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Type III Hyperlipoproteinemia: Paradoxical Hypolipidemic Response to Estrogen
- RAMPRATAP S. KUSHWAHA, Ph.D.;
- WILLIAM R. HAZZARD, M.D.;
- CLAUDE GAGNE, M.D.;
- ALAN CHAIT, M.D., M.R.C.P.; and
- JOHN J. ALBERS, Ph.D.
Abstract
Exogenous estrogens (ethinyl estradiol, 1 µg/kg body weight per day), which stimulate triglyceride production in normal women and those with endogenous hypertriglyceridemia, were found to exert a paradoxical, hypolipidemic effect in six subjects (five women, one man) with type III hyperlipoproteinemia on diets both of normal and of fat-free, high-carbohydrate composition. Moreover, very low-density (VLD) lipoprotein lipid and apolipoprotein composition and electrophoretic mobility became normal during estrogen administration in these subjects. Levels of normal VLD lipoproteins remained mildly to moderately elevated in a type IV lipoprotein pattern. Estrogen withdrawal promptly restored the type III pattern with its abnormal enrichment of VLD lipoproteins with apolipoprotein E (the arginine-rich peptide). These findings suggest that estrogens facilitate the assimilation of chylomicron and VLD lipoprotein remnants, a defect that appears likely to represent the metabolic abnormality underlying type III hyperlipoproteinemia.
Article and Author Information
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▸From the Northwest Lipid Research Clinic, University of Washington School of Medicine; Seattle, Washington.
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Grant support: by NHLBI Contract 71-2157, and NIH Grants HL 18291 and AM 05020. Portions of this work were conducted through the Clinical Research Center facilities of the University of Washington (NIH Grant FR-37), and Harborview Medical Center (NIH Grant RR-133). Dr. Hazzard is an Investigator, Howard Hughes Medical Institute. Dr. Gagne was a Fellow of the Medical Research Council of Canada, and Dr. Chait a Fellow of the Medical Research Council of the United Kingdom.
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▸Requests for reprints should be addressed to William R. Hazzard, M.D. Northwest Lipid Research Clinic, Harborview Medical Center; 326 Ninth Avenue; Seattle, WA 98104.
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- Received November 11, 1976.
- Accepted July 7, 1977.
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