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Treatment of hyperlipidemias

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      Abstract

      The long-term effects of ethyl chlorophenoxyisobutyrate (CPIB), thyroid-active substances and diet were observed in seventy-two patients with five different types of hyperlipoproteinemias. Essential hypercholesterolemia (Sf 0–20 hyperlipoproteinemia) with tendon xanthomatosis proved refractory to CPIB, and to supplementary corn oil, but Sf 0–20 concentrations were reduced slightly (up to 20 per cent) by thyroid-active substances. Sf 0–20 hyperlipoproteinemia without tendon xanthomatosis was moderately reduced by CPIB or thyroid-active substances. In xanthoma tuberosum (characterized by very low Sf 0–12 and high Sf 12–400 lipoprotein concentrations), lipoprotein concentrations decreased to normal levels with severe carbohydrate restriction or (more acceptable to patients) CPIB therapy. In Sf 20–400 hyperlipoproteinemia, CPIB greatly reduced very low density lipoprotein, cholesterol and triglyceride levels but in 80 per cent of patients Sf 0–20 concentrations rose concurrently. In view of the atherogenicity of Sf 0–20 lipoproteins, if Sf 0–20 lipoprotein concentrations rise to high levels CPIB therapy should be discontinued. Carbohydrate restriction caused no consistent similar shift and appeared preferable to CPIB in this group. In combined Sf 0–20, Sf 20–400 hyperlipoproteinemia, CPIB reliably reduced Sf 20–400 levels; in some patients it decreased, and in some it increased Sf 0–20 concentrations; when increases occurred, added thyroid sometimes proved helpful.
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