Lipoprotein changes in patients with chronic hepatitis C treated with interferon-alpha.

OBJECTIVE: The aim of this study was to evaluate the effects of interferon-alpha therapy on the lipid profile of patients with chronic hepatitis C. METHODS: In 36 consecutive patients with chronic hepatitis C, fasting lipoproteins were evaluated prospectively at baseline, 1, 3 and 6 months during interferon-alpha therapy and 3 months after the end of treatment. RESULTS: During interferon-alpha therapy, there was a progressive increase in total and very low density lipoprotein (VLDL)-triglycerides, VLDL-cholesterol and a sustained raise in apolipoprotein (apo) B. In parallel, there was a reduction in high density lipoprotein (HDL)-cholesterol and apo A1 levels. In contrast, total and low density lipoprotein (LDL)-cholesterol and lipoprotein (a) levels remained essentially unchanged during interferon-alpha therapy. Three patients developed chylomicronemia, two of them with severe hypertriglyceridemia, although none of them presented with pancreatitis. Chylomicronemia and severe hypertriglyceridemia were more common in patients with basal triglycerides above 200 mg/dl. Nineteen patients responded to interferon-alpha therapy, but their lipid profile did nor differ from that of nonresponders. Three months after the end of interferon-alpha therapy lipid changes subsided, although VLDL and HDL-cholesterol and apo B did not reach basal levels. CONCLUSION: In patients with chronic hepatitis C, interferon-alpha therapy is associated with an increase of total and VLDL-triglycerides, VLDL-cholesterol and apo B, and a decline of HDL-cholesterol and apo A1. The development of chylomicronemia and severe hypertriglyceridemia in some cases makes mandatory a close monitoring of triglycerides during interferon-alpha therapy, particularly among patients with increased triglycerides at baseline.

[Long-term course of blood lipids and body mass index in patients with testicular cancer treated with chemotherapy]. / Evolución a largo plazo de los lípidos séricos y del índice de masa corporal en varones con cáncer testicular tratados con quimioterapia.

OBJECTIVE: To evaluate whether males with testicular cancer treated with chemotherapy including cisplatin (Qt-C) develop an increase in serum cholesterol and triglyceride levels and in the body mass index (BMI), which might pose a cardiovascular risk. PATIENTS AND METHODS: Fifty-six male patients with the previous diagnosis of testicular carcinoma, and apparently cured now, were studied. Thirty-six were Qt-C treated. The median age was 28 years and the median follow-up 81 months. The other 20 patients, with testicular cancer stage I and who did not require Qt-C, did not differ in mean age nor in the median of follow-up. Twenty healthy males were also studied, and their cholesterol and triglyceride levels and BMI were compared with those in patients treated with Qt-C at the end of follow-up; both group were of similar age. In all patients (prior to diagnosis and yearly up to the end of the study) and in healthy subjects total serum cholesterol and triglyceride levels were measured, as well as BMI (weight/height2). RESULTS: Levels of cholesterol, triglycerides and BMI were not different at diagnosis of testicular cancer, both in patients treated with Qt-C and those not receiving such therapy. When comparing yearly cholesterol and triglyceride levels in both groups of patients during the first 6 years of evolution, no significant differences were observed. Again, no differences were observed between patients treated and not treated with Qt-C at the end of the follow-up period regarding cholesterol (211 +/- 41 vs 219 +/- 44 mg/dl; p = 0.51), triglyceride (128 +/- 57 vs 129 +/- 51 mg/dl; p = 0.94) and BMI (25.7 +/- 3.3 vs 25.5 +/- 3.4 kg/m2; p = 0.86) values. No significant differences were observed in the three parameters between parameters in patients treated with Qt-C at the end of follow-up and in healthy males. CONCLUSIONS: In males with testicular cancer treated with Qt-C, no long term increase in cholesterol, triglyceride, and BMI values was detected, which might predispose to the development of cardiovascular diseases.