Interrelationship between fatty acid composition, lipid peroxidation and alpha-tocopherol consumption post-LDL-apheresis treatment evaluated by liquid chromatography and gas chromatography Original Research Article

The performance of regular low-density lipoprotein (LDL)-apheresis (LA) permits the achievement of lower levels of LDL-cholesterol (LDL-C) and the related apolipoprotein B-containing lipoproteins. Consequently, the application of LA may offer opportunities to study the influence of rapid changes of lipid homeostasis upon particular atherogenic species. The purpose of the study was to analyze the interrelationship between fatty acid composition, lipid peroxidation, and alpha-tocopherol consumption post-immuno-LA (Sepharose 4b columns carrying an anti-apoprotein B antibody) in six hyperlipidemic patients (three men and three women, age 14–56 years) by liquid chromatography (LC) and gas chromatography (GC). Immediately after LA, we observed significantly decreased serum thiobarbituric acid-reactive substances (TBARS) and serum total Vitamin E (P<0.01), and Vitamin E in lipoprotein fractions (P<0.01). Lipoprotein myristic acid was increased in intermediate-density lipoprotein (IDL) (P<0.05) and in LDL (P=0.07), and was decreased in high-density lipoprotein (HDL) (P<0.05). Linoleic acid was significantly increased in plasma (P=0.01) and decreased in LDL (P<0.05). Docosahexaenoic acid significantly decreased in plasma (P=0.02), and non-significantly increased in LDL (P=0.08). Analysis of long-term effects of LA upon lipid metabolism revealed that Vitamin E in serum and lipoprotein fractions, neither serum TBARS did change significantly. Plasma phospholipids significantly decreased (P<0.05). Plasma myristic, HDL stearic, and LDL docosatetraenoic acids significantly increased (P<0.05). Plasma linoleic acid significantly increased at month 6 (P<0.05). LDL-bound gamma-linolenic acid did not change significantly. In conclusion, aggressive hypolipidemic treatment with LA not only decreases the pool of atherogenic LDL, but as a consequence of a short-term changes in the fatty acids composition, it also induces other anti-atherogenic properties via decreased lipoperoxidation. Simultaneous LC and GC assay of plasma lipoprotein fatty acids, lipid peroxidation, and alpha-tocopherol consumption post-LA treatment is shown to be clinically relevant.