10% | -15% |
| LDL Cholesterol | -16 | -19 |
| HDL Cholesterol | +19 | +10 |
| Triglycerides | -14 | -29 |
| Apo-A-I | +16 | +10 |
| Apo-B | -20 | -25 |
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WMNA indicates wax-matrix nicotinic acid (extended-release); CHD, coronary heart disease; LDL, low-density lipoprotein, HDL, high-density lipoprotein, Apo-B, apolipoprotein B, Apo-A-I, apolipoprotein A-I. |
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These findings indicate that an WMNA-mediated change in HDL cholesterol is accompanied by an HDL-mediated increase in plasma cholesterol esterification, which may be a protective factor against coronary atherosclerosis.
