Niacin and hyperlipidemia

Abstract

Overnutrition and physical inactivity have been having unfavorable effects on public health, such as obesity, diabetes, and metabolic syndrome, over recent decades. One appreciable consequence is the excessive and prolonged period of postprandial hyperlipidemia after the ingestion of numerous fat-enriched meals throughout the day. Raised blood levels of exogenous triglycerides (TG) in the form of apolipoprotein B48 (apoB48) containing TG-rich lipoproteins (TRLs) are characteristics of postprandial hyperlipidemia. TRLs have an important role in the pathogenesis and progression of cardiovascular diseases. Healthy diet and exercise and traditional lipid-lowering therapies such as niacin, statins, and fibrates could have positive effects on postprandial metabolism. Niacin has been applied as an atheroprotective drug for 50 years. Studies on this drug have demonstrated that niacin may reduce fasting levels of plasma very-low-density lipoproteins, low-density lipoprotein cholesterol, and lipoprotein [a], but may raise high-density lipoprotein cholesterol. Hence the aim of this chapter is to supply updated data on the effects and mechanisms associated with the pharmacological actions of niacin on hyperlipidemia.