To the Editor.—
The Preliminary Communication by Nimer et al1 on the cholesterol-lowering activity of granulocyte-macrophage colony-stimulating factor that appeared in the December 9 issue of The Journal was interesting, but indeed preliminary.There is a piece of important information that was omitted from this study: the total cholesterol and triglyceride levels were measured, but there was no measurement of high-density lipoprotein cholesterol. The triglyceride levels were not changed significantly and thus it was assumed the levels of very low-density lipoprotein cholesterol did not change. How much of the cholesterol-lowering effect of granulocyte-macrophage colony-stimulating factor was from lowering of low-density lipoprotein cholesterol and how much from lowering of high-density lipoprotein cholesterol was not determined. If there was a significant reduction in high-density lipoprotein cholesterol in addition to the reduction in low-density lipoprotein cholesterol, any potential benefit in the prevention of atherosclerosis would be negated—especially if there was an unfavorable
Goldstein MR. Lowering Cholesterol With Granulocyte-Macrophage Colony-Stimulating Factor. JAMA. 1989;261(16):2331–2332. doi:10.1001/jama.1989.03420160055024
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