A controlled, double-blind study was conducted to evaluate the metabolic effects of coenzyme A (CoA) on postprandial hyperlipidemia, by monitoring changes in plasma triglyceride levels and levels of PAI-1, the circulating inhibitor of fibrinolysis. Twenty patients of both sexes with moderate hypertriglyceridemia (>250 mg/dl), some with adult-onset diabetes, participated. The subjects were randomly assigned to receive 2 weeks of treatment with CoA 4000 IU IM or a corresponding placebo. At the beginning and end of treatment, the patients were challenged with a lipid-rich meal eliciting, in our experience, a close to doubling of baseline triglyceridemia. Treatment with CoA significantly inhibited postprandial hypertriglyceridemia; the increase in plasma triglyceride levels was 90% to 97% before and after placebo treatment, whereas it was less than half that after CoA. Although only modest changes were noted in high-density lipoprotein cholesterol levels, high-density lipoprotein triglyceride levels were somewhat elevated after CoA treatment. The reduction in PAI-1 levels noted after the fatty meal was more consistent in the CoA group. These results demonstrate that parenteral CoA can effectively prevent postprandial hypertrigly ceridemia and may also have some effects on the fibrinolytic system.
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