Sucralfate on serum lipids and lipoproteins in normal volunteers

Sucralfate is used in the treatment and prophylaxis of peptic ulcer disease. One possible mechanism of action is the binding of bile acids. Because the absorption of dietary fat and cholesterol is dependent on the presence of bile acids in the small intestines, sucralfate therapy may produce changes in serum lipoprotein composition qualitatively similar to bile acid sequestrants, such as cholestyramine, which reduce serum cholesterol levels. Although changes in total serum cholesterol have not been reported in sucralfate efficacy studies, the effect of sucralfate on serum lipoprotein composition has not been specifically addressed. The purpose of this study was to prospectively examine the effect of sucralfate on serum lipids and lipoproteins in normal volunteers. Eight healthy volunteers (six men, two women) were recruited for this 10-week study. Drugs known to affect cholesterol levels were not permitted before or during the study. Diet composition during the study period was unaltered from before the study. Subjects took 1 g sucralfate orally 1 hour before meals and at bedtime (four times a day) for 8 weeks, followed by a 2-week washout period. Fasting blood samples were obtained at baseline and weekly, and were analyzed for serum total and HDL cholesterol and for triglycerides. Levels of LDL cholesterol were estimated. After eight weeks of sucralfate, HDL cholesterol increased from baseline by 2.5 mg/dL (6.6%, from 37.6 ± 9.5 to 40.1 ± 8.69 mg/dL), and LDL cholesterol decreased by 7.6 mg/dL (6.4%, from 134 ± 28.1 to 125.4 ± 34.1). Total cholesterol decreased by 3.5 mg/dL (1.8%, from 192.9 ± 34.3 to 189.4 ± 37.2 mg/dL). All cholesterol levels were higher at week 10 than at baseline. These changes were not statistically significant, possibly because of the small sample size and high dietary fat intake in this study. However, the changes in total, HDL, and LDL cholesterol would be clinically significant. Based on these findings, sucralfate should be studied in a larger cohort of hypercholesterolemic patients.